Search

Your search keyword '"Giuliani, Giorgio"' showing total 47 results
Start Over Author "Giuliani, Giorgio"
47 results on '"Giuliani, Giorgio"'

2. Experimental study of ice gouging in a sand seabed

Author

Giuliani, Giorgio

Subjects
620
Abstract

This thesis aims to investigate ice gouging processes in general and the influence of geotechnical parameters on subgouge deformation. A sand channel has been built up at the University of Aberdeen where a number of scaled models of iceberg have been tested. A number of scaled models were manufactured with a base 150 x150mm and different shapes (specifically with the front face angle of 90°, 75º, 60° and 30°) to represent the part of the iceberg below the water line as a rigid body. During the tests several parameters were varied such as: the velocity at which the iceberg models were towed/moved, their mass and shape, and the soil density. All tests were performed in cohesionless soil, dry silica sand placed in a wooden channel. At this stage two different types of tests were carried out: tests at free penetration and tests at fixed penetration. The effects of the iceberg geometry under these various conditions were explored using an instrumented model gouge, with particular attention paid to the resulting tow force and penetration. Tests at free penetration showed that the penetration (P) of the object into the seabed is influenced by its weight and shape as it increased with an increase of the mass and the front face angle (P90º > P75º > P60º > P30º). The drag force (F) is also considered and it increases with an increase in penetration and mass of the object due to the mound of sand formed at front. For tests at fixed penetration (20mm and 30mm depth from the top surface) the attention was on the drag force which was influenced by the shape of the ice models (F90º < F60º < F30º). Pressure sensors were positioned inside the tank from the start point aligned long the same vertical. The purpose was to measure the stress within the seabed during the ice gouging event exerted by the front mound formed on the front of the object. Results showed that the pressure induced by the object decreased with the depth. The test results were compared to an empirical model developed by Kioka (2006) and Barrette (2011). A burial depth of pipeline has been proposed based on the physical gouge model which may allow trenching contractors to make better predictions of ice gouging performance in sands.

Published
2013

3. Increasing age at disability milestones among MS patients in the MSBase Registry

Author

Kister, Ilya, Chamot, Eric, Cutter, Gary, Bacon, Tamar E., Jokubaitis, Vilija G., Hughes, Stella E., Gray, Orla M., Trojano, Maria, Izquierdo, Guillermo, Grand'Maison, Francois, Duquette, Pierre, Lugaresi, Alessandra, Grammond, Pierre, Boz, Cavit, Hupperts, Raymond, Petersen, Thor, Giuliani, Giorgio, Oreja-Guevara, Celia, Iuliano, Gerardo, Lechner-Scott, Jeannette, Bergamaschi, Roberto, Rio, Maria Edite, Verheul, Freek, Fiol, Marcela, Van Pesch, Vincent, Slee, Mark, Butzkueven, Helmut, and Herbert, Joseph

Published
2012
Full Text
View/download PDF

4. Seasonal variation of relapse rate in multiple sclerosis is latitude dependent

Author

Spelman, Tim, Gray, Orla, Trojano, Maria, Petersen, Thor, Izquierdo, Guillermo, Lugaresi, Alessandra, Hupperts, Raymond, Bergamaschi, Roberto, Duquette, Pierre, Grammond, Pierre, Giuliani, Giorgio, Boz, Cavit, Verheul, Freek, Oreja-Guevara, Celia, Barnett, Michael, GrandʼMaison, Francois, Edite Rio, Maria, Lechner-Scott, Jeannette, Van Pesch, Vincent, Fernandez Bolanos, Ricardo, Flechter, Shlomo, Den Braber-Moerland, Leontien, Iuliano, Gerardo, Amato, Maria Pia, Slee, Mark, Cristiano, Edgardo, Saladino, Maria Laura, Paine, Mark, Vella, Norbert, Kasa, Krisztian, Deri, Norma, Herbert, Joseph, Moore, Fraser, Petkovska-Boskova, Tatjana, Alroughani, Raed, Savino, Aldo, Shaw, Cameron, Vucic, Steve, Santiago, Vetere, Bacile, Elizabeth Alejandra, Skromne, Eli, Poehlau, Dieter, Cabrera-Gomez, Jose Antonio, Lucas, Robyn, and Butzkueven, Helmut

Published
2014
Full Text
View/download PDF

5. Sex as a determinant of relapse incidence and progressive course of multiple sclerosis

Author

Kalincik, Tomas, Vivek, Vino, Jokubaitis, Vilija, Lechner-Scott, Jeannette, Trojano, Maria, Izquierdo, Guillermo, Lugaresi, Alessandra, Grand’Maison, Francois, Hupperts, Raymond, Oreja-Guevara, Celia, Bergamaschi, Roberto, Iuliano, Gerardo, Alroughani, Raed, Van Pesch, Vincent, Amato, Maria Pia, Slee, Mark, Verheul, Freek, Fernandez-Bolanos, Ricardo, Fiol, Marcela, Spitaleri, Daniele La, Cristiano, Edgardo, Gray, Orla, Cabrera-Gomez, Jose Antonio, Shaygannejad, Vahid, Herbert, Joseph, Vucic, Steve, Needham, Merilee, Petkovska-Boskova, Tatjana, Sirbu, Carmen-Adella, Duquette, Pierre, Girard, Marc, Grammond, Pierre, Boz, Cavit, Giuliani, Giorgio, Rio, Maria Edite, Barnett, Michael, Flechter, Shlomo, Moore, Fraser, Singhal, Bhim, Bacile, Elizabeth Alejandra, Saladino, Maria Laura, Shaw, Cameron, Skromne, Eli, Poehlau, Dieter, Vella, Norbert, Spelman, Timothy, Liew, Danny, Kilpatrick, Trevor J., and Butzkueven, Helmut

