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1. Impact of methodological choices in comparative effectiveness studies: application in natalizumab versus fingolimod comparison among patients with multiple sclerosis

Author

M. Lefort, S. Sharmin, J. B. Andersen, S. Vukusic, R. Casey, M. Debouverie, G. Edan, J. Ciron, A. Ruet, J. De Sèze, E. Maillart, H. Zephir, P. Labauge, G. Defer, C. Lebrun-Frenay, T. Moreau, E. Berger, P. Clavelou, J. Pelletier, B. Stankoff, O. Gout, E. Thouvenot, O. Heinzlef, A. Al-Khedr, B. Bourre, O. Casez, P. Cabre, A. Montcuquet, A. Wahab, J. P. Camdessanché, A. Maurousset, H. Ben Nasr, K. Hankiewicz, C. Pottier, N. Maubeuge, D. Dimitri-Boulos, C. Nifle, D. A. Laplaud, D. Horakova, E. K. Havrdova, R. Alroughani, G. Izquierdo, S. Eichau, S. Ozakbas, F. Patti, M. Onofrj, A. Lugaresi, M. Terzi, P. Grammond, F. Grand’Maison, B. Yamout, A. Prat, M. Girard, P. Duquette, C. Boz, M. Trojano, P. McCombe, M. Slee, J. Lechner-Scott, R. Turkoglu, P. Sola, D. Ferraro, F. Granella, V. Shaygannejad, J. Prevost, D. Maimone, O. Skibina, K. Buzzard, A. Van der Walt, R. Karabudak, B. Van Wijmeersch, T. Csepany, D. Spitaleri, S. Vucic, N. Koch-Henriksen, F. Sellebjerg, P. S. Soerensen, C. C. Hilt Christensen, P. V. Rasmussen, M. B. Jensen, J. L. Frederiksen, S. Bramow, H. K. Mathiesen, K. I. Schreiber, H. Butzkueven, M. Magyari, T. Kalincik, and E. Leray

Subjects
Effectiveness, Multiple sclerosis, Propensity score, Indication bias, Causal contrasts, Censoring, Medicine (General), R5-920
Abstract

Abstract Background Natalizumab and fingolimod are used as high-efficacy treatments in relapsing–remitting multiple sclerosis. Several observational studies comparing these two drugs have shown variable results, using different methods to control treatment indication bias and manage censoring. The objective of this empirical study was to elucidate the impact of methods of causal inference on the results of comparative effectiveness studies. Methods Data from three observational multiple sclerosis registries (MSBase, the Danish MS Registry and French OFSEP registry) were combined. Four clinical outcomes were studied. Propensity scores were used to match or weigh the compared groups, allowing for estimating average treatment effect for treated or average treatment effect for the entire population. Analyses were conducted both in intention-to-treat and per-protocol frameworks. The impact of the positivity assumption was also assessed. Results Overall, 5,148 relapsing–remitting multiple sclerosis patients were included. In this well-powered sample, the 95% confidence intervals of the estimates overlapped widely. Propensity scores weighting and propensity scores matching procedures led to consistent results. Some differences were observed between average treatment effect for the entire population and average treatment effect for treated estimates. Intention-to-treat analyses were more conservative than per-protocol analyses. The most pronounced irregularities in outcomes and propensity scores were introduced by violation of the positivity assumption. Conclusions This applied study elucidates the influence of methodological decisions on the results of comparative effectiveness studies of treatments for multiple sclerosis. According to our results, there are no material differences between conclusions obtained with propensity scores matching or propensity scores weighting given that a study is sufficiently powered, models are correctly specified and positivity assumption is fulfilled.

Published
2022
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2. Coencapsulation of Immunosuppressive Drug with Anti-Inflammatory Molecule in Pickering Emulsions as an Innovative Therapeutic Approach for Inflammatory Dermatoses

Author

Maxime Sintès, Petra Kovjenic, Liasmine Haine (Hablal), Kevin Serror, Mohamed Beladjine, Véronique Parietti (Montcuquet), Marine Delagrange, Bertrand Ducos, Jean-David Bouaziz, David Boccara, Maurice Mimoun, Armand Bensussan, Martine Bagot, Nicolas Huang, and Laurence Michel

Subjects
Coencapsulation, Inflammatory dermatoses, Nanoparticles, Pickering emulsions, Psoriasis, Dermatology, RL1-803
Abstract

Psoriasis is an inflammatory skin disease characterized by epidermal and immune dysfunctions. Although efficient, current topical treatments display adverse effects, including skin atrophy and burning sensation, leading to poor patient adherence. To overcome these downsides, pickering emulsions were formulated in which the calcitriol-containing dispersed phase was stabilized with either cyclosporin A– or tacrolimus-loaded poly(lactic-co-glycolic) acid nanoparticles. This study aimed to investigate their biological effects on lymphocytes and epidermal cells and their effectiveness in an imiquimod-induced psoriasis-like mouse model. Results showed that both emulsions significantly inhibited nuclear factor of activated T cell translocation in T lymphocytes as well as their IL-2 production, cell activation, and proliferation. In keratinocytes, inhibition of nuclear factor of activated T cell translocation decreased the production of IL-8 and TNF-α. Topical application of emulsions over skin biopsies ex vivo showed accumulation of rhodamin B–coupled poly(lactic-co-glycolic) acid nanoparticles throughout the epidermis by immunofluorescence and significantly decreased the antigen-presenting capacity of Langerhans cells in relation to a reduced expression of activation markers CD40, CD86, and HLA-DR. Using an imiquimod-induced psoriasis model in vivo, pickering emulsions significantly alleviated psoriasiform lesions potentially attributed to the decreased cutaneous expression of T-cell markers, proinflammatory cytokines, chemokines, and specific epidermal cell genes. Altogether, pickering emulsion might be a very efficient formulation for treating inflammatory dermatoses.

Published
2024
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3. Coencapsulation of Immunosuppressive Drug with Anti-Inflammatory Molecule in Pickering Emulsions as an Innovative Therapeutic Approach for Inflammatory Dermatoses

Author

Sintès, Maxime, Kovjenic, Petra, Haine (Hablal), Liasmine, Serror, Kevin, Beladjine, Mohamed, Parietti (Montcuquet), Véronique, Delagrange, Marine, Ducos, Bertrand, Bouaziz, Jean-David, Boccara, David, Mimoun, Maurice, Bensussan, Armand, Bagot, Martine, Huang, Nicolas, and Michel, Laurence

Published
2024
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4. Beyond 40 fluorescent probes for deep phenotyping of blood mononuclear cells, using spectral technology

Author

Sandrine Schmutz, Pierre-Henri Commere, Nicolas Montcuquet, Ana Cumano, Cédric Ait-Mansour, Sophie Novault, and Milena Hasan

Subjects
spectral cytometry, autofluorescence, high-dimension, unsupervised analysis, immunophenotyping, Immunologic diseases. Allergy, RC581-607
Abstract

The analytical capability of flow cytometry is crucial for differentiating the growing number of cell subsets found in human blood. This is important for accurate immunophenotyping of patients with few cells and a large number of parameters to monitor. Here, we present a 43-parameter panel to analyze peripheral blood mononuclear cells from healthy individuals using 41 fluorescence-labelled monoclonal antibodies, an autofluorescent channel, and a viability dye. We demonstrate minimal population distortions that lead to optimized population identification and reproducible results. We have applied an advanced approach in panel design, in selection of sample acquisition parameters and in data analysis. Appropriate autofluorescence identification and integration in the unmixing matrix, allowed for resolution of unspecific signals and increased dimensionality. Addition of one laser without assigned fluorochrome resulted in decreased fluorescence spill over and improved discrimination of cell subsets. It also increased the staining index when autofluorescence was integrated in the matrix. We conclude that spectral flow cytometry is a highly valuable tool for high-end immunophenotyping, and that fine-tuning of major experimental steps is key for taking advantage of its full capacity.

