Author Topic: DMTs not beneficial in SPMS (NEJM)  (Read 80 times)

0 Members and 1 Guest are viewing this topic.

Offline agate

  • Administrator
  • *****
  • Posts: 9821
  • MS diagnosed 1980
  • Location: Pacific Northwest
DMTs not beneficial in SPMS (NEJM)
« on: March 25, 2018, 09:33:12 am »
This article has become available in its entirety after the standard 6-month waiting period. In NEJM Journal Watch (September 21, 2017), Robert T. Naismith, MD, reviews and comments on an article in Neurology. Naismith's article is entitled "Disease modifying therapies not beneficial in secondary progressive multiple sclerosis," and the article he is reviewing is "Anti-inflammatory disease-modifying treatment and short-term disability progression in secondary progressive MS" by Lorscheider et al.


https://www.jwatch.org/na44978/2017/09/21/disease-modifying-therapies-not-beneficial-secondary?query=etoc_jwneuro&jwd=000100983645&jspc=


These remarks on the study's limitations are is from the comment section:


Quote
Several limitations are important to consider. Although propensity matching is a powerful tool, this was not a randomized study, and there may be unknown variables between patients who are treated versus those who discontinue treatment. Whereas some patients had follow-up for >4 years, median follow-up was 2 years — perhaps not enough time to appreciate any long-term benefits. Because treatments were largely standard-efficacy agents, this study was underpowered to show whether high-efficacy therapies provide additional benefit on disability. Randomized discontinuation studies are underway to determine the safety of stopping treatment. For patients who wish to discontinue due to older age or progressive MS, a program of withdrawal under medical and imaging observation would be prudent to identify disease reactivation, should it occur.





Abstract of the study being reviewed above:


http://n.neurology.org/content/89/10/1050


The evidence presented in the study is classified as Class IV. Class I evidence is the best.
« Last Edit: March 25, 2018, 08:59:46 pm by agate »
MS Speaks--online for 17 years

SPMS, diagnosed 1980. Avonex 2001-2004. Copaxone 2007-2010. Glatopa (glatiramer acetate 40mg 3 times/week) since 12/16/20.

 

Related Topics

  Subject / Started by Replies Last post
0 Replies
94 Views
Last post February 24, 2017, 11:15:22 am
by agate
0 Replies
150 Views
Last post November 16, 2017, 04:11:14 pm
by agate
0 Replies
59 Views
Last post May 23, 2019, 09:25:17 pm
by agate
0 Replies
169 Views
Last post August 26, 2019, 04:45:30 pm
by agate
1 Replies
93 Views
Last post November 15, 2019, 07:49:05 pm
by agate