Published
2013
Full Text
View/download PDF

6. The Kurtzke EDSS rank stability increases 4 years after the onset of multiple sclerosis: results from the MSBase Registry

Author

Hughes, Stella, Spelman, Timothy, Trojano, Maria, Lugaresi, Alessandra, Izquierdo, Guillermo, GrandʼMaison, Francois, Duquette, Pierre, Girard, Marc, Grammond, Pierre, Oreja-Guevara, Celia, Hupperts, Raymond, Boz, Cavit, Bergamaschi, Roberto, Giuliani, Giorgio, Rio, Maria Edite, Lechner-Scott, Jeannette, van Pesch, Vincent, Iuliano, Gerardo, Fiol, Marcela, Verheul, Freek, Barnett, Michael, Slee, Mark, Herbert, Joseph, Kister, Ilya, Vella, Norbert, Moore, Fraser, Petkovska-Boskova, Tatjana, Shaygannejad, Vahid, Jokubaitis, Vilija, McDonnell, Gavin, Hawkins, Stanley, Kee, Frank, Gray, Orla, and Butzkueven, Helmut

Published
2012
Full Text
View/download PDF

7. Comparative efficacy of first-line natalizumab vs IFN-β or glatiramer acetate in relapsing MS

Author

Spelman, Tim, Kalincik, Tomas, Jokubaitis, Vilija, Zhang, Annie, Pellegrini, Fabio, Wiendl, Heinz, Belachew, Shibeshih, Hyde, Robert, Verheul, Freek, Lugaresi, Alessandra, Havrdova, Eva, Horakova, Dana, Grammond, Pierre, Duquette, Pierre, Prat, Alexandre, Iuliano, Gerardo, Terzi, Murat, Izquierdo, Guillermo, Hupperts, Raymond M. M., Boz, Cavit, Pucci, Eugenio, Giuliani, Giorgio, Sola, Patrizia, Spitaleri, Daniele L. A., Lechner-Scott, Jeannette, Bergamaschi, Roberto, Grand'Maison, Francois, Granella, Franco, Kappos, Ludwig, Trojano, Maria, Butzkueven, Helmut, MSBase Investigators TOP Investiga, DIPARTIMENTO DI SCIENZE BIOMEDICHE E NEUROMOTORIE, OMÜ, Spelman, T, Kalincik, T, Jokubaitis, V, Zhang, A, Pellegrini, F, Wiendl, H, Belachew, S, Hyde, R, Verheul, F, Lugaresi, A, Havrdová, E, Horáková, D, Grammond, P, Duquette, P, Prat, A, Iuliano, G, Terzi, M, Izquierdo, G, Hupperts, R.M.M, Boz, C, Pucci, E, Giuliani, G, Sola, P, Spitaleri, D.L.A, Lechner-Scott, J, Bergamaschi, R, Grand'Maison, F, Granella, F, Kappos, L, Trojano, M, Butzkueven, H., RS: MHeNs - R1 - Cognitive Neuropsychiatry and Clinical Neuroscience, MUMC+: MA Med Staf Spec Neurologie (9), Klinische Neurowetenschappen, [Spelman, Tim] Univ Melbourne, Royal Melbourne Hosp, Dept Med, Melbourne, Vic 3010, Australia, [Kalincik, Tomas] Univ Melbourne, Royal Melbourne Hosp, Dept Med, Melbourne, Vic 3010, Australia, [Jokubaitis, Vilija] Univ Melbourne, Royal Melbourne Hosp, Dept Med, Melbourne, Vic 3010, Australia, [Butzkueven, Helmut] Univ Melbourne, Royal Melbourne Hosp, Dept Med, Melbourne, Vic 3010, Australia, [Spelman, Tim] Univ Melbourne, Royal Melbourne Hosp, Melbourne Brain Ctr, Melbourne, Vic 3010, Australia, [Kalincik, Tomas] Univ Melbourne, Royal Melbourne Hosp, Melbourne Brain Ctr, Melbourne, Vic 3010, Australia, [Jokubaitis, Vilija] Univ Melbourne, Royal Melbourne Hosp, Melbourne Brain Ctr, Melbourne, Vic 3010, Australia, [Butzkueven, Helmut] Univ Melbourne, Royal Melbourne Hosp, Melbourne Brain Ctr, Melbourne, Vic 3010, Australia, [Zhang, Annie] Biogen Idec Inc, Cambridge, MA USA, [Pellegrini, Fabio] Biogen Idec Inc, Cambridge, MA USA, [Belachew, Shibeshih] Biogen Idec Inc, Cambridge, MA USA, [Hyde, Robert] Biogen Idec Inc, Cambridge, MA USA, [Wiendl, Heinz] Univ Munster, Dept Neurol, Munster, Germany, [Verheul, Freek] Groene Hart Ziekenhuis, Gouda, Netherlands, [Lugaresi, Alessandra] Univ G DAnnunzio, Dept Neurosci Imaging & Clin Sci, MS Ctr, Chieti, Italy, [Havrdova, Eva] Charles Univ Prague, Dept Neurol, MS Ctr, Fac Med 1, Prague, Czech Republic, [Horakova, Dana] Charles Univ Prague, Dept Neurol, MS Ctr, Fac Med 1, Prague, Czech Republic, [Grammond, Pierre] Ctr Readaptat Deficience Phys Chaudiere Appalache, Levis, PQ, Canada, [Duquette, Pierre] Hop Notre Dame De Bon Secours, Montreal, PQ, Canada, [Prat, Alexandre] Hop Notre Dame De Bon Secours, Montreal, PQ, Canada, [Iuliano, Gerardo] Osped Riuniti Salerno, Salerno, Italy, [Terzi, Murat] 19 Mayis Univ, Fac Med, Samsun, Turkey, [Izquierdo, Guillermo] Hosp Univ Virgen Macarena, Seville, Spain, [Hupperts, Raymond M. M.] Orbis Med Ctr, Sittard Geleen, Netherlands, [Boz, Cavit] Farabi Hosp, KTU Med Fac, Trabzon, Turkey, [Pucci, Eugenio] ASUR Marche AV3, Neurol Unit, Macerata, Italy, [Giuliani, Giorgio] ASUR Marche AV3, Neurol Unit, Macerata, Italy, [Sola, Patrizia] Nuovo Osped Civile S Agostino, Modena, Italy, [Spitaleri, Daniele L. A.] AORN San Giuseppe Moscati, Avellino, Italy, [Lechner-Scott, Jeannette] John Hunter Hosp, Newcastle, NSW, Australia, [Bergamaschi, Roberto] IRCCS Mondino, Neurol Inst, Pavia, Italy, [Grand'Maison, Francois] Hop Charles LeMoyne, Neuro Rive Sud, Longueuil, PQ, Canada, [Granella, Franco] Univ Parma, I-43100 Parma, Italy, [Kappos, Ludwig] Univ Basel Hosp, Dept Neurol, Basel, Switzerland, [Trojano, Maria] Univ Bari, Dept Basic Med Sci Neurosci & Sense Organs, I-70121 Bari, Italy, [Butzkueven, Helmut] Monash Univ, Dept Neurol, Eastern Hlth, Clayton, Vic 3800, Australia, NHMRC, NHMRC Center for Research Excellence, MSBase Foundation, Merck Serono, Biogen, Novartis Pharma, Bayer-Schering, Sanofi-Aventis, BioCSL, and Czech Ministry of Education