Published
2024
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7. Comparative Effectiveness of Natalizumab Versus Anti-CD20 in Highly Active Relapsing–Remitting Multiple Sclerosis After Fingolimod Withdrawal

Author

Rollot, Fabien, Couturier, Justine, Casey, Romain, Wiertlewski, Sandrine, Debouverie, Marc, Pelletier, Jean, De Sèze, Jérôme, Labauge, Pierre, Ruet, Aurélie, Thouvenot, Eric, Ciron, Jonathan, Berger, Eric, Gout, Olivier, Clavelou, Pierre, Stankoff, Bruno, Casez, Olivier, Bourre, Bertrand, Zephir, Hélène, Moreau, Thibault, Lebrun-Frenay, Christine, Maillart, Elisabeth, Edan, Gilles, Neau, Jean-Philippe, Montcuquet, Alexis, Cabre, Philippe, Camdessanché, Jean-Philippe, Defer, Gilles, Nasr, Haifa Ben, Maurousset, Aude, Hankiewicz, Karolina, Pottier, Corinne, Leray, Emmanuelle, Vukusic, Sandra, and Laplaud, David-Axel

Published
2022
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8. Impact of methodological choices in comparative effectiveness studies: application in natalizumab versus fingolimod comparison among patients with multiple sclerosis

Author

Lefort, M., Sharmin, S., Andersen, J. B., Vukusic, S., Casey, R., Debouverie, M., Edan, G., Ciron, J., Ruet, A., De Sèze, J., Maillart, E., Zephir, H., Labauge, P., Defer, G., Lebrun-Frenay, C., Moreau, T., Berger, E., Clavelou, P., Pelletier, J., Stankoff, B., Gout, O., Thouvenot, E., Heinzlef, O., Al-Khedr, A., Bourre, B., Casez, O., Cabre, P., Montcuquet, A., Wahab, A., Camdessanché, J. P., Maurousset, A., Ben Nasr, H., Hankiewicz, K., Pottier, C., Maubeuge, N., Dimitri-Boulos, D., Nifle, C., Laplaud, D. A., Horakova, D., Havrdova, E. K., Alroughani, R., Izquierdo, G., Eichau, S., Ozakbas, S., Patti, F., Onofrj, M., Lugaresi, A., Terzi, M., Grammond, P., Grand’Maison, F., Yamout, B., Prat, A., Girard, M., Duquette, P., Boz, C., Trojano, M., McCombe, P., Slee, M., Lechner-Scott, J., Turkoglu, R., Sola, P., Ferraro, D., Granella, F., Shaygannejad, V., Prevost, J., Maimone, D., Skibina, O., Buzzard, K., Van der Walt, A., Karabudak, R., Van Wijmeersch, B., Csepany, T., Spitaleri, D., Vucic, S., Koch-Henriksen, N., Sellebjerg, F., Soerensen, P. S., Hilt Christensen, C. C., Rasmussen, P. V., Jensen, M. B., Frederiksen, J. L., Bramow, S., Mathiesen, H. K., Schreiber, K. I., Butzkueven, H., Magyari, M., Kalincik, T., and Leray, E.

Published
2022
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13. Infections and multiple sclerosis: Recommendations from the French Multiple Sclerosis Society

Author

Papeix, C., Donzé, C., Lebrun-Frénay, C., Laplaud, D., Thouvenot, E., Ayrignac, X., Pourcher-Martinez, V., Zéphir, H., de Seze, J., Michel, L., Bensa, C., Cara-Dalliere, C., Guen-noc, A.M., Casez, O., Maarouf, A., Bourre, B., Kwiatkowski, A., Cohen, M., Maillart, E., Collongues, N., Louapre, C., Androdias, G., Guegen, A., Audoin, B., Mattey, G., Bernady, P., Faucheux, J.M., Labauge, P., Meckies, C., Stankoff, B., Tourniaire, P., Dinh, A., Guennoc, A.M., Durnad-Dubief, F., Wiertlewski, S., Derache, N., Le page, E., Pittion, S., Vukusic, S., Clavelou, P., Heinzlef, O., Colamarino, R., Planque, E., Rico, A., Sheiber nogueira, C., de Seze, M., Ciron, J., Alchaar, H., Bensmail, D., Biotti, D., Branger, P., Brochet, B., Castan, B., Creange, A., Creisson, E., DeBroucker, T., Depaz, R., Douay, X., Dulau, C., Faucher, M., Fournier, M., Fromont, A., Gallien, P., Gout, O., Grimaud, J., Hervé, Y., Kerbrat, A., Kremer, L., Lanotte, L., Magy, L., Mania, A., Maurousset, A., Moisset, X., Montcuquet, A., Moreau, T., Morel, N., Patry, I., Peaureaux, D., Pouget, M.C., Ruet, A., Saint-Val, C., Stahl, J.P., Taithe, F., Tattevin, P., Vaillant, M., Vuoto, F., and Donze, C.

Published
2021
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14. The effectiveness of natalizumab vs fingolimod–A comparison of international registry studies

Author

Andersen, Johanna B, Sharmin, Sifat, Lefort, Mathilde, Koch-Henriksen, Nils, Sellebjerg, Finn, Sørensen, Per Soelberg, Hilt Christensen, Claudia C, Rasmussen, Peter V, Jensen, Michael B, Frederiksen, Jette L, Bramow, Stephan, Mathiesen, Henrik K, Schreiber, Karen I, Horakova, Dana, Havrdova, Eva K, Alroughani, Raed, Izquierdo, Guillermo, Eichau, Sara, Ozakbas, Serkan, Patti, Francesco, Onofrj, Marco, Lugaresi, Alessandra, Terzi, Murat, Grammond, Pierre, Grand Maison, Francois, Yamout, Bassem, Prat, Alexandre, Girard, Marc, Duquette, Pierre, Boz, Cavit, Trojano, Maria, McCombe, Pamela, Slee, Mark, Lechner-Scott, Jeannette, Turkoglu, Recai, Sola, Patrizia, Ferraro, Diana, Granella, Franco, Shaygannejad, Vahid, Prevost, Julie, Skibina, Olga, Solaro, Claudio, Karabudak, Rana, Wijmeersch, Bart V, Csepany, Tunde, Spitaleri, Daniele, Vucic, Steve, Casey, Romain, Debouverie, Marc, Edan, Gilles, Ciron, Jonathan, Ruet, Aurélie, Sèze, Jérôme D, Maillart, Elisabeth, Zephir, Hélène, Labauge, Pierre, Defer, Gilles, Lebrun, Christine, Moreau, Thibault, Berger, Eric, Clavelou, Pierre, Pelletier, Jean, Stankoff, Bruno, Gout, Olivier, Thouvenot, Eric, Heinzlef, Olivier, Al-Khedr, Abdullatif, Bourre, Bertrand, Casez, Olivier, Cabre, Philippe, Montcuquet, Alexis, Wahab, Abir, Camdessanché, Jean-Philippe, Marousset, Aude, Patry, Ivania, Hankiewicz, Karolina, Pottier, Corinne, Maubeuge, Nicolas, Labeyrie, Céline, Nifle, Chantal, Leray, Emmanuelle, Laplaud, David A, Butzkueven, Helmut, Kalincik, Tomas, Vukusic, Sandra, and Magyari, Melinda

Published
2021
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17. Artificial intelligence to predict clinical disability in patients with multiple sclerosis using FLAIR MRI

Author

Brochet, B., Casey, R., Cotton, F., De Sèze, J., Douek, P., Guillemin, F., Laplaud, D., Lebrun-Frenay, C., Mansuy, L., Moreau, T., Olaiz, J., Pelletier, J., Rigaud-Bully, C., Stankoff, B., Vukusic, S., Marignier, R., Debouverie, M., Edan, G., Ciron, J., Ruet, A., Collongues, N., Lubetzki, C., Vermersch, P., Labauge, P., Defer, G., Cohen, M., Fromont, A., Wiertlewsky, S., Berger, E., Clavelou, P., Audoin, B., Giannesini, C., Gout, O., Thouvenot, E., Heinzlef, O., Al-Khedr, A., Bourre, B., Casez, O., Cabre, P., Montcuquet, A., Créange, A., Camdessanché, J.-P., Faure, J., Maurousset, A., Patry, I., Hankiewicz, K., Pottier, C., Maubeuge, N., Labeyrie, C., Nifle, C., Ameli, R., Anxionnat, R., Attye, A., Bannier, E., Barillot, C., Ben Salem, D., Boncoeur-Martel, M.-P., Bonneville, F., Boutet, C., Brisset, J.-C., Cervenanski, F., Claise, B., Commowick, O., Constans, J.-M., Dardel, P., Desal, H., Dousset, Vincent, Durand-Dubief, F., Ferre, J.-C., Gerardin, E., Glattard, T., Grand, S., Grenier, T., Guillevin, R., Guttmann, C., Krainik, A., Kremer, S., Lion, S., Menjot de Champfleur, N., Mondot, L., Outteryck, O., Pyatigorskaya, N., Pruvo, J.-P., Rabaste, S., Ranjeva, J.-P., Roch, J.-A., Sadik, J.C., Sappey-Marinier, D., Savatovsky, J., Tanguy, J.-Y., Tourbah, A., Tourdias, T., Roca, P., Colas, L., Tucholka, A., Rubini, P., Cackowski, S., Ding, J., Budzik, J.-F., Renard, F., Doyle, S., Barbier, E.L., Bousaid, I., Lassau, N., and Verclytte, S.

