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COMBAT-MS :
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Piehl, FredrikDepartment of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Department of Neurology, Karolinska University Hospital, Stockholm, Sweden; Academic Specialist Center, Stockholm Health Services, Stockholm, Sweden
(författare)
COMBAT-MS : A Population-Based Observational Cohort Study Addressing the Benefit-Risk Balance of Multiple Sclerosis Therapies Compared with Rituximab
- Artikel/kapitelEngelska2024
Förlag, utgivningsår, omfång ...
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2024
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John Wiley & Sons,2024
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printrdacarrier
Nummerbeteckningar
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LIBRIS-ID:oai:DiVA.org:oru-114446
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https://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-114446URI
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https://doi.org/10.1002/ana.27012DOI
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Språk:engelska
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Sammanfattning på:engelska
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Ämneskategori:ref swepub-contenttype
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Ämneskategori:art swepub-publicationtype
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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 och genrebeteckningar
Biuppslag (personer, institutioner, konferenser, titlar ...)
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Alping, PeterDepartment of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
(författare)
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Virtanen, SuviClinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
(författare)
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Englund, SimonDepartment of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
(författare)
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Burman, JoachimDepartment of Neurology, Uppsala University Hospital, and Department of Medical Sciences, Uppsala University, Uppsala, Sweden
(författare)
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Fink, KatharinaDepartment of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Department of Neurology, Karolinska University Hospital, Stockholm, Sweden
(författare)
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Fogdell-Hahn, AnnaDepartment of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
(författare)
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Gunnarsson, Martin,1973-Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,Department of Neurology(Swepub:oru)mign
(författare)
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Hillert, JanDepartment of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
(författare)
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Langer-Gould, AnnetteClinical and Translational Neuroscience, Southern California Permanente Medical Group, Kaiser Permanente, Los Angeles, CA, USA
(författare)
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Lycke, JanDepartment of Neurology, Sahlgrenska University Hospital, and Department of Clinical Neuroscience, University of Gothenburg, Gothenburg, Sweden
(författare)
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Mellergård, JohanDepartment of Neurology in Linköping, and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
(författare)
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Nilsson, PetraDepartment of Neurology, Skåne University Hospital, and Department of Clinical Sciences/Neurology, Lund University, Lund, Sweden
(författare)
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Olsson, TomasDepartment of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
(författare)
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Salzer, JonatanDepartment of Neurology, Umeå University Hospital, and Department of Clinical Science, Neurosciences, Umeå University, Umeå, Sweden
(författare)
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Svenningsson, AndersDepartment of Neurology, Danderyd Hospital, and Department of Clinical Sciences, Karolinska Institutet, Stockholm, Sweden
(författare)
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Frisell, ThomasClinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
(författare)
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Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Department of Neurology, Karolinska University Hospital, Stockholm, Sweden; Academic Specialist Center, Stockholm Health Services, Stockholm, SwedenDepartment of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
(creator_code:org_t)
Sammanhörande titlar
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Ingår i:Annals of Neurology: John Wiley & Sons0364-51341531-8249
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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
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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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