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| Fältnamn | Indikatorer | Metadata |
|---|---|---|
| 000 | 03127naa a2200505 4500 | |
| 001 | oai:prod.swepub.kib.ki.se:139409519 | |
| 003 | SwePub | |
| 008 | 240701s2018 | |||||||||||000 ||eng| | |
| 024 | 7 | a http://kipublications.ki.se/Default.aspx?queryparsed=id:1394095192 URI |
| 024 | 7 | a https://doi.org/10.1177/13524585187981472 DOI |
| 040 | a (SwePub)ki | |
| 041 | a engb eng | |
| 042 | 9 SwePub | |
| 072 | 7 | a ref2 swepub-contenttype |
| 072 | 7 | a art2 swepub-publicationtype |
| 100 | 1 | a Min, M4 aut |
| 245 | 1 0 | a Silent lesions on MRI imaging - Shifting goal posts for treatment decisions in multiple sclerosis |
| 264 | c 2018-09-20 | |
| 264 | 1 | b SAGE Publications,c 2018 |
| 520 | a The current best practice suggests yearly magnetic resonance imaging (MRI) to monitor treatment response in multiple sclerosis (MS) patients. Objective: To evaluate the current practice of clinicians changing MS treatment based on subclinical new MRI lesions alone. Methods: Using MSBase, an international MS patient registry with MRI data, we analysed the probability of treatment change among patients with clinically silent new MRI lesions. Results: A total of 8311 MRI brain scans of 4232 patients were identified. Around 26.9% (336/1247) MRIs with one new T2 lesion were followed by disease-modifying therapy (DMT) change, increasing to 50.2% (129/257) with six new T2 lesions. DMT change was twice as likely with new T1 contrast enhancing compared to new T2 lesions odds ratio (OR): 2.43, 95% confidence interval (CI): 2.00–2.96 vs OR: 1.26 (95% CI: 1.22–1.29). DMT change with new MRI lesions occurred most frequently with ‘injectable’ DMTs. The probability of switching therapy was greater only after high-efficacy therapies became available in 2007 (after, OR: 1.43, 95% CI: 1.28–1.59 vs before, OR: 0.98, 95% CI: 0.520–1.88). Conclusion: MS clinicians rely increasingly on MRI alone in their treatment decisions, utilizing low thresholds (1 new T2 lesion) for optimizing MS therapy. This signals a shift towards no evidence of disease activity (NEDA)-3 since high-efficacy therapies became available. | |
| 700 | 1 | a Spelman, T4 aut |
| 700 | 1 | a Lugaresi, A4 aut |
| 700 | 1 | a Boz, C4 aut |
| 700 | 1 | a Spitaleri, DLA4 aut |
| 700 | 1 | a Pucci, E4 aut |
| 700 | 1 | a Grand'Maison, F4 aut |
| 700 | 1 | a Granella, F4 aut |
| 700 | 1 | a Izquierdo, G4 aut |
| 700 | 1 | a Butzkueven, H4 aut |
| 700 | 1 | a Sanchez-Menoyo, JL4 aut |
| 700 | 1 | a Barnett, M4 aut |
| 700 | 1 | a Girard, M4 aut |
| 700 | 1 | a Trojano, M4 aut |
| 700 | 1 | a Grammond, P4 aut |
| 700 | 1 | a Duquette, P4 aut |
| 700 | 1 | a Sola, P4 aut |
| 700 | 1 | a Alroughani, R4 aut |
| 700 | 1 | a Hupperts, R4 aut |
| 700 | 1 | a Vucic, S4 aut |
| 700 | 1 | a Kalincik, T4 aut |
| 700 | 1 | a Van pesch, V4 aut |
| 700 | 1 | a Lechner-Scott, J4 aut |
| 773 | 0 | t Multiple sclerosis (Houndmills, Basingstoke, England)d : SAGE Publicationsg 24:12, s. 1569-1577q 24:12<1569-1577x 1477-0970x 1352-4585 |
| 856 | 4 8 | u http://kipublications.ki.se/Default.aspx?queryparsed=id:139409519 |
| 856 | 4 8 | u https://doi.org/10.1177/1352458518798147 |
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- Av författaren/redakt...
- Min, M
- Spelman, T
- Lugaresi, A
- Boz, C
- Spitaleri, DLA
- Pucci, E
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- Grand'Maison, F
- Granella, F
- Izquierdo, G
- Butzkueven, H
- Sanchez-Menoyo, ...
- Barnett, M
- Girard, M
- Trojano, M
- Grammond, P
- Duquette, P
- Sola, P
- Alroughani, R
- Hupperts, R
- Vucic, S
- Kalincik, T
- Van pesch, V
- Lechner-Scott, J
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- Multiple scleros ...
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- Karolinska Institutet
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