Published
2020
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18. New OFSEP recommendations for MRI assessment of multiple sclerosis patients: Special consideration for gadolinium deposition and frequent acquisitions

Author

Ameli, R., Anxionnat, R., Audoin, B., Attye, A., Bannier, E., Barillot, C., Ben Salem, D., Boncoeur-Martel, M.-P., Bonhomme, G., Bonneville, F., Boutet, C., Brisset, J.C., Cervenanski, F., Claise, B., Commowick, O., Constans, J.-M., Cotton, F., Dardel, P., Desal, H., Dousset, V., Durand-Dubief, F., Ferre, J.-C., Gaultier, A., Gerardin, E., Glattard, T., Grand, S., Grenier, T., Guillevin, R., Guttmann, C., Krainik, A., Kremer, S., Lion, S., Champfleur, N. Menjot De, Mondot, L., Outteryck, O., Pyatigorskaya, N., Pruvo, J.-P., Rabaste, S., Ranjeva, J.-P., Roch, J.-A., Sadik, J.-C., Sappey-Marinier, D., Savatovsky, J., Stankoff, B., Tanguy, J.-Y., Tourbah, A., Tourdias, T., Brochet, B., Casey, R., De Sèze, J., Douek, P., Guillemin, F., Laplaud, D., Lebrun-Frenay, C., Mansuy, L., Moreau, T., Olaiz, J., Pelletier, J., Rigaud-Bully, C., Vukusic, S., Debouverie, M., Edan, G., Ciron, J., Lubetzki, C., Vermersch, P., Labauge, P., Defer, G., Berger, E., Clavelou, P., Gout, O., Thouvenot, E., Heinzlef, O., Al-Khedr, A., Bourre, B., Casez, O., Cabre, P., Montcuquet, A., Créange, A., Camdessanché, J.-P., Bakchine, S., Maurousset, A., Patry, I., De Broucker, T., Pottier, C., Neau, J.-P., Labeyrie, C., Nifle, C., Brisset, Jean-Christophe, Kremer, Stephane, Hannoun, Salem, Bonneville, Fabrice, Durand-Dubief, Francoise, Tourdias, Thomas, Barillot, Christian, Guttmann, Charles, Vukusic, Sandra, Dousset, Vincent, and Cotton, Francois

Published
2020
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19. “Co-encapsulation of Immunosuppressive Drug with Anti-inflammatory Molecule in Pickering Emulsions as a Novel Therapeutic Approach for Inflammatory Dermatoses”

Author

Sintès, Maxime, primary, Kovjenic, Petra, additional, Haine (Hablal), Liasmine, additional, Serror, Kevin, additional, Beladjine, Mohamed, additional, Parietti (Montcuquet), Véronique, additional, Delagrange, Marine, additional, Ducos, Bertrand, additional, Bouaziz, Jean-David, additional, Boccara, David, additional, Mimoun, Maurice, additional, Bensussan, Armand, additional, Bagot, Martine, additional, Huang, Nicolas, additional, and Michel, Laurence, additional

Published
2024
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20. Gynaecological follow-up for women of reproductive age with multiple sclerosis: The GYNESEP study

Author

Renaud, Juliette, primary, Buissonnière, Pauline, additional, Dulau, Cécile, additional, Deloire, Mathilde, additional, Hontarrede, Florian, additional, Montcuquet, Alexis, additional, Chansel-Debordeaux, Lucie, additional, Hocké, Claude, additional, Ouallet, Jean-Christophe, additional, Ruet, Aurélie, additional, and Bernard, Valérie, additional

Published
2024
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21. Cancer and multiple sclerosis: 2023 recommendations from the French Multiple Sclerosis Society

Author

Collongues, Nicolas, primary, Durand-Dubief, Françoise, additional, Lebrun-Frenay, Christine, additional, Audoin, Bertrand, additional, Ayrignac, Xavier, additional, Bensa, Caroline, additional, Bigaut, Kévin, additional, Bourre, Bertrand, additional, Carra-Dallière, Clarisse, additional, Ciron, Jonathan, additional, Defer, Gilles, additional, Kwiatkowski, Arnaud, additional, Leray, Emmanuelle, additional, Maillart, Elisabeth, additional, Marignier, Romain, additional, Mathey, Guillaume, additional, Morel, Nathalie, additional, Thouvenot, Eric, additional, Zéphir, Hélène, additional, Boucher, Julie, additional, Boutière, Clémence, additional, Branger, Pierre, additional, Da Silva, Angélique, additional, Demortière, Sarah, additional, Guillaume, Maxime, additional, Hebant, Benjamin, additional, Januel, Edouard, additional, Kerbrat, Anne, additional, Manchon, Eric, additional, Moisset, Xavier, additional, Montcuquet, Alexis, additional, Pierret, Chloé, additional, Pique, Julie, additional, Poupart, Julien, additional, Prunis, Chloé, additional, Roux, Thomas, additional, Schmitt, Perrine, additional, Androdias, Géraldine, additional, and Cohen, Mikael, additional

Published
2024
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22. Outcome and risk of recurrence in a large cohort of idiopathic longitudinally extensive transverse myelitis without AQP4/MOG antibodies

Author

Elisabeth Maillart, Françoise Durand-Dubief, Céline Louapre, Bertrand Audoin, Bertrand Bourre, Nathalie Derache, Jonathan Ciron, Nicolas Collongues, Jérome de Sèze, Mikael Cohen, Christine Lebrun-Frenay, Nawel Hadhoum, Hélène Zéphir, Romain Deschamps, Clarisse Carra-Dallière, Pierre Labauge, Philippe Kerschen, Alexis Montcuquet, Sandrine Wiertlewski, David Laplaud, Gwenaëlle Runavot, Sandra Vukusic, Caroline Papeix, Romain Marignier, and on behalf of the OFSEP, SFSEP, and NOMADMUS study groups

Subjects
Longitudinally extensive transverse myelitis, Seronegative, Neuromyelitis optica, Outcome, Treatment, Neurology. Diseases of the nervous system, RC346-429
Abstract

Abstract Background Longitudinally extensive transverse myelitis (LETM) is classically related to aquaporin (AQP4)-antibodies (Ab) neuromyelitis optica spectrum disorders (NMOSD) or more recently to myelin oligodendrocyte glycoprotein (MOG)-Ab associated disease. However, some patients remain negative for any diagnosis, despite a large work-up including AQP4-Ab and MOG-Ab. Data about natural history, disability outcome, and treatment are limited in this group of patients. We aimed to (1) describe clinical, biological, and radiological features of double seronegative LETM patients; (2) assess the clinical course and identify prognostic factors; and (3) assess the risk of recurrence, according to maintenance immunosuppressive therapy. Methods Retrospective evaluation of patients with a first episode of LETM, tested negative for AQP-Ab and MOG-Ab, from the French nationwide observatory study NOMADMUS. Results Fifty-three patients (median age 38 years (range 16–80)) with double seronegative LETM were included. Median nadir EDSS at onset was 6.0 (1–8.5), associated to a median EDSS at last follow-up of 4.0 (0–8). Recurrence was observed in 24.5% of patients in the 18 following months, with a median time to first relapse of 5.7 months. The risk of recurrence was lower in the group of patients treated early with an immunosuppressive drug (2/22, 9%), in comparison with untreated patients (10/31, 32%). Conclusions A first episode of a double seronegative LETM is associated to a severe outcome and a high rate of relapse in the following 18 months, suggesting that an early immunosuppressive treatment may be beneficial in that condition.

Published
2020
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23. 6 months versus 12 months of adjuvant trastuzumab in early breast cancer (PHARE): final analysis of a multicentre, open-label, phase 3 randomised trial