Subjects
Risk, Oncology, medicine.medical_specialty, Outcomes, 03 medical and health sciences, 0302 clinical medicine, Natalizumab, Patient selection, Internal medicine, Disease-activity, Medicine, 030212 general & internal medicine, Long-term safety, Glatiramer acetate, Autoimmune disease, Predictors, business.industry, Progressive multifocal leukoencephalopathy, Multiple sclerosis, Research, Double-blind, Interferon-beta, medicine.disease, Remitting multiple-sclerosis, Benefits, Institutional repository, Physical therapy, Population study, Observational study, Neurology (clinical), business, 030217 neurology & neurosurgery, medicine.drug
Abstract

Jokubaitis, Vilija G./0000-0002-3942-4340; pietrolongo, erika/0000-0002-6311-5994; Horakova, Dana/0000-0003-1915-0036; Lugaresi, Alessandra/0000-0003-2902-5589; Belachew, Shibeshih/0000-0003-3976-1950; Havrdova, Eva Kubala/0000-0002-9543-4359; Trojano, Maria/0000-0002-6329-8946; Butzkueven, Helmut/0000-0003-3940-8727; Kalincik, Tomas/0000-0003-3778-1376; pucci, eugenio/0000-0001-7606-7330 WOS: 000392602400009 Background: We compared efficacy and treatment persistence in treatment-naive patients with relapsing-remitting multiple sclerosis (RRMS) initiating natalizumab compared with interferon-beta (IFN-beta)/glatiramer acetate (GA) therapies, using propensity score-matched cohorts from observational multiple sclerosis registries. Methods: The study population initiated IFN-beta/GA in the MSBase Registry or natalizumab in the Tysabri Observational Program, had >= 3 months of on-treatment follow-up, and had active RRMS, defined as >= 1 gadolinium-enhancing lesion on cerebral MRI at baseline or >= 1 relapse within the 12 months prior to baseline. Baseline demographics and disease characteristics were balanced between propensity-matched groups. Annualized relapse rate (ARR), time to first relapse, treatment persistence, and disability outcomes were compared between matched treatment arms in the total population (n = 366/group) and subgroups with higher baseline disease activity. Results: First-line natalizumab was associated with a 68% relative reduction in ARR from a mean (SD) of 0.63 (0.92) on IFN-beta/GA to 0.20 (0.63) (p [signed-rank] < 0.0001), a 64% reduction in the rate of first relapse (hazard ratio [HR] 0.36, 95% confidence interval [CI] 0.28-0.47; p < 0.001), and a 27% reduction in the rate of discontinuation (HR 0.73, 95% CI 0.58-0.93; p = 0.01), compared with first-line IFN-beta/GA therapy. Confirmed disability progression and area under the Expanded Disability Status Scale-time curve analyses were not significant. Similar relapse and treatment persistence results were observed in each of the higher disease activity subgroups. Conclusions: This study provides Class IV evidence that first-line natalizumab for RRMS improves relapse and treatment persistence outcomes compared to first-line IFN-beta/GA. This needs to be balanced against the risk of progressive multifocal leukoencephalopathy in natalizumab-treated patients. Classification of evidence: This study provides Class IV evidence that first-line natalizumab for RRMS improves relapse rates and treatment persistence outcomes compared to first-line IFN-beta/GA. NHMRCNational Health and Medical Research Council of Australia [628856, 1071124, 1032484, 1083539]; NHMRC Center for Research ExcellenceNational Health and Medical Research Council of Australia [1001216]; MSBase Foundation; Merck SeronoMerck SeronoMerck & Company; BiogenBiogen; Novartis Pharma; Bayer-ScheringBayer AG; Sanofi-AventisSanofi-Aventis; BioCSL; Czech Ministry of EducationMinistry of Education, Youth & Sports - Czech Republic [PRVOUK-P26/LF1/4] Supported by the NHMRC Career Development Award (Clinical) to H.B. (ID628856), NHMRC Early Career Fellowship (1071124), NHMRC Project Grants (1032484 and 1083539), NHMRC Center for Research Excellence (Grant ID 1001216), and the MSBase Foundation. The MSBase Foundation is a not-for-profit organization that receives support from Merck Serono, Biogen, Novartis Pharma, Bayer-Schering, Sanofi-Aventis, and BioCSL. The Tysabri Observational Program is fully funded by Biogen. E. Havrdova and D. Horakova have been supported by Research Grant of Czech Ministry of Education, PRVOUK-P26/LF1/4.

