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COMBAT-MS :
COMBAT-MS : A Population-Based Observational Cohort Study Addressing the Benefit-Risk Balance of Multiple Sclerosis Therapies Compared with Rituximab
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- Piehl, Fredrik (författare)
- Karolinska Institute,Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Department of Neurology, Karolinska University Hospital, Stockholm, Sweden; Academic Specialist Center, Stockholm Health Services, Stockholm, Sweden
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- Alping, Peter (författare)
- Karolinska Institute,Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
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- Virtanen, Suvi (författare)
- Karolinska Institute,Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
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- Englund, Simon (författare)
- Karolinska Institute,Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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- Burman, Joachim (författare)
- Department of Neurology, Uppsala University Hospital, and Department of Medical Sciences, Uppsala University, Uppsala, Sweden,Uppsala Univ, Sweden; Uppsala Univ, Sweden
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- Fink, Katharina (författare)
- Karolinska Institute,Karolinska Institutet,Karolinska Inst, Sweden; Karolinska Univ Hosp, Sweden,Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Department of Neurology, Karolinska University Hospital, Stockholm, Sweden
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- Fogdell-Hahn, Anna (författare)
- Karolinska Institute,Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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- Gunnarsson, Martin, 1973- (författare)
- Örebro University,Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,Department of Neurology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden,Orebro Univ, Sweden
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- Hillert, Jan (författare)
- Karolinska Institute,Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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- Langer-Gould, Annette (författare)
- Clinical and Translational Neuroscience, Southern California Permanente Medical Group, Kaiser Permanente, CA, Los Angeles, United States
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- Lycke, Jan, 1956 (författare)
- Gothenburg University,Göteborgs universitet,Institutionen för neurovetenskap och fysiologi, sektionen för klinisk neurovetenskap,Institute of Neuroscience and Physiology, Department of Clinical Neuroscience,Univ Gothenburg, Sweden; Univ Gothenburg, Sweden,Department of Neurology, Sahlgrenska University Hospital, and Department of Clinical Neuroscience, University of Gothenburg, Gothenburg, Sweden
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- Mellergård, Johan (författare)
- Linköping University,Linköpings universitet,Centrum för social och affektiv neurovetenskap,Medicinska fakulteten,Region Östergötland, Neurologiska kliniken i Linköping,Department of Neurology in Linköping, and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
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- Nilsson, Petra (författare)
- Lund University,Lunds universitet,Neurologi, Lund,Sektion IV,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Neurology, Lund,Section IV,Department of Clinical Sciences, Lund,Faculty of Medicine,Department of Neurology, Skåne University Hospital, and Department of Clinical Sciences/Neurology, Lund University, Lund, Sweden
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- Olsson, Tomas (författare)
- Karolinska Institute,Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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- Salzer, Jonatan (författare)
- Umeå universitet,Neurovetenskaper,Department of Neurology, Umeå University Hospital, Umeå, Sweden
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- Svenningsson, Anders (författare)
- Karolinska Institutet,Karolinska Inst, Sweden,Department of Neurology, Danderyd Hospital, and Department of Clinical Sciences, Karolinska Institutet, Stockholm, Sweden
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- Frisell, Thomas (författare)
- Karolinska Institute,Karolinska Institutet,Karolinska Inst, Sweden,Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
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(creator_code:org_t)
- 2024
- 2024
- Engelska.
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Ingår i: Annals of Neurology. - : John Wiley & Sons. - 0364-5134 .- 1531-8249.
- Relaterad länk:
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https://doi.org/10.1...
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https://urn.kb.se/re...
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Abstract
Ämnesord
Stäng
- OBJECTIVE: To assess comparative effectiveness, safety, and tolerability of off-label rituximab, compared with frequently used therapies approved for multiple sclerosis (MS).METHODS: A Swedish cohort study of persons with relapsing-remitting MS, age 18 to 75 years at inclusion and with a first therapy start or a first therapy switch between 2011 and 2018. Low-dose rituximab was compared with MS-approved therapies. Primary outcomes were proportions with 12 months confirmed disability worsening and change in MS Impact Scale-29 (MSIS-29) scores, respectively. Secondary endpoints included relapses, therapy discontinuation, and serious adverse events. Analyses used an intention-to-treat approach and were adjusted for demographics, MS features, and health characteristics.RESULTS: We included 2,449 participants as first therapy start and 2,463 as first therapy switch. Proportions with disability worsening at 3 years were 9.1% for rituximab as first therapy and 5.1% after therapy switch, with no differences to MS-approved comparators. Worsening on rituximab was mostly independent of relapses. MSIS-29 with rituximab at 3 years improved by 1.3/8.4 points (physical/psychological) for first disease-modifying therapy (DMT) and 0.4/3.6 for DMT switch, and was mostly similar across therapies. Rituximab had lower relapse rates and higher therapy persistence in both groups. The rate of hospital-treated infections was higher with rituximab after a therapy switch, but not as a first therapy.INTERPRETATION: This population-based real-world cohort study found low rates of disability progression, mostly independent of relapses, and without significant differences between rituximab and MS-approved comparators. Rituximab led to lower rates of inflammatory activity and higher treatment persistence, but was associated with an increased rate of serious infections. ANN NEUROL 2024.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Neurologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Neurology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Medicinska och farmaceutiska grundvetenskaper -- Neurovetenskaper (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Basic Medicine -- Neurosciences (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Geriatrik (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Geriatrics (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Allmänmedicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- General Practice (hsv//eng)
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- Av författaren/redakt...
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Piehl, Fredrik
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Alping, Peter
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Virtanen, Suvi
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Englund, Simon
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Burman, Joachim
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Fink, Katharina
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visa fler...
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Fogdell-Hahn, An ...
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Gunnarsson, Mart ...
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Hillert, Jan
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Langer-Gould, An ...
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Lycke, Jan, 1956
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Mellergård, Joha ...
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Nilsson, Petra
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Olsson, Tomas
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Salzer, Jonatan
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Svenningsson, An ...
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Frisell, Thomas
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- Om ämnet
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Klinisk medicin
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och Neurologi
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Medicinska och f ...
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och Neurovetenskaper
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Klinisk medicin
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och Geriatrik
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Klinisk medicin
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och Allmänmedicin
- Artiklar i publikationen
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Annals of Neurol ...
- Av lärosätet
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Örebro universitet
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Göteborgs universitet
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Karolinska Institutet
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Linköpings universitet
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Lunds universitet
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Umeå universitet
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