Author

Piprot, C, Cals, L, Chaigneau, L, Demarchi, F, N'Guyen, T, Stein, U, Villanueva, C, Bréau, JL, Chouahnia, AK, Saintigny, P, Boué, F, deSaint-Hilaire, P, Guimont, I, Grossat, N, Valenza, B, Lévy, E, Médioni, J, Delbaldo, C, Grenier, J, Pouessel, D, Lavau-Denès, S, Falandry, C, Fournel-Fédérico, C, Freyer, G, Tartas, S, Trillet-Lenoir, V, Bons, F, Auclerc, G, Chièze, S, Raban, N, Tournigand, C, Trager-Maury, S, Bousquet, G, Cuvier, C, Giacchetti, S, Hocini, A, LeMaignan, C, Misset, JL, Avenin, D, Beerblock, C, Gligorov, J, Rivera, P, Roché, H, Bougnoux, P, Hajjaji, N, Capitain, O, Delva, R, Maillart, P, Soulié, P, Bonnefoi, H, Durand, M, Madranges, N, Mauriac, L, Chollet, P, Dillies, AF, Durando, X, Ferrière, JP, Mouret-Reynier, C, Nabholtz, JM, Van Praagh, I, Cottu, P, Diéras, V, Durieux, A, Galotte, M, Girre, V, Henry, S, Iurisci, I, Jouve, M, Laurence, V, Mignot, L, Piperno-Neumann, S, Tresca, P, Coudert, B, Ferrant, E, Mayer, F, Vanneuville, AC, Bonneterre, J, Servent, V, Vanlemmens, L, Vennin, P, Guastalla, JP, Biron, P, Dupuy-Brousseau, L, Lancry, L, Ray-Coquard, I, Rebattu, P, Trédan, O, Extra, JM, Rousseau, F, Tarpin, C, Fabbro, M, Luporsi, E, Uwer, L, Weber, B, Berton-Rigaud, D, Bourbouloux, E, Campone, M, Ferrero, JM, Follana, P, Largillier, R, Mari, V, Costa, B, Curé, H, Eymard, JC, Jovenin, N, Lebrun, D, Meunier, J, Yazbek, G, Gedoin, D, Laguerre, B, Lefeuvre, C, Vauléon, E, Chevrier, A, Guillemet, C, Leheurteur, M, Rigal, O, Tennevet, I, Veyret, C, Brain, E, Guiterrez, M, Mefti-Lacheraf, F, Petit, T, Dalenc, F, Gladieff, L, André, F, Delaloge, S, Domont, J, Ezenfis, J, Spielmann, M, Guillet, P, Boulanger, V, Provençal, J, Stefani, L, Alliot, C, Ré, D, Bellaiche-Miccio, C, Boutan-Laroze, G, Vanica, R, Dion, P, Sadki-Benaoudia, G, Marti, A, Villing, AL, Slama, B, Dutel, JL, Nguyen, S, Saad, R, Arsène, O, Merad-Boudia, Z, Orfeuvre, H, Egreteau, J, Goudier, MJ, Lamy, R, Leduc, B, Sarda, C, Salles, B, Agostini, C, Cauvin, I, Dufresne, A, Mangold, M, Lebouvier-Sadot, S, Audhuy, B, Barats, JC, Cluet-Dennetière, S, Zylberait, D, Netter, G, Gautier-Felizot, L, Cojean-Zelek, I, Plantade, A, Vignot, S, Guardiola, E, Marti, P, deHartingh, I, Diab, R, Dietmann, A, Ruck, S, Portois, C, Oddou-Lagranière, S, Campos-Gazeau, F, Bourcier, A, Priou, F, Geay, JF, Mayeur, D, Gabez, P, ElAmarti, R, Combe, M, Raichon-Patru, P, Amsalhem, P, Dauba, J, Paraiso, D, Guinet, F, Duvert, B, Litor, M, Kara-Slimane, F, Bichoffe, A, Denizon, N, Soyer, P, Morvan, F, Van-Hulst, S, Vincent, L, Alleaume, C, Ibanez-Martin, P, Youssef, A, Tadrist, Z, Carola, E, Pourny, C, Toccanier, JF, Al-Aukla, N, Mahour-Bacha, K, Salvat, J, Nouyrigat, P, Clippe, S, Gouttebel, MC, Vedrine, L, Clavreul, G, Collard, O, Mille, D, Goubely, Y, Hervé, R, Kirscher, S, Plat, F, Delecroix, V, Ligeza-Poisson, V, Coeffic, D, Fric, D, Garnier, C, Leyronnas, C, Kreitman, T, Teissier, E, Martin, P, Rohart deCordoue, S, ElKouri, C, Ramée, JF, Laporte, C, Bernard, O, Altwegg, T, Darut-Jouve, A, Dujols, JP, Darloy, F, Giraud, C, Pottier-Kyndt, V, Achour, N, Drony, S, Moriceau, M, Sarrazin, C, Legueul, JC, Mandet, J, Besson, D, Hardy-Bessard, AC, Cretin, J, Houyau, P, Achille, E, Genêt, D, Thévenot, H, Moran-Ribon, A, Pavlovitch, JM, Ardisson, P, Moullet, I, Couderc, B, Fichet, V, Burki, F, Auliard, A, Levaché, CB, Cailleux, P, Schaeffer, F, Albin, N, Sévin-Robiche, D, Domas, J, Ellis, S, Montcuquet, P, Baumont, GA, Bégue, M, Gréget, S, Ratoanina, JL, Vanoli, A, Bielsa, C, Bonichon-Lamichhane, M, Jaubert, D, Laharie-Mineur, H, Alcaraz, L, Legouffe, E, Bourgeois, H, Cartron, G, Denis, F, Dupuis, O, Ganem, G, Roche-Forestier, S, Delzenne, L, Chirat, E, Baticle, JL, Béguier, E, Jacquot, S, Janssen, E, Lauché, H, LeRol, A, Chantelard, JP, L'Helgoualc'h, GA, Antoine, EC, Kanoui, A, Llory, JF, Vannetzel, JM, Vignoud, J, Bruna, C, Facchini, T, Moutel-Corviole, K, Voloch, A, Ghoul, A, Loiseau, D, Barbet, N, Dohollou, N, Yakendji, K, Pivot, Xavier, Romieu, Gilles, Debled, Marc, Pierga, Jean-Yves, Kerbrat, Pierre, Bachelot, Thomas, Lortholary, Alain, Espié, Marc, Fumoleau, Pierre, Serin, Daniel, Jacquin, Jean-Philippe, Jouannaud, Christelle, Rios, Maria, Abadie-Lacourtoisie, Sophie, Venat-Bouvet, Laurence, Cany, Laurent, Catala, Stéphanie, Khayat, David, Gambotti, Laetitia, Pauporté, Iris, Faure-Mercier, Celine, Paget-Bailly, Sophie, Henriques, Julie, and Grouin, Jean Marie

Published
2019
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24. Immunization and multiple sclerosis: Recommendations from the French Multiple Sclerosis Society

Author

Abadie, V., Achour, C., Ader, F., Alchaar, H., Alkhedr, A., Andreux, F., Androdias, G., Arjmand, R., Audoin, B., Audry, D., Aufauvre, D., Autreaux, C., Ayrignac, X., Bailbe, M., Benazet, M., Bensa, C., Bensmail, D., Berger, E., Bernady, P., Bertagna, Y., Biotti, D., Blanchard-Dauphin, A., Bonenfant, J., Bonnan, M., Bonnemain, B., Borgel, F., Botelho-Nevers, E., Boucly, S., Bourre, B., Boutière, C., Branger, P., Brassat, D., Bresch, S., Breuil, V., Brochet, B., Brugeilles, H., Bugnon, P., Cabre, P., Camdessanché, J.-P., Carra-Dalière, C., Casez, O., Chamouard, J.-M., Chassande, B., Chataignier, P., Chbicheb, M., Chenet, A., Ciron, J., Clavelou, P., Cohen, M., Colamarino, R., Collongues, N., Coman, I., Corail, P.-R., Courtois, S., Coustans, M., Creange, A., Creisson, E., Daluzeau, N., Davenas, C., De Seze, J., Debouverie, M., Depaz, R., Derache, N., Divio, L., Douay, X., Dulau, C., Durand-Dubief, F., Edan, G., Elias, Z., Fagniez, O., Faucher, M., Faucheux, J.-M., Fournier, M., Gagneux-Brunon, A., Gaida, P., Galli, P., Gallien, P., Gaudelus, J., Gault, D., Gayou, A., Genevray, M., Gentil, A., Gere, J., Gignoux, L., Giroux, M., Givron, P., Gout, O., Grimaud, J., Guennoc, A.-M., Hadhoum, N., Hautecoeur, P., Heinzlef, O., Jaeger, M., Jeannin, S., Kremer, L., Kwiatkowski, A., Labauge, P., Labeyrie, C., Lachaud, S., Laffont, I., Lanctin-Garcia, C., Lannoy, J., Lanotte, L., Laplaud, D., Latombe, D., Lauxerois, M., Le Page, E., Lebrun-Frenay, C., Lejeune, P., Lejoyeux, P., Lemonnier, B., Leray, E., Loche, C.-M., Louapre, C., Lubetzki, C., Maarouf, A., Mada, B., Magy, L., Maillart, E., Manchon, E., Marignier, R., Marque, P., Mathey, G., Maurousset, A., Mekies, C., Merienne, M., Michel, L., Milor, A.-M., Moisset, X., Montcuquet, A., Moreau, T., Morel, N., Moussa, M., Naudillon, J.-P., Normand, M., Olive, P., Ouallet, J.-C., Outteryck, O., Pacault, C., Papeix, C., Patry, I., Peaureaux, D., Pelletier, J., Pichon, B., Pittion, S., Planque, E., Pouget, M.-C., Pourcher, V., Radot, C., Robert, I., Rocher, F., Ruet, A., Saint-Val, C., Salle, J.-Y., Salmon, A., Sartori, E., Schaeffer, S., Stankhof, B., Taithe, F., Thouvenot, E., Tizon, C., Tourbah, A., Tourniaire, P., Vaillant, M., Vermersch, P., Vidil, S., Wahab, A., Warter, M.-H., Wiertlewski, S., Wiplosz, B., Wittwer, B., Zaenker, C., Zephir, H., Lebrun, C., and Vukusic, S.