Published
2016

9. Male sex is independently associated with faster disability accumulation in relapse-onset MS but not in primary progressive MS

Author

UCL - SSS/IONS/CEMO - Pôle Cellulaire et moléculaire, UCL - (SLuc) Service de neurologie, Ribbons, Karen Ann, McElduff, Patrick, Boz, Cavit, Trojano, Maria, Izquierdo, Guillermo, Duquette, Pierre, Girard, Marc, Grand'Maison, Francois, Hupperts, Raymond, Grammond, Pierre, Oreja-Guevara, Celia, Petersen, Thor, Bergamaschi, Roberto, Giuliani, Giorgio, Barnett, Michael, Van Pesch, Vincent, Amato, Maria-Pia, Iuliano, Gerardo, Fiol, Marcela, Slee, Mark, Verheul, Freek, Cristiano, Edgardo, Fernandez-Bolanos, Ricardo, Saladino, Maria-Laura, Rio, Maria Edite, Cabrera-Gomez, Jose, Butzkueven, Helmut, Van Munster, Erik, Braber-Moerland, Leontien Den, Spitaleri, Daniele La, Lugaresi, Alessandra, Shaygannejad, Vahid, Gray, Orla, Deri, Norma, Alroughani, Raed, Lechner-Scott, Jeannette, UCL - SSS/IONS/CEMO - Pôle Cellulaire et moléculaire, UCL - (SLuc) Service de neurologie, Ribbons, Karen Ann, McElduff, Patrick, Boz, Cavit, Trojano, Maria, Izquierdo, Guillermo, Duquette, Pierre, Girard, Marc, Grand'Maison, Francois, Hupperts, Raymond, Grammond, Pierre, Oreja-Guevara, Celia, Petersen, Thor, Bergamaschi, Roberto, Giuliani, Giorgio, Barnett, Michael, Van Pesch, Vincent, Amato, Maria-Pia, Iuliano, Gerardo, Fiol, Marcela, Slee, Mark, Verheul, Freek, Cristiano, Edgardo, Fernandez-Bolanos, Ricardo, Saladino, Maria-Laura, Rio, Maria Edite, Cabrera-Gomez, Jose, Butzkueven, Helmut, Van Munster, Erik, Braber-Moerland, Leontien Den, Spitaleri, Daniele La, Lugaresi, Alessandra, Shaygannejad, Vahid, Gray, Orla, Deri, Norma, Alroughani, Raed, and Lechner-Scott, Jeannette

Abstract

Background: Multiple Sclerosis is more common in women than men and females have more relapses than men. In a large international cohort we have evaluated the effect of gender on disability accumulation and disease progression to determine if male MS patients have a worse clinical outcome than females. Methods: Using the MSBase Registry, data from 15,826 MS patients from 25 countries was analysed. Changes in the severity of MS (EDSS) were compared between sexes using a repeated measures analysis in generalised linear mixed models. Kaplan-Meier analysis was used to test for sex difference in the time to reach EDSS milestones 3 and 6 and the secondary progressive MS. Results: In relapse onset MS patients (n = 14,453), males progressed significantly faster in their EDSS than females (0.133 vs 0.112 per year, P<0.001,). Females had a reduced risk of secondary progressive MS (HR (95% CI) = 0.77 (0.67 to 0.90) P = 0.001). In primary progressive MS (n = 1,373), there was a significant increase in EDSS over time in males and females (P<0.001) but there was no significant sex effect on the annualized rate of EDSS change. Conclusion: Among registrants of MSBase, male relapse-onset patients accumulate disability faster than female patients. In contrast, the rate of disability accumulation between male and female patients with primary progressive MS is similar.

Published
2015

10. Predictors of disability worsening in clinically isolated syndrome.

Author

UCL - (SLuc) Service de neurologie, UCL - SSS/IONS/CEMO - Pôle Cellulaire et moléculaire, Jokubaitis, Vilija G, Spelman, Tim, Kalincik, Tomas, Izquierdo, Guillermo, Grand'Maison, François, Duquette, Pierre, Girard, Marc, Lugaresi, Alessandra, Grammond, Pierre, Hupperts, Raymond, Cabrera-Gomez, José, Oreja-Guevara, Celia, Boz, Cavit, Giuliani, Giorgio, Fernández-Bolaños, Ricardo, Iuliano, Gerardo, Lechner-Scott, Jeannette, Verheul, Freek, Van Pesch, Vincent, Petkovska-Boskova, Tatjana, Fiol, Marcela, Moore, Fraser, Cristiano, Edgardo, Alroughani, Raed, Bergamaschi, Roberto, Barnett, Michael, Slee, Mark, Vella, Norbert, Herbert, Joseph, Shaw, Cameron, Saladino, Maria Laura, Amato, Maria Pia, Liew, Danny, Paolicelli, Damiano, Butzkueven, Helmut, Trojano, Maria, UCL - (SLuc) Service de neurologie, UCL - SSS/IONS/CEMO - Pôle Cellulaire et moléculaire, Jokubaitis, Vilija G, Spelman, Tim, Kalincik, Tomas, Izquierdo, Guillermo, Grand'Maison, François, Duquette, Pierre, Girard, Marc, Lugaresi, Alessandra, Grammond, Pierre, Hupperts, Raymond, Cabrera-Gomez, José, Oreja-Guevara, Celia, Boz, Cavit, Giuliani, Giorgio, Fernández-Bolaños, Ricardo, Iuliano, Gerardo, Lechner-Scott, Jeannette, Verheul, Freek, Van Pesch, Vincent, Petkovska-Boskova, Tatjana, Fiol, Marcela, Moore, Fraser, Cristiano, Edgardo, Alroughani, Raed, Bergamaschi, Roberto, Barnett, Michael, Slee, Mark, Vella, Norbert, Herbert, Joseph, Shaw, Cameron, Saladino, Maria Laura, Amato, Maria Pia, Liew, Danny, Paolicelli, Damiano, Butzkueven, Helmut, and Trojano, Maria

