Clinical follow‐up of 411 patients with relapsing and progressive multiple sclerosis 10 years after discontinuing mitoxantrone treatment: a real‐life cohort study

Chartier, N.; Epstein, Jonathan; Soudant, Marc; Dahan, C.; Michaud, Maud; Pittion‐Vouyovitch, S.; Guillemin, Françis; Debouverie, Marc; Mathey, Guillaume

doi:10.1111/ene.13748

Cited by 16 publications

(11 citation statements)

References 21 publications

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“…The previous studies came either from the French health insurance system restricted to salaried workers, 2,4 or from the French Observatory for MS (OFSEP; Observatoire Français de la Scl erose En Plaques) 16 in which data collection is mainly based upon the CRC SEP or from the Lorraine registry. [17][18][19] The use of SNDS allowed access to patients without any neurological follow-up or followed exclusively in private settings, which represented 14,357 patients (12.8%) and 19,691 (17.5%), respectively.…”

Section: Discussionmentioning

confidence: 99%

Use of healthcare services by patients with multiple sclerosis in France over 2010–2015: a nationwide population-based study using health administrative data

Roux

Guilleux

Lefort

et al. 2019

Multiple Sclerosis Journal - Experimental, Translational and Cl

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Background: Most of the knowledge about people with multiple sclerosis (PwMS) in France comes from cohorts, which may suffer from recruitment bias or from the unique registry located in Lorraine, East France. Objective: To describe use of care in the French population of PwMS, over 2010-2015. Methods: All PwMS in the French national health data system (97% of the general population covered) were included. Demographics, and use of care were described (visits with general practitioners (GPs), neurologists, nurses, physiotherapists and hospitalisations). A focus on the neurological follow-up was also conducted. Results: A total of 112,415 PwMS were identified (sex ratio F:M ¼ 2.4, median age 46), of whom 5005 died during follow-up. The median numbers of visits with GPs and neurologists were 6.6 and 1.3 respectively per patient-year. Moreover, 53,457 (47.6%) received multiple sclerosis (MS) treatments; about 13% of patients had no neurological follow-up, and 81.8% had at least one hospitalisation. Conclusions: For the first time in France, this exhaustive dataset offered the opportunity to provide objective figures regarding care practices for MS at the national level, without any selection bias. It also allowed description of patients with MS according to their neurological follow-up, especially those who were absent from cohorts led by neurologists.

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Section: Discussionmentioning

confidence: 99%

Use of healthcare services by patients with multiple sclerosis in France over 2010–2015: a nationwide population-based study using health administrative data

Roux

Guilleux

Lefort

et al. 2019

Multiple Sclerosis Journal - Experimental, Translational and Cl

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“…In this issue of the European Journal of Neurology , Chartier et al . report on the outcome in 411 relapsing or progressive MS patients who had received mitoxantrone in the region of Lorraine, located in the northeast of France, between 1995 and 2005 . All patients were followed in a local MS registry for a remarkable mean duration of 11.9 years.…”

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confidence: 99%

Where mitoxantrone for multiple sclerosis is still valuable in 2018

Buttmann

2018

Euro J of Neurology

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“…It is used for EDSS scores of 3 to 6 [93]. The effectiveness of MTX administration has been confirmed by long-and short-term follow-ups [93,94].…”

Section: Directions After Diagnosis Of Spmsmentioning

confidence: 99%

“…Summarising the oldest studies with interferons, the inclusion criteria were very similar regardless of treatment effectiveness [100,103]. Studies with mitoxantrone gave generally positive results in short and long-term follow-ups [11,94]. The inclusion criteria for the study were very similar to those in the study with interferons [100,103].…”

Section: Directions After Diagnosis Of Spmsmentioning

confidence: 99%

Secondary progressive multiple sclerosis — from neuropathology to definition and effective treatment

Adamczyk-Sowa

Adamczyk

Kułakowska

et al. 2020

Neurol Neurochir Pol.

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Introduction.There is no single, commonly accepted, standard definition of secondary progressive multiple sclerosis (SPMS), an absence that poses a challenge for clinicians.State of the art. SPMS is characterised by inflammation, neurodegeneration and disease progression with the presence or absence of relapses. No biochemical or radiological biomarkers are currently available to indicate the precise secondary progressive course in individual patients. The retrospective approach to identifying SPMS patients raises many difficulties, especially in terms of determining the time point of progression. Currently, the most precise diagnosis of SPMS is based on the definition proposed by Lorscheider et al., where SPMS is defined as a disability progression by 1 step on the Expanded Disability Status Scale (EDSS) in patients with EDSS ≤ 5.5 or of 0.5 EDSS steps in patients with EDSS ≥ 6 in the absence of a relapse, a minimum EDSS score of 4 and pyramidal functional system (FS) score of 2, and confirmed progression over ≥ 3 months, including confirmation within the leading FS. Clinical implications. The need to establish criteria for the diagnosis of SPMS is currently of crucial importance due to emerging treatment opportunities including siponimod, a sphingosine 1-phosphate (S1P) receptor modulator selective for S1P1 and S1P5 receptors. It is reasonable to introduce drugs at the earliest possible stage of lesion progression to reduce inflammation and to protect the central nervous system (CNS) against irreversible neurodegeneration. Future directions. Further studies with prospective, multicentre and long term follow-up design are needed to provide better insights into SP course in MS patients. This should be supported by radiological, biochemical and pathological evaluations to help establish reliable and sensitive biomarkers to guide clinical practice.

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Clinical follow‐up of 411 patients with relapsing and progressive multiple sclerosis 10 years after discontinuing mitoxantrone treatment: a real‐life cohort study

Abstract: Patients with the most active forms of MS are the most likely to benefit from MITOX in the long term.

Cited by 16 publications

References 21 publications

Use of healthcare services by patients with multiple sclerosis in France over 2010–2015: a nationwide population-based study using health administrative data

Use of healthcare services by patients with multiple sclerosis in France over 2010–2015: a nationwide population-based study using health administrative data

Where mitoxantrone for multiple sclerosis is still valuable in 2018

Secondary progressive multiple sclerosis — from neuropathology to definition and effective treatment

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