Published
2019
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26. Evaluation of treatment response in adults with relapsing MOG-Ab-associated disease

Author

Alvaro Cobo-Calvo, María Sepúlveda, Fabien Rollot, Thais Armangué, Anne Ruiz, Elisabeth Maillart, Caroline Papeix, Bertrand Audoin, Helene Zephir, Damien Biotti, Jonathan Ciron, Francoise Durand-Dubief, Nicolas Collongues, Xavier Ayrignac, Pierre Labauge, Eric Thouvenot, Bertrand Bourre, Alexis Montcuquet, Mikael Cohen, Romain Deschamps, Nuria Solà-Valls, Sara Llufriu, Jerome De Seze, Yolanda Blanco, Sandra Vukusic, Albert Saiz, and Romain Marignier

Subjects
MOG antibodies, Treatment response, Neuromyelitis optica, Multiple sclerosis, Propensity score, Neurology. Diseases of the nervous system, RC346-429
Abstract

Abstract Background Myelin oligodendrocyte glycoprotein antibodies (MOG-Ab) are related to several acquired demyelinating syndromes in adults, but the therapeutic approach is currently unclear. We aimed to describe the response to different therapeutic strategies in adult patients with relapsing MOG-Ab-associated disease. Methods This is a retrospective study conducted in France and Spain including 125 relapsing MOG-Ab patients aged ≥ 18 years. First, we performed a survival analysis to investigate the relapse risk between treated and non-treated patients, performing a propensity score method based on the inverse probability of treatment weighting. Second, we assessed the annualised relapse rates (ARR), Expanded Disability Status Scale (EDSS) and visual acuity pre-treatment and on/end-treatment. Results Median age at onset was 34.1 years (range 18.0–67.1), the female to male ratio was 1.2:1, and 96% were Caucasian. At 5 years, 84% (95% confidence interval [CI], 77.1–89.8) patients relapsed. At the last follow-up, 66 (52.8%) received maintenance therapy. Patients initiating immunosuppressants (azathioprine, mycophenolate mophetil [MMF], rituximab) were at lower risk of new relapse in comparison to non-treated patients (HR, 0.41; 95CI%, 0.20–0.82; p = 0.011). Mean ARR (standard deviation) was reduced from 1.05(1.20) to 0.43(0.79) with azathioprine (n = 11; p = 0.041), from 1.20(1.11) to 0.23(0.60) with MMF (n = 11; p = 0.033), and from 1.08(0.98) to 0.43(0.89) with rituximab (n = 26; p = 0.012). Other immunosuppressants (methotrexate/mitoxantrone/cyclophosphamide; n = 5), or multiple sclerosis disease-modifying drugs (MS-DMD; n = 9), were not associated with significantly reduced ARR. Higher rates of freedom of EDSS progression were observed with azathioprine, MMF or rituximab. Conclusion In adults with relapsing MOG-Ab-associated disease, immunosuppressant therapy (azathioprine, MMF and rituximab) is associated with reduced risk of relapse and better disability outcomes. Such an effect was not found in the few patients treated with MS-DMD.

Published
2019
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27. Paradigm shifts in multiple sclerosis management: Implications for daily clinical practice

Author

B, Bourre, O, Casez, J, Ciron, A, Gueguen, A, Kwiatkowski, X, Moisset, A, Montcuquet, and X, Ayrignac

Subjects
Neurology, Neurology (clinical)
Abstract

Multiple sclerosis (MS) is the most common chronic inflammatory neurological disease. The emergence of disease-modifying therapies (DMTs) has greatly improved disease activity control and progression of disability in MS patients. DMTs differ in their mode of action, route of administration, efficacy, and safety profiles, offering multiple options for clinicians. Personalized medicine aims at tailoring the therapeutic strategy to patients' characteristics and disease activity but also patients' needs and preferences. New therapeutic options have already changed treatment paradigms for patients with active relapsing MS (RMS). The traditional approach consists in initiating treatment with moderate-efficacy DMTs and subsequently, escalating to higher-efficacy DMTs when there is evidence of clinical and/or radiological breakthrough activity. Recent real-world studies suggest that initiation of high-efficacy DMTs from disease onset can improve long-term outcomes for RMS patients. In this article, we review different treatment strategies and discuss challenges associated with personalized therapy.

Published
2023
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28. Usefulness of MOG-antibody titres at first episode to predict the future clinical course in adults

Author

Cobo-Calvo, Alvaro, Sepúlveda, María, d’Indy, Hyacintha, Armangué, Thais, Ruiz, Anne, Maillart, Elisabeth, Papeix, Caroline, Audoin, Bertrand, Zephir, Helene, Biotti, Damien, Ciron, Jonathan, Durand-Dubief, Francoise, Collongues, Nicolas, Ayrignac, Xavier, Labauge, Pierre, Thouvenot, Eric, Montcuquet, Alexis, Deschamps, Romain, Solà-Valls, Nuria, Llufriu, Sara, Blanco, Yolanda, de Seze, Jerome, Vukusic, Sandra, Saiz, Albert, Marignier, Romain, The OFSEP Group, and The REEM Group

Published
2019
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31. Prévalence et prise en charge de la douleur chez les patients présentant un cancer métastatique en Franche-Comté

Author

Dénommé, Fanny, Kroemer, Marie, Montcuquet, Philippe, Nallet, Gilles, Thiery-Vuillemin, Antoine, Bazan, Fernando, Mouillet, Guillaume, Villanueva, Cristian, Demarchi, Martin, Stein, Ulrich, Almotlak, Hamadi, Chaigneau, Loïc, Curtit, Elsa, Meneveau, Nathalie, Maurina, Tristan, Dobi, Erion, Hon, Thierry Nguyen Tan, Cals, Laurent, Mansi, Laura, Verlut, Clotilde, Pana-Katatali, Héloïse, Caubet, Mathieu, Paillard, Marie-Justine, Limat, Samuel, Pivot, Xavier, and Nerich, Virginie

Published
2016
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32. Interleukin-15-Dependent T-Cell-like Innate Intraepithelial Lymphocytes Develop in the Intestine and Transform into Lymphomas in Celiac Disease

Author

Ettersperger, Julien, Montcuquet, Nicolas, Malamut, Georgia, Guegan, Nicolas, Lopez-Lastra, Silvia, Gayraud, Ségolène, Reimann, Christian, Vidal, Elodie, Cagnard, Nicolas, Villarese, Patrick, Andre-Schmutz, Isabelle, Gomes Domingues, Rita, Godinho-Silva, Cristina, Veiga-Fernandes, Henrique, Lhermitte, Ludovic, Asnafi, Vahid, Macintyre, Elizabeth, Cellier, Christophe, Beldjord, Kheira, Di Santo, James P., Cerf-Bensussan, Nadine, and Meresse, Bertrand

Published
2016
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33. Comparative effectiveness of teriflunomide vs dimethyl fumarate in multiple sclerosis

Author

Laplaud, David-Axel, Casey, Romain, Barbin, Laetitia, Debouverie, Marc, De Sèze, Jérôme, Brassat, David, Wiertlewski, Sandrine, Brochet, Bruno, Pelletier, Jean, Vermersch, Patrick, Edan, Gilles, Lebrun-Frenay, Christine, Clavelou, Pierre, Thouvenot, Eric, Camdessanché, Jean-Philippe, Tourbah, Ayman, Stankoff, Bruno, Al Khedr, Abdullatif, Cabre, Philippe, Lubetzki, Catherine, Papeix, Caroline, Berger, Eric, Heinzlef, Olivier, Debroucker, Thomas, Moreau, Thibault, Gout, Olivier, Bourre, Bertrand, Wahab, Abir, Labauge, Pierre, Magy, Laurent, Defer, Gilles, Guennoc, Anne-Marie, Maubeuge, Nicolas, Labeyrie, Céline, Patry, Ivania, Nifle, Chantal, Casez, Olivier, Michel, Laure, Rollot, Fabien, Leray, Emmanuelle, Vukusic, Sandra, Foucher, Yohann, Fontaine, B., Marignier, R., Durand-Dubief, F., Mathey, G., Le Page, E., Peaureaux-Averseng, D., Ouallet, J.C., Ruet, A., Collongues, N., Hautecoeur, P., Zephir, H., Maillard, E., Cohen, M., Derache, N., Branger, P., Ayrignac, X., Carra-Dalliere, C., Fromont, A., Chamard-Witkowski, L., Taithe, F., Moisset, X., Audoin, B., Rico-Lamy, A., Castelnovo, G., Giannesini, C., Fagniez, O., Bensa, C., Gueguen, A., Kasonde, I. Tabellah, De Vilmarest, A., Montcuquet, A., Vaillants, M., Beltran, S., Creange, A., Ayache, S., Abdellaoui, M., Pottier, C., Slesari, I., Deburghraeve, V., Neau, J.P., Servan, J., Pico, F., Henry, C., and Hankiewicz, K.