Abstract

To assess demographic, clinical, magnetic resonance imaging, and treatment exposure predictors of time to 3 or 12-month confirmed disability worsening in clinically isolated syndrome (CIS) and early multiple sclerosis (MS).

Published
2015

11. Predictors of disability worsening in clinically isolated syndrome

Author

Jokubaitis, Vilija G, Spelman, Tim, Kalincik, Tomas, Izquierdo, Guillermo, Grand'Maison, Francois, Duquette, Pierre, Girard, Marc, Lugaresi, Alessandra, Grammond, Pierre, Hupperts, Raymond, Cabrera-Gomez, Jose, Oreja-Guevara, Celia, Boz, Cavit, Giuliani, Giorgio, Fernández-Bolaños, Ricardo, Iuliano, Gerardo, Lechner-Scott, Jeannette, Verheul, Freek, van Pesch, Vincent, Petkovska-Boskova, Tatjana, Fiol, Marcela, Moore, Fraser, Cristiano, Edgardo, Alroughani, Raed, Bergamaschi, Roberto, Barnett, Michael, Slee, Mark, Vella, Norbert, Herbert, Joseph, Shaw, Cameron, Saladino, Maria Laura, Amato, Maria Pia, Liew, Danny, Paolicelli, Damiano, Butzkueven, Helmut, Trojano, Maria, MSBasis Study Group, Jokubaitis, Vilija G, Spelman, Tim, Kalincik, Tomas, Izquierdo, Guillermo, Grand'Maison, Francois, Duquette, Pierre, Girard, Marc, Lugaresi, Alessandra, Grammond, Pierre, Hupperts, Raymond, Cabrera-Gomez, Jose, Oreja-Guevara, Celia, Boz, Cavit, Giuliani, Giorgio, Fernández-Bolaños, Ricardo, Iuliano, Gerardo, Lechner-Scott, Jeannette, Verheul, Freek, van Pesch, Vincent, Petkovska-Boskova, Tatjana, Fiol, Marcela, Moore, Fraser, Cristiano, Edgardo, Alroughani, Raed, Bergamaschi, Roberto, Barnett, Michael, Slee, Mark, Vella, Norbert, Herbert, Joseph, Shaw, Cameron, Saladino, Maria Laura, Amato, Maria Pia, Liew, Danny, Paolicelli, Damiano, Butzkueven, Helmut, Trojano, Maria, and MSBasis Study Group

Abstract

Objective To assess demographic, clinical, magnetic resonance imaging, and treatment exposure predictors of time to 3 or 12-month confirmed disability worsening in clinically isolated syndrome (CIS) and early multiple sclerosis (MS). Methods We utilized the MSBase Incident Study (MSBasis), a prospective cohort study of outcome after CIS. Predictors of time to first 3 and 12-month confirmed expanded disability status scale worsening were analyzed using Cox proportional hazards regression. Results About 1989 patients were analyzed, the largest seen-from-onset cohort reported to-date. A total of 391 patients had a first 3-month confirmed disability worsening event, of which 307 were sustained for 12 months. Older age at CIS onset (adjusted hazard ratio: aHR 1.17, 95% 1.06, 1.30), pyramidal (aHR 1.45, 95% CI 1.13, 1.89) and ambulation (HR 1.60, 95% CI 1.09, 2.34) system dysfunction, annualized relapse rate (aHR 1.20, 95% CI 1.18, 1.22), and lower proportion of observation time on treatment were associated with 3-month confirmed worsening. Predictors of time to 12-month sustained worsening included pyramidal system dysfunction (Hazard ratio: aHR 1.38, 95% CI 1.05, 1.83), and older age at CIS onset (aHR 1.17, 95% CI 1.04, 1.31). Greater proportion of follow-up time exposed to treatment was associated with greater reductions in the rate of worsening. Interpretation This study provides class IV evidence for a strong protective effect of disease-modifying treatment to reduce disability worsening events in patients with CIS and early MS, and confirms age and pyramidal dysfunction at onset as risk factors.

Published
2015

12. Multiple sclerosis in Latin America: A different disease course severity? A collaborative study from the MSBase Registry

Author

Rojas, Juan Ignacio, primary, Patrucco, Liliana, additional, Trojano, Maria, additional, Lugaresi, Alessandra, additional, Izquierdo, Guillermo, additional, Butzkueven, Helmut, additional, Jokubaitis, Vilija, additional, Duquette, Pierre, additional, Girard, Marc, additional, Grand’Maison, Francois, additional, Grammond, Pierre, additional, Oreja-Guevara, Celia, additional, Hupperts, Raymond, additional, Boz, Cavit, additional, Petersen, Thor, additional, Bergamaschi, Roberto, additional, Giuliani, Giorgio, additional, Lechner-Scott, Jeannette, additional, Barnett, Michael, additional, Rio, Maria Edite, additional, Van Pesch, Vincent, additional, Amato, Maria Pia, additional, Iuliano, Gerardo, additional, Fiol, Marcela, additional, Slee, Mark, additional, Verheul, Freek, additional, Fernandez-Bolanos, Ricardo, additional, Poehlau, Dieter, additional, Saladino, Maria Laura, additional, Braber-Moerland, Leontien Den, additional, Deri, Norma, additional, Oleschko-Arruda, Walter, additional, Cabrera-Gomez, Jose Antonio, additional, Paine, Mark, additional, Vella, Norbert, additional, Kister, Ilya, additional, Skromne, Eli, additional, Savino, Aldo, additional, Shaw, Cameron, additional, Moore, Fraser, additional, Vucic, Steve, additional, Petkovska-Boskova, Tatjana, additional, Bacile, Elizabeth Alejandra Bacile, additional, Santiago, Vetere, additional, and Cristiano, Edgardo, additional

Published
2015
Full Text
View/download PDF

13. Male Sex Is Independently Associated with Faster Disability Accumulation in Relapse-Onset MS but Not in Primary Progressive MS

Author

Ribbons, Karen Ann, primary, McElduff, Patrick, additional, Boz, Cavit, additional, Trojano, Maria, additional, Izquierdo, Guillermo, additional, Duquette, Pierre, additional, Girard, Marc, additional, Grand’Maison, Francois, additional, Hupperts, Raymond, additional, Grammond, Pierre, additional, Oreja-Guevara, Celia, additional, Petersen, Thor, additional, Bergamaschi, Roberto, additional, Giuliani, Giorgio, additional, Barnett, Michael, additional, van Pesch, Vincent, additional, Amato, Maria-Pia, additional, Iuliano, Gerardo, additional, Fiol, Marcela, additional, Slee, Mark, additional, Verheul, Freek, additional, Cristiano, Edgardo, additional, Fernandez-Bolanos, Ricardo, additional, Saladino, Maria-Laura, additional, Rio, Maria Edite, additional, Cabrera-Gomez, Jose, additional, Butzkueven, Helmut, additional, van Munster, Erik, additional, Den Braber-Moerland, Leontien, additional, La Spitaleri, Daniele, additional, Lugaresi, Alessandra, additional, Shaygannejad, Vahid, additional, Gray, Orla, additional, Deri, Norma, additional, Alroughani, Raed, additional, and Lechner-Scott, Jeannette, additional

Published
2015
Full Text
View/download PDF

14. Predictors and dynamics of postpartum relapses in women with multiple sclerosis

Author

UCL - SSS/IONS/CEMO - Pôle Cellulaire et moléculaire, UCL - (SLuc) Service de neurologie, Hughes, Stella E, Spelman, Tim, Gray, Orla M, Boz, Cavit, Trojano, Maria, Lugaresi, Alessandra, Izquierdo, Guillermo, Duquette, Pierre, Girard, Marc, Grand'maison, Francois, MSBase study group, Grammond, Pierre, Oreja-Guevara, Celia, Hupperts, Raymond, Bergamaschi, Roberto, Giuliani, Giorgio, Lechner-Scott, Jeannette, Barnett, Michael, Edite Rio, Maria, Van Pesch, Vincent, Amato, Maria Pia, Iuliano, Gerardo, Slee, Mark, Verheul, Freek, Cristiano, Edgardo, Fernández-Bolaños, Ricardo, Poehlau, Dieter, Saladino, Maria Laura, Deri, Norma, Cabrera-Gomez, Jose, Vella, Norbert, Herbert, Joseph, Skromne, Eli, Savino, Aldo, Shaw, Cameron, Moore, Fraser, Vucic, Steve, Petkovska-Boskova, Tatjana, McDonnell, Gavin, Hawkins, Stanley, Kee, Frank, Butzkueven, Helmut, UCL - SSS/IONS/CEMO - Pôle Cellulaire et moléculaire, UCL - (SLuc) Service de neurologie, Hughes, Stella E, Spelman, Tim, Gray, Orla M, Boz, Cavit, Trojano, Maria, Lugaresi, Alessandra, Izquierdo, Guillermo, Duquette, Pierre, Girard, Marc, Grand'maison, Francois, MSBase study group, Grammond, Pierre, Oreja-Guevara, Celia, Hupperts, Raymond, Bergamaschi, Roberto, Giuliani, Giorgio, Lechner-Scott, Jeannette, Barnett, Michael, Edite Rio, Maria, Van Pesch, Vincent, Amato, Maria Pia, Iuliano, Gerardo, Slee, Mark, Verheul, Freek, Cristiano, Edgardo, Fernández-Bolaños, Ricardo, Poehlau, Dieter, Saladino, Maria Laura, Deri, Norma, Cabrera-Gomez, Jose, Vella, Norbert, Herbert, Joseph, Skromne, Eli, Savino, Aldo, Shaw, Cameron, Moore, Fraser, Vucic, Steve, Petkovska-Boskova, Tatjana, McDonnell, Gavin, Hawkins, Stanley, Kee, Frank, and Butzkueven, Helmut

Abstract

BACKGROUND: Several studies have shown that pregnancy reduces multiple sclerosis (MS) relapses, which increase in the early postpartum period. Postpartum relapse risk has been predicted by pre-pregnancy disease activity in some studies. OBJECTIVE: To re-examine effect of pregnancy on relapses using the large international MSBase Registry, examining predictors of early postpartum relapse. METHODS: An observational case-control study was performed including pregnancies post-MS onset. Annualised relapse rate (ARR) and median Expanded Disability Status Scale (EDSS) scores were compared for the 24 months pre-conception, pregnancy and 24 months postpartum periods. Clustered logistic regression was used to investigate predictors of early postpartum relapses. RESULTS: The study included 893 pregnancies in 674 females with MS. ARR (standard error) pre-pregnancy was 0.32 (0.02), which fell to 0.13 (0.03) in the third trimester and rose to 0.61 (0.06) in the first three months postpartum. Median EDSS remained unchanged. Pre-conception ARR and disease-modifying treatment (DMT) predicted early postpartum relapse in a multivariable model. CONCLUSION: Results confirm a favourable effect on relapses as pregnancy proceeds, and an early postpartum peak. Pre-conception DMT exposure and low ARR were independently protective against postpartum relapse. This novel finding could provide clinicians with a strategy to minimise postpartum relapse risk in women with MS planning pregnancy.

Published
2014

15. Seasonal variation of relapse rate in multiple sclerosis is latitude dependent

Author

UCL - SSS/IONS/CEMO - Pôle Cellulaire et moléculaire, UCL - (SLuc) Service de neurologie, Spelman, Tim, Gray, Orla, Trojano, Maria, Petersen, Thor, Izquierdo, Guillermo, Lugaresi, Alessandra, Hupperts, Raymond, Bergamaschi, Roberto, Duquette, Pierre, Grammond, Pierre, Giuliani, Giorgio, Boz, Cavit, Verheul, Freek, Oreja-Guevara, Celia, Barnett, Michael, Grand'Maison, Francois, Edite Rio, Maria, Lechner-Scott, Jeannette, Van Pesch, Vincent, Fernandez Bolanos, Ricardo, Flechter, Shlomo, Den Braber-Moerland, Leontien, Iuliano, Gerardo, Amato, Maria Pia, Slee, Mark, Cristiano, Edgardo, Saladino, Maria Laura, Paine, Mark, Vella, Norbert, Kasa, Krisztian, Deri, Norma, Herbert, Joseph, Moore, Fraser, Petkovska-Boskova, Tatjana, Alroughani, Raed, Savino, Aldo, Shaw, Cameron, Vucic, Steve, Santiago, Vetere, Bacile, Elizabeth Alejandra, Skromne, Eli, Poehlau, Dieter, Cabrera-Gomez, Jose Antonio, Lucas, Robyn, Butzkueven, Helmut, UCL - SSS/IONS/CEMO - Pôle Cellulaire et moléculaire, UCL - (SLuc) Service de neurologie, Spelman, Tim, Gray, Orla, Trojano, Maria, Petersen, Thor, Izquierdo, Guillermo, Lugaresi, Alessandra, Hupperts, Raymond, Bergamaschi, Roberto, Duquette, Pierre, Grammond, Pierre, Giuliani, Giorgio, Boz, Cavit, Verheul, Freek, Oreja-Guevara, Celia, Barnett, Michael, Grand'Maison, Francois, Edite Rio, Maria, Lechner-Scott, Jeannette, Van Pesch, Vincent, Fernandez Bolanos, Ricardo, Flechter, Shlomo, Den Braber-Moerland, Leontien, Iuliano, Gerardo, Amato, Maria Pia, Slee, Mark, Cristiano, Edgardo, Saladino, Maria Laura, Paine, Mark, Vella, Norbert, Kasa, Krisztian, Deri, Norma, Herbert, Joseph, Moore, Fraser, Petkovska-Boskova, Tatjana, Alroughani, Raed, Savino, Aldo, Shaw, Cameron, Vucic, Steve, Santiago, Vetere, Bacile, Elizabeth Alejandra, Skromne, Eli, Poehlau, Dieter, Cabrera-Gomez, Jose Antonio, Lucas, Robyn, and Butzkueven, Helmut

Abstract

OBJECTIVE: Previous studies assessing seasonal variation of relapse onset in multiple sclerosis have had conflicting results. Small relapse numbers, differing diagnostic criteria, and single region studies limit the generalizability of prior results. The aim of this study was to determine whether there is a temporal variation in onset of relapses in both hemispheres and to determine whether seasonal peak relapse probability varies with latitude. METHODS: The international MSBase Registry was utilized to analyze seasonal relapse onset distribution by hemisphere and latitudinal location. All analyses were weighted for the patient number contributed by each center. A sine regression model was used to model relapse onset and ultraviolet radiation (UVR) seasonality. Linear regression was used to investigate associations of latitude and lag between UVR trough and subsequent relapse peak. RESULTS: A total of 32,762 relapses from 9,811 patients across 30 countries were analyzed. Relapse onset followed an annual cyclical sinusoidal pattern with peaks in early spring and troughs in autumn in both hemispheres. Every 10° of latitude away from the equator was associated with a mean decrease in UVR trough to subsequent relapse peak lag of 28.5 days (95% confidence interval = 3.29-53.71, p = 0.028). INTERPRETATION: We demonstrate for the first time that there is a latitude-dependent relationship between seasonal UVR trough and relapse onset probability peak independent of location-specific UVR levels, with more distal latitude associated with shorter gaps. We confirm prior meta-analyses showing a strong seasonal relapse onset probability variation in the northern hemisphere, and extend this observation to the southern hemisphere. Ann Neurol 2014;76:880-890.

Published
2014

16. Risk of relapse phenotype recurrence in multiple sclerosis

Author

UCL - SSS/IONS/CEMO - Pôle Cellulaire et moléculaire, UCL - (SLuc) Service de neurologie, Kalincik, Tomas, Buzzard, Katherine, Jokubaitis, Vilija, Trojano, Maria, Duquette, Pierre, Izquierdo, Guillermo, Girard, Marc, Lugaresi, Alessandra, Grammond, Pierre, Grand'Maison, Francois, Oreja-Guevara, Celia, Boz, Cavit, Hupperts, Raymond, Petersen, Thor, Giuliani, Giorgio, Iuliano, Gerardo, Lechner-Scott, Jeannette, Barnett, Michael, Bergamaschi, Roberto, Van Pesch, Vincent, Amato, Maria Pia, van Munster, Erik, Fernandez-Bolanos, Ricardo, Verheul, Freek, Fiol, Marcela, Cristiano, Edgardo, Slee, Mark, Rio, Maria Edite, Spitaleri, Daniele, Alroughani, Raed, Gray, Orla, Saladino, Maria Laura, Flechter, Sholmo, Herbert, Joseph, Cabrera-Gomez, Jose Antonio, Vella, Norbert, Paine, Mark, Shaw, Cameron, Moore, Fraser, Vucic, Steve, Savino, Aldo, Singhal, Bhim, Petkovska-Boskova, Tatjana, Parratt, John, Sirbu, Carmen-Adella, Rozsa, Csilla, Liew, Danny, Butzkueven, Helmut, UCL - SSS/IONS/CEMO - Pôle Cellulaire et moléculaire, UCL - (SLuc) Service de neurologie, Kalincik, Tomas, Buzzard, Katherine, Jokubaitis, Vilija, Trojano, Maria, Duquette, Pierre, Izquierdo, Guillermo, Girard, Marc, Lugaresi, Alessandra, Grammond, Pierre, Grand'Maison, Francois, Oreja-Guevara, Celia, Boz, Cavit, Hupperts, Raymond, Petersen, Thor, Giuliani, Giorgio, Iuliano, Gerardo, Lechner-Scott, Jeannette, Barnett, Michael, Bergamaschi, Roberto, Van Pesch, Vincent, Amato, Maria Pia, van Munster, Erik, Fernandez-Bolanos, Ricardo, Verheul, Freek, Fiol, Marcela, Cristiano, Edgardo, Slee, Mark, Rio, Maria Edite, Spitaleri, Daniele, Alroughani, Raed, Gray, Orla, Saladino, Maria Laura, Flechter, Sholmo, Herbert, Joseph, Cabrera-Gomez, Jose Antonio, Vella, Norbert, Paine, Mark, Shaw, Cameron, Moore, Fraser, Vucic, Steve, Savino, Aldo, Singhal, Bhim, Petkovska-Boskova, Tatjana, Parratt, John, Sirbu, Carmen-Adella, Rozsa, Csilla, Liew, Danny, and Butzkueven, Helmut

Abstract

OBJECTIVES: The aim was to analyse risk of relapse phenotype recurrence in multiple sclerosis and to characterise the effect of demographic and clinical features on this phenotype. METHODS: Information about relapses was collected using MSBase, an international observational registry. Associations between relapse phenotypes and history of similar relapses or patient characteristics were tested with multivariable logistic regression models. Tendency of relapse phenotypes to recur sequentially was assessed with principal component analysis. RESULTS: Among 14,969 eligible patients (89,949 patient-years), 49,279 phenotypically characterised relapses were recorded. Visual and brainstem relapses occurred more frequently in early disease and in younger patients. Sensory relapses were more frequent in early or non-progressive disease. Pyramidal, sphincter and cerebellar relapses were more common in older patients and in progressive disease. Women presented more often with sensory or visual symptoms. Men were more prone to pyramidal, brainstem and cerebellar relapses. Importantly, relapse phenotype was predicted by the phenotypes of previous relapses. (OR = 1.8-5, p = 10(-14)). Sensory, visual and brainstem relapses showed better recovery than other relapse phenotypes. Relapse severity increased and the ability to recover decreased with age or more advanced disease. CONCLUSION: Relapse phenotype was associated with demographic and clinical characteristics, with phenotypic recurrence significantly more common than expected by chance.

Published
2014

17. Clinical Predictors Of Expanded Disability Status Scale Rank Change Over 5-Year Intervals In The MSBase Registry (P4.187)

Author

Hughes, Stella, primary, Spelman, Timothy, additional, Trojano, Maria, additional, Lugaresi, Alessandra, additional, Izquierdo, Guillermo, additional, Grand-Maison, Francois, additional, Duquette, Pierre, additional, Girard, Marc, additional, Grammond, Pierre, additional, Oreja-Guevara, Celia, additional, Hupperts, Raymond, additional, Boz, Cavit, additional, Bergamaschi, Roberto, additional, Giuliani, Giorgio, additional, Rio, Edite, additional, Lechner-Scott, Jeannette, additional, Van Pesch, Vincent, additional, Iuliano, Gerardo, additional, Fiol, Marcela, additional, Verheul, Freek, additional, Barnett, Michael, additional, Slee, Mark, additional, Herbert, Joseph, additional, Kister, Ilya, additional, Vella, Norbert, additional, Moore, Fraser, additional, Petkovska-Boskova, Tatjana, additional, Shaygannejad, Vahid, additional, Jokubaitis, Vilija, additional, McDonnell, Gavin, additional, Hawkins, Stanley, additional, Kee, Frank, additional, Butzkueven, Helmut, additional, and Gray, Orla, additional

Published
2014
Full Text
View/download PDF

18. Sex as a determinant of relapse incidence and progressive course of multiple sclerosis.

Author

UCL - SSS/IONS/CEMO - Pôle Cellulaire et moléculaire, UCL - (SLuc) Service de neurologie, Kalincik, Tomas, Vivek, Vino, Jokubaitis, Vilija, Lechner-Scott, Jeannette, Trojano, Maria, Izquierdo, Guillermo, Lugaresi, Alessandra, Grand'maison, Francois, Hupperts, Raymond, Oreja-Guevara, Celia, Bergamaschi, Roberto, Iuliano, Gerardo, Alroughani, Raed, Van Pesch, Vincent, Amato, Maria Pia, Slee, Mark, Verheul, Freek, Fernandez-Bolanos, Ricardo, Fiol, Marcela, Spitaleri, Daniele La, Cristiano, Edgardo, Gray, Orla, Cabrera-Gomez, Jose Antonio, Shaygannejad, