Prediction of long-term disability in Chinese patients with multiple sclerosis: A prospective cohort study

Zhang, Yao; Xu, Yuanfu; Xu, Tao; Yin, Hexiang; Zhu, Yicheng; Peng, Bin

doi:10.1016/j.msard.2020.102461

Cited by 9 publications

(8 citation statements)

References 33 publications

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“…Based on the nationwide hospital-based study, the mean age at MS diagnosis was 45.3 years old in tertiary hospitals of China [ 10 ]. In two review papers published in 2009, the age of MS onset was around 30 years in Chinese patients with MS [ 9 , 36 ], which was similar to findings from other studies [ 37 , 38 ]. This means that there was a delay of more than 10 years for MS diagnosis and/or a high proportion of misdiagnosis or missed diagnosis of MS.…”

Section: Delayed Diagnosis Of Ms In Mainland Chinasupporting

confidence: 81%

The incidence and prevalence, diagnosis, and treatment of multiple sclerosis in China: a narrative review

Jia

Yang

2022

Neurol Sci

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In 2018, the first list of rare diseases was published by the National Health Council of China, and multiple sclerosis (MS) was included in this list. Since then, the Chinese government and neurologists have made efforts to improve the clinical outcomes of patients with MS. During last few years, the incidence of MS in China was also investigated. The early and accurate diagnosis of MS was improved due to the application and promotion of magnetic resonance imaging and new diagnosis criteria. The market for and medical insurance access to disease-modifying therapies (DMTs) has been greatly accelerated, which has provided more treatment options and improved clinical outcomes for patients with MS, as well as reduced treatment cost. The pattern of MS in China is gradually changing, from delayed to early diagnosis, and from no treatment to treatment with DMTs during remission. This narrative review aimed to summarize an update to the status of MS in China, including incidence and prevalence, diagnosis, and available treatments. This would help to better understand the diagnosis and treatment gap between mainland China and other Asian regions, demonstrating the necessity of accurate diagnosis and optimized treatment of MS in China.

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Section: Delayed Diagnosis Of Ms In Mainland Chinasupporting

confidence: 81%

The incidence and prevalence, diagnosis, and treatment of multiple sclerosis in China: a narrative review

Jia

Yang

2022

Neurol Sci

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“…This prospective, observational, cohort study used the MSNMOBase, a hospital-based electronic database established in 2011 [ 18 , 19 ] to collect data on consecutive patients with MS and related disorders. Patients included in this database were followed up at least semi-annually, regardless of the clinical disease course.…”

Section: Methodsmentioning

confidence: 99%

Real-world outcomes of teriflunomide in relapsing–remitting multiple sclerosis: a prospective cohort study

et al. 2022

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Objectives To explore efficacy, risk factors, safety, and persistence of teriflunomide in relapsing–remitting multiple sclerosis (RRMS) cohort. Methods This prospective, observational cohort study included 217 consecutive teriflunomide treated RRMS patients, 192 of which with at least 3-month persistence on teriflunomide were included in effectiveness and risk factor analyses. Multivariate Cox proportional regression analysis was performed to identify factors associated with failure of no evidence of disease activity (NEDA) 3. Results At baseline 82% patients were treatment naïve while 18.0% interferon-β1b treated patients had stopped treatments for more than 1 year. After treatment, 79.0% patients achieved NEDA 3 at 12-month, mean annualized relapse rate (ARR) reduced significantly (0.79 ± 0.80 vs 0.16 ± 0.70; P < 0.001), and mean expanded disability status score (EDSS) remained stable (1.40 ± 1.67 vs 1.56 ± 1.88; P > 0.05). Male sex (hazard ratio [HR] 1.856; 95% confidence interval [CI] 1.118–3.082, P < 0.05), baseline EDSS score ≥ 4 (HR 2.682; 95% CI 1.375–5.231, P < 0.01), and frequent relapses before treatment (HR 3.056; 95% CI 1.737–5.377, P < 0.01) were independent factors significantly associated with failure of NEDA 3. The most frequent adverse events (AEs) were hair thinning, alanine aminotransferase (ALT) elevation, and leukopenia, the latter two most commonly lead to teriflunomide discontinuation during the first 3 months. Persistence rates at 6, 12, and 24 months after teriflunomide initiation were 86.9%, 72.4%, and 52.8%, respectively. Conclusions Our results support efficacy and tolerability of teriflunomide for treatment-naïve RRMS patients in real-world practice. Female patients, patients with less relapses and less disability before treatment are most likely to benefit from teriflunomide treatment.

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“…Beginning on June 1, 2020, we conducted an online survey using questionnaires mainly focusing on relapses, treatments, behavioral changes, and COVID-19 infections during the pandemic (from December 15, 2019, to June 1, 2020) in NMOSD patients registered in the MSNMOBase, a hospitalbased electronic registry for multiple sclerosis (MS) and related disorders established in 2011 (16)(17)(18). Additional information was also obtained from patient hospital visits, online visits, and phone calls.…”

Section: Study Design and Populationmentioning

confidence: 99%

The Impact of COVID-19 on Patients With Neuromyelitis Optica Spectrum Disorder Beyond Infection Risk

Yin

Zhang

et al. 2021

Front. Neurol.

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There is an increasing need for better understanding of the impact of coronavirus disease 2019 (COVID-19) on patients with neuromyelitis optica spectrum disorder (NMOSD). A few pilot studies have investigated COVID-19 infections in NMOSD, but few studies have addressed disease activity and immune status of these patients during the pandemic. We carried out a cross-sectional study to examine immune status, relapses, and COVID-19 infections in a cohort of NMOSD patients using an electronic patient registry (MSNMOBase) for multiple sclerosis and related disorders. An online questionnaire was administered to all NMOSD patients in the registry from January 1, 2011, to June 1, 2020. Clinical demographic characteristics, immune status, relapses, treatments, COVID-19 infections, and preventive measures were evaluated. Of the 752 registered patients, 535 (71.1%) with qualified data were included. A total of 486 used preventive therapies during the pandemic, including mycophenolate mofetil (71.2%), azathioprine (13.3%), and other immunosuppressants (6.4%). Neither median immune cell counts nor immunoglobulin levels (p > 0.05) were significantly different between patients with or without immunosuppression. During the pandemic, no patients were diagnosed with COVID-19, and the majority (>95%) took one or more effective protective measures (e.g., wearing a mask and social distancing). However, a significantly higher annualized relapse rate (ARR) was observed in the 33 patients with treatment interruptions due to the pandemic compared to before it (p < 0.05), whereas ARR changes were not found in patients with continuous treatments or those without treatments (p > 0.05). Interruption frequency was significantly higher in patients with relapses compared to those without (34.9 vs. 15.7%, p < 0.01). For stable NMOSD patients during the pandemic, the risk of relapse due to treatment interruption may be higher than the risk of COVID-19 infection when protective measures are used, and continuous relapse-prevention treatments may be necessary.

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Prediction of long-term disability in Chinese patients with multiple sclerosis: A prospective cohort study

Cited by 9 publications

References 33 publications

The incidence and prevalence, diagnosis, and treatment of multiple sclerosis in China: a narrative review

The incidence and prevalence, diagnosis, and treatment of multiple sclerosis in China: a narrative review

Real-world outcomes of teriflunomide in relapsing–remitting multiple sclerosis: a prospective cohort study

The Impact of COVID-19 on Patients With Neuromyelitis Optica Spectrum Disorder Beyond Infection Risk

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