Published
2019
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35. Improving the decision to switch from first- to second-line therapy in multiple sclerosis: A dynamic scoring system

Author

Camille Sabathé, Romain Casey, Sandra Vukusic, Emmanuelle Leray, Guillaume Mathey, Jérôme De Sèze, Jonathan Ciron, Sandrine Wiertlewski, Aurélie Ruet, Jean Pelletier, Hélène Zéphir, Laure Michel, Christine Lebrun-Frenay, Xavier Moisset, Eric Thouvenot, Jean-Philippe Camdessanché, Serge Bakchine, Bruno Stankoff, Abdullatif Al Khedr, Philippe Cabre, Elisabeth Maillart, Eric Berger, Olivier Heinzlef, Karolina Hankiewicz, Thibault Moreau, Olivier Gout, Bertrand Bourre, Abir Wahab, Pierre Labauge, Alexis Montcuquet, Gilles Defer, Aude Maurousset, Nicolas Maubeuge, Dalia Dimitri Boulos, Haïfa Ben Nasr, Chantal Nifle, Olivier Casez, David-Axel Laplaud, Yohann Foucher, Université de Nantes, Université de Tours, Inserm, UMR1246 Sphere, Nantes, Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Département Méthodes quantitatives en santé publique (METIS), École des Hautes Études en Santé Publique [EHESP] (EHESP), Recherche sur les services et le management en santé (RSMS), Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Pôle de Neurosciences Cliniques, Service de Neurologie, APHM, Hôpital de la Timone, Aix-Marseille University, Marseille, France, Centre de résonance magnétique biologique et médicale (CRMBM), Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-Centre National de la Recherche Scientifique (CNRS), Centre hospitalier universitaire de Poitiers (CHU Poitiers), Recherche en Pharmaco-épidémiologie et Recours aux Soins (REPERES), and Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)

Subjects
Multiple sclerosis, Neurology, Epidemiology, Second-line treatment, Neurology (clinical), Treatment response, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

Background: In relapsing-remitting multiple sclerosis (RRMS), early identification of suboptimal responders can prevent disability progression. Objective: We aimed to develop and validate a dynamic score to guide the early decision to switch from first- to second-line therapy. Methods: Using time-dependent propensity scores (PS) from a French cohort of 12,823 patients with RRMS, we constructed one training and two validation PS-matched cohorts to compare the switched patients to second-line treatment and the maintained patients. We used a frailty Cox model for predicting individual hazard ratios (iHRs). Results: From the validation PS-matched cohort of 348 independent patients with iHR ⩽ 0.69, we reported the 5-year relapse-free survival at 0.14 (95% confidence interval (CI) 0.09–0.22) for the waiting group and 0.40 (95% CI 0.32–0.51) for the switched group. From the validation PS-matched cohort of 518 independent patients with iHR > 0.69, these values were 0.37 (95% CI 0.30–0.46) and 0.44 (95% CI 0.37–0.52), respectively. Conclusions: By using the proposed dynamic score, we estimated that at least one-third of patients could benefit from an earlier switch to prevent relapse.

Published
2023
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36. Pregnancy and neuromyelitis optica spectrum disorders: 2022 recommendations from the French Multiple Sclerosis Society

Author

Sandra Vukusic, Romain Marignier, Jonathan Ciron, Bertrand Bourre, Mikael Cohen, Romain Deschamps, Maxime Guillaume, Laurent Kremer, Julie Pique, Clarisse Carra-Dalliere, Laure Michel, Emmanuelle Leray, Anne-Marie Guennoc, David Laplaud, Géraldine Androdias, Caroline Bensa, Kevin Bigaut, Damien Biotti, Pierre Branger, Olivier Casez, Elodie Daval, Cécile Donze, Anne-Laure Dubessy, Cécile Dulau, Françoise Durand-Dubief, Benjamin Hebant, Arnaud Kwiatkowski, Julien Lannoy, Adil Maarouf, Eric Manchon, Guillaume Mathey, Xavier Moisset, Alexis Montcuquet, Thomas Roux, Elisabeth Maillart, Christine Lebrun-Frenay, Centre de recherche en neurosciences de Lyon - Lyon Neuroscience Research Center (CRNL), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Hospices Civils de Lyon (HCL), Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity), Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), CHU Rouen, Normandie Université (NU), Fondation Ophtalmologique Adolphe de Rothschild [Paris], Les Hôpitaux Universitaires de Strasbourg (HUS), Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle (MIRCEM), CHU Montpellier, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Pontchaillou [Rennes], École des Hautes Études en Santé Publique [EHESP] (EHESP), Département Méthodes quantitatives en santé publique (METIS), Centre de Recherches sur l'Action Politique en Europe (ARENES), Université de Rennes (UR)-Institut d'Études Politiques [IEP] - Rennes-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Centre National de la Recherche Scientifique (CNRS), Recherche sur les services et le management en santé (RSMS), Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Collectif de recherche handicap, autonomie et société inclusive (CoRHASI), Centre d’Investigation Clinique de Nantes (CIC Nantes), Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre hospitalier universitaire de Nantes (CHU Nantes), Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications Grenoble - UMR 5525 (TIMC-IMAG), VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP ), Université Grenoble Alpes (UGA), Centre de résonance magnétique biologique et médicale (CRMBM), Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-Centre National de la Recherche Scientifique (CNRS), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), and Hôpital Pasteur [Nice] (CHU)

Subjects
disease modifying treatments, Neurology, breastfeeding, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Neurology (clinical), pregnancy, Neuromyelitis optica, reproductive assistance
Abstract

Background: In 2020, the French Multiple Sclerosis (MS) Society (SFSEP) decided to develop a national evidence-based consensus on pregnancy in MS. As neuromyelitis optica spectrum disorders (NMOSD) shares a series of commonalities with MS, but also some significant differences, specific recommendations had to be developed. Objectives: To establish recommendations on pregnancy in women with NMOSD. Methods: The French Group for Recommendations in Multiple Sclerosis (France4MS) reviewed PubMed and universities databases (January 1975 through June 2021). The RAND/UCLA appropriateness method, which was developed to synthesise the scientific literature and expert opinions on health care topics, was used to reach a formal agreement. Fifty-six MS experts worked on the full-text review and initial wording of recommendations. A sub-group of nine NMOSD experts was dedicated to analysing available data on NMOSD. A group of 62 multidisciplinary healthcare specialists validated the final proposal of summarised evidence. Results: A strong agreement was reached for all 66 proposed recommendations. They cover diverse topics, such as pregnancy planning, follow-up during pregnancy and postpartum, delivery routes, loco-regional analgesia or anaesthesia, prevention of postpartum relapses, breastfeeding, vaccinations, reproductive assistance, management of relapses, and disease-modifying treatments. Conclusion: Physicians and patients should be aware of the new and specific evidence-based recommendations of the French MS Society for pregnancy in women with NMOSD. They should help harmonise counselling and treatment practise, allowing for better individualised choices.

Published
2023
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37. Pregnancy and multiple sclerosis: 2022 recommendations from the French multiple sclerosis society

Author

Sandra Vukusic, Clarisse Carra-Dalliere, Jonathan Ciron, Elisabeth Maillart, Laure Michel, Emmanuelle Leray, Anne-Marie Guennoc, Bertrand Bourre, David Laplaud, Géraldine Androdias, Caroline Bensa, Kevin Bigaut, Damien Biotti, Pierre Branger, Olivier Casez, Mikael Cohen, Elodie Daval, Romain Deschamps, Cécile Donze, Anne-Laure Dubessy, Cécile Dulau, Françoise Durand-Dubief, Maxime Guillaume, Benjamin Hebant, Laurent Kremer, Arnaud Kwiatkowski, Julien Lannoy, Adil Maarouf, Eric Manchon, Guillaume Mathey, Xavier Moisset, Alexis Montcuquet, Julie Pique, Thomas Roux, Romain Marignier, Christine Lebrun-Frenay, Centre de recherche en neurosciences de Lyon - Lyon Neuroscience Research Center (CRNL), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Observatoire Français de la Sclérose En Plaques [Lyon] (OFSEP), Université de Lyon, Fondation Eugène Devic EDMUS, Hôpital Gui de Chauliac, Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Centre Ressources et Compétences sclérose en plaques (CRC-SEP) [CHU Toulouse] (CRC-SEP ), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre de Ressources et de Compétences sur la Sclérose en Plaques (CRC-SEP) [CHU Pitié-Salpêtrière] (CRC-SEP Paris APHP), Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Pontchaillou [Rennes], École des Hautes Études en Santé Publique [EHESP] (EHESP), Centre de Recherches sur l'Action Politique en Europe (ARENES), Université de Rennes (UR)-Institut d'Études Politiques [IEP] - Rennes-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Centre National de la Recherche Scientifique (CNRS), Recherche sur les services et le management en santé (RSMS), Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Service de neurologie [Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU), Centre d’Investigation Clinique de Nantes (CIC Nantes), Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre hospitalier universitaire de Nantes (CHU Nantes), Hospices Civils de Lyon, Departement de Neurologie (HCL), Hôpital de la Fondation Ophtalmologique Adolphe de Rothschild [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre de Ressources et de Compétences sur la Sclérose en Plaques (CRC-SEP) [Strasbourg] (CRC-SEP Alsace), Les Hôpitaux Universitaires de Strasbourg (HUS), Service de Neurologie [CHU Caen], Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN), Université Grenoble Alpes (UGA), Translational Research in Autoimmunity and Inflammation Group (TIMC-T-RAIG), Translational Innovation in Medicine and Complexity / Recherche Translationnelle et Innovation en Médecine et Complexité - UMR 5525 (TIMC ), VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP ), Université Grenoble Alpes (UGA)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP ), Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications Grenoble - UMR 5525 (TIMC-IMAG), Centre Ressources et Compétences sclérose en plaques (CRC-SEP) [CHU de Nice Pasteur 2] (CRC-SEP Côte d'Azur), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Fondation Ophtalmologique Adolphe de Rothschild [Paris], Groupe Hospitalier de l'Institut Catholique de Lille (GHICL), Université catholique de Lille (UCL), Hôpital Saint Philibert [Lomme], Groupement des Hôpitaux de l'Institut Catholique de Lille (GHICL), Université catholique de Lille (UCL)-Université catholique de Lille (UCL), Faculté de Médecine, Maïeutique, Sciences de la Santé - Campus VAUBAN [Lille] (F2M2S), CHU Saint-Antoine [AP-HP], Centre Ressources et Compétences sclérose en plaques (CRC-SEP) [CHU de Bordeaux] (CRC-SEP - Hôpital Pellegrin), Hôpital neurologique et neurochirurgical Pierre Wertheimer [CHU - HCL], Hospices Civils de Lyon (HCL), Normandie Université (NU), Centre Hospitalier de Lens, Centre de résonance magnétique biologique et médicale (CRMBM), Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier de Gonesse, Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Neuro-Dol (Neuro-Dol), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Clermont Auvergne (UCA), Unité de Recherche Clinique de la Côte d’Azur [Nice] (URRIS UR2CA), Université Côte d'Azur (UCA), Jonchère, Laurent, Hôpital Gui de Chauliac [CHU Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre Ressources et Compétences sclérose en plaques (CRC-SEP) [CHU Toulouse] (CRC-SEP Toulouse), Département Neurologie [CHU Toulouse], Pôle Neurosciences [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Pôle Neurosciences [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Unité de Recherche Clinique de la Côte d’Azur (URRIS UR2CA), and Centre Hospitalier Universitaire de Nice (CHU Nice)-Université Côte d'Azur (UCA)

Subjects
Multiple sclerosis, [SDV] Life Sciences [q-bio], Neurology, breastfeeding, [SDV]Life Sciences [q-bio], Neurology (clinical), disease-modifying treatments, pregnancy, reproductive assistance
Abstract

Objective: The objective of this study was to develop evidence-based recommendations on pregnancy management for persons with multiple sclerosis (MS). Background: MS typically affects young women in their childbearing years. Increasing evidence is available to inform questions raised by MS patients and health professionals about pregnancy issues. Methods: The French Group for Recommendations in Multiple Sclerosis (France4MS) reviewed PubMed and university databases (January 1975 through June 2021). The RAND/UCLA appropriateness method was developed to synthesise the scientific literature and expert opinions on healthcare topics; it was used to reach a formal agreement. Fifty-six MS experts worked on the full-text review and initial wording of recommendations. A group of 62 multidisciplinary healthcare specialists validated the final proposal of summarised evidence. Results: A strong agreement was reached for all 104 proposed recommendations. They cover diverse topics, such as pregnancy planning, follow-up during pregnancy and postpartum, delivery routes, locoregional analgesia or anaesthesia, prevention of postpartum relapses, breastfeeding, vaccinations, reproductive assistance, management of relapses and disease-modifying treatments. Conclusion: The 2022 recommendations of the French MS society should be helpful to harmonise counselling and treatment practice for pregnancy in persons with MS, allowing for better and individualised choices.

Published
2023
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38. Improving the decision to switch from first- to second-line therapy in multiple sclerosis: A dynamic scoring system

Author

Sabathé, Camille, primary, Casey, Romain, additional, Vukusic, Sandra, additional, Leray, Emmanuelle, additional, Mathey, Guillaume, additional, De Sèze, Jérôme, additional, Ciron, Jonathan, additional, Wiertlewski, Sandrine, additional, Ruet, Aurélie, additional, Pelletier, Jean, additional, Zéphir, Hélène, additional, Michel, Laure, additional, Lebrun-Frenay, Christine, additional, Moisset, Xavier, additional, Thouvenot, Eric, additional, Camdessanché, Jean-Philippe, additional, Bakchine, Serge, additional, Stankoff, Bruno, additional, Al Khedr, Abdullatif, additional, Cabre, Philippe, additional, Maillart, Elisabeth, additional, Berger, Eric, additional, Heinzlef, Olivier, additional, Hankiewicz, Karolina, additional, Moreau, Thibault, additional, Gout, Olivier, additional, Bourre, Bertrand, additional, Wahab, Abir, additional, Labauge, Pierre, additional, Montcuquet, Alexis, additional, Defer, Gilles, additional, Maurousset, Aude, additional, Maubeuge, Nicolas, additional, Dimitri Boulos, Dalia, additional, Ben Nasr, Haïfa, additional, Nifle, Chantal, additional, Casez, Olivier, additional, Laplaud, David-Axel, additional, and Foucher, Yohann, additional

Published
2022
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39. Time to steroids impacts visual outcome of optic neuritis in MOGAD

Author

Rode, Julie, primary, Pique, Julie, additional, Maarouf, Adil, additional, Ayrignac, Xavier, additional, Bourre, Bertrand, additional, Ciron, Jonathan, additional, Cohen, Mikael, additional, Collongues, Nicolas, additional, Deschamps, Romain, additional, Maillart, Elisabeth, additional, Montcuquet, Alexis, additional, Papeix, Caroline, additional, Ruet, Aurelie, additional, Wiertlewski, Sandrine, additional, Zephir, Helene, additional, Marignier, Romain, additional, and Audoin, Bertrand, additional

Published
2022
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40. Pregnancy and neuromyelitis optica spectrum disorders: 2022 recommendations from the French Multiple Sclerosis Society

Author

Vukusic, Sandra, primary, Marignier, Romain, additional, Ciron, Jonathan, additional, Bourre, Bertrand, additional, Cohen, Mikael, additional, Deschamps, Romain, additional, Guillaume, Maxime, additional, Kremer, Laurent, additional, Pique, Julie, additional, Carra-Dalliere, Clarisse, additional, Michel, Laure, additional, Leray, Emmanuelle, additional, Guennoc, Anne-Marie, additional, Laplaud, David, additional, Androdias, Géraldine, additional, Bensa, Caroline, additional, Bigaut, Kevin, additional, Biotti, Damien, additional, Branger, Pierre, additional, Casez, Olivier, additional, Daval, Elodie, additional, Donze, Cécile, additional, Dubessy, Anne-Laure, additional, Dulau, Cécile, additional, Durand-Dubief, Françoise, additional, Hebant, Benjamin, additional, Kwiatkowski, Arnaud, additional, Lannoy, Julien, additional, Maarouf, Adil, additional, Manchon, Eric, additional, Mathey, Guillaume, additional, Moisset, Xavier, additional, Montcuquet, Alexis, additional, Roux, Thomas, additional, Maillart, Elisabeth, additional, and Lebrun-Frenay, Christine, additional

Published
2022
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41. Pregnancy and multiple sclerosis: 2022 recommendations from the French multiple sclerosis society

Author

Vukusic, Sandra, primary, Carra-Dalliere, Clarisse, additional, Ciron, Jonathan, additional, Maillart, Elisabeth, additional, Michel, Laure, additional, Leray, Emmanuelle, additional, Guennoc, Anne-Marie, additional, Bourre, Bertrand, additional, Laplaud, David, additional, Androdias, Géraldine, additional, Bensa, Caroline, additional, Bigaut, Kevin, additional, Biotti, Damien, additional, Branger, Pierre, additional, Casez, Olivier, additional, Cohen, Mikael, additional, Daval, Elodie, additional, Deschamps, Romain, additional, Donze, Cécile, additional, Dubessy, Anne-Laure, additional, Dulau, Cécile, additional, Durand-Dubief, Françoise, additional, Guillaume, Maxime, additional, Hebant, Benjamin, additional, Kremer, Laurent, additional, Kwiatkowski, Arnaud, additional, Lannoy, Julien, additional, Maarouf, Adil, additional, Manchon, Eric, additional, Mathey, Guillaume, additional, Moisset, Xavier, additional, Montcuquet, Alexis, additional, Pique, Julie, additional, Roux, Thomas, additional, Marignier, Romain, additional, and Lebrun-Frenay;, Christine, additional

Published
2022
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48. Time to steroids impacts visual outcome of optic neuritis in MOGAD

Author

Julie Rode, Julie Pique, Adil Maarouf, Xavier Ayrignac, Bertrand Bourre, Jonathan Ciron, Mikael Cohen, Nicolas Collongues, Romain Deschamps, Elisabeth Maillart, Alexis Montcuquet, Caroline Papeix, Aurelie Ruet, Sandrine Wiertlewski, Helene Zephir, Romain Marignier, Bertrand Audoin, Pôle de Neurosciences Cliniques, Service de Neurologie, APHM, Hôpital de la Timone, Aix-Marseille University, Marseille, France, Centre de résonance magnétique biologique et médicale (CRMBM), and Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-Centre National de la Recherche Scientifique (CNRS)

Subjects
Psychiatry and Mental health, Surgery, Neurology (clinical), [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

BackgroundTo characterise the response to treatment of inaugural optic neuritis (ON) in patients with myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD).MethodsWe searched the French MOGAD database for adults with inaugural ON with a detailed report of acute treatment modalities and measures of high-contrast best-corrected visual acuity (BCVA) at nadir and after 3 months. Predictors of visual outcomes were assessed by multivariable analysis.ResultsAmong 245 patients with at least one episode of ON, 82 fulfilled all criteria, and data on the peripapillary retinal nerve fibre layer (pRNFL) were available for 44. All patients received methylprednisolone (MP), combined with plasma exchange in 18. After 3 months, 75 of 82 (91%) patients retained full BCVA recovery, and median (range) pRNFL of the affected eye was 72 µm (40–102). Failure to regain 0.0 logarithmic minimum angle of resolution vision (Snellen 20/20) at 3 months was associated with time to first MP treatment ≥10 days (OR 16, 95% CI 1.14 to 213, p=0.01). pRNFL thickness after 3 months was related to better BCVA at nadir and time to first MP treatment ConclusionsTime to MP affects functional but also structural visual outcomes of ON in MOGAD.

Published
2022
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50. Untreated patients with multiple sclerosis: A study of French expert centers

Author

Xavier Moisset, Bruno Stankoff, Pierre Clavelou, Karolina Hankiewicz, Bruno Brochet, Olivier Casez, Bruno Pereira, Chantal Nifle, Thibault Moreau, Sandra Vukusic, Christine Lebrun-Frenay, Eric Thouvenot, Alain Créange, Olivier Gout, Corinne Pottier, Olivier Heinzlef, Caroline Papeix, Gilles Defer, Eric Berger, David Laplaud, Audrey-Anne Fouchard, S. Bakchine, Alexis Montcuquet, Jean Pelletier, Jérôme De Seze, Dalia Dimitri Boulos, Jean-Philippe Camdessanché, Pierre Labauge, Bertrand Bourre, Philippe Cabre, Abdullatif Al-Khedr, Aude Maurousset, Frederic Taithe, Gilles Edan, Jonathan Ciron, Nicolas Maubeuge, Guillaume Mathey, Patrick Vermersch, Jonchère, Laurent, Cohortes - Observatoire Français de la Sclérose en Plaques - - OFSEP2010 - ANR-10-COHO-0002 - COHO - VALID, CHU Clermont-Ferrand, Adaptation, mesure et évaluation en santé. Approches interdisciplinaires (APEMAC), Université de Lorraine (UL), Service de neurologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Pontchaillou [Rennes], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Université de Bordeaux (UB), Neurocentre Magendie : Physiopathologie de la Plasticité Neuronale (U1215 Inserm - UB), Université de Bordeaux (UB)-Institut François Magendie-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Bordeaux [Bordeaux], CHU Strasbourg, CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), CHU Lille, Hôpital Lapeyronie [Montpellier] (CHU), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Hôpital Pasteur [Nice] (CHU), Centre d'épidémiologie des populations (CEP), Université de Bourgogne (UB)-Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL), UNICANCER-UNICANCER, Centre hospitalier universitaire de Nantes (CHU Nantes), Centre de Recherche en Transplantation et Immunologie (U1064 Inserm - CRTI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Hôpital de la Timone [CHU - APHM] (TIMONE), CHU Saint-Antoine [AP-HP], Fondation Ophtalmologique Adolphe de Rotschild, Institut de Génomique Fonctionnelle (IGF), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), CHI Poissy-Saint-Germain, CHU Amiens-Picardie, CHU Rouen, Normandie Université (NU), Centre Hospitalier Universitaire [Grenoble] (CHU), CHU de la Martinique [Fort de France], CHU Limoges, CHU Henri Mondor, Centre Hospitalier Universitaire de Saint-Etienne (CHU de Saint-Etienne), Centre Hospitalier Universitaire de Reims (CHU Reims), CHU Trousseau [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Centre Hospitalier de Saint-Denis [Ile-de-France], Centre Hospitalier René Dubos [Pontoise], Centre hospitalier universitaire de Poitiers (CHU Poitiers), Hôpital Bicêtre, Centre Hospitalier Versailles, 78000 Le Chesnay, France, parent, Centre de recherche en neurosciences de Lyon - Lyon Neuroscience Research Center (CRNL), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Université de Lyon, Agence Nationale de la Recherche French National Research Agency (ANR) European Commission [ANR-10-COHO-002], ANR-10-COHO-0002,OFSEP,Observatoire Français de la Sclérose en Plaques(2010), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Toulouse [Toulouse], INSERM, Neurocentre Magendie, U1215, Physiopathologie de la Plasticité Neuronale, F-33000 Bordeaux, France, Université Paul-Valéry - Montpellier 3 (UPVM), Université de Montpellier (UM)-Université Montpellier 1 (UM1)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Montpellier 2 - Sciences et Techniques (UM2)-Centre National de la Recherche Scientifique (CNRS), Centre de recherche en neurosciences de Lyon (CRNL), Université de Lyon-Université de Lyon-Université Jean Monnet [Saint-Étienne] (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), CHU Henri Mondor [Créteil], and Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] (CHU ST-E)

Subjects
Adult, medicine.medical_specialty, Multiple Sclerosis, Multivariate analysis, untreated, [SDV]Life Sciences [q-bio], progressive, Unmet needs, Primary progressive, 03 medical and health sciences, Multiple Sclerosis, Relapsing-Remitting, 0302 clinical medicine, Internal medicine, medicine, Humans, 030212 general & internal medicine, 10. No inequality, Retrospective Studies, unmet medical needs, Expanded Disability Status Scale, business.industry, Multiple sclerosis, Retrospective cohort study, Odds ratio, Middle Aged, Multiple Sclerosis, Chronic Progressive, medicine.disease, relapsing-remitting, Confidence interval, [SDV] Life Sciences [q-bio], Neurology, Neurology (clinical), Neoplasm Recurrence, Local, business, 030217 neurology & neurosurgery
Abstract

International audience; Background and purpose: Disease-modifying therapies (DMTs) have an impact on relapses and disease progression. Nonetheless, many patients with multiple sclerosis (MS) remain untreated. The objectives of the present study were to determine the proportion of untreated patients with MS followed in expert centers in France and to determine the predictive factors of nontreatment. Methods: We conducted a retrospective cohort study. Data were extracted from the 38 centers participating in the European Database for Multiple Sclerosis (EDMUS) on December 15, 2018, and patients with MS seen at least once during the study period (from June 15, 2016 to June 14, 2017) were included. Results: Of the 21,189 patients with MS (age 47.1 +/- 13.1 years; Expanded Disability Status Scale (EDSS) score 3.4 +/- 2.4), 6,631 (31.3%; 95% confidence interval [CI] 30.7-31.9) were not receiving any DMT. Although patients with a relapsing-remitting course (n = 11,693) were the most likely to receive DMT, 14.8% (95% CI 14.2-15.4) were still untreated (6.8% never treated). After multivariate analysis among patients with relapsing-remitting MS, the main factors explaining never having been treated were: not having >= 9 lesions on brain magnetic resonance imaging (odds ratio [OR] 0.52 [95% CI 0.44-0.61]) and lower EDSS score (OR 0.78 [95% CI 0.74-0.82]). Most patients with progressive MS (50.4% for secondary and 64.2% for primary progressive MS) did not receive any DMT during the study period, while 11.6% of patients with secondary and 34.0% of patients with primary progressive MS had never received any DMT. Conclusion: A significant proportion of patients with MS did not receive any DMT, even though such treatments are reimbursed by the healthcare system for French patients. This result highlights the unmet need for current DMTs for a large subgroup of patients with MS.

Published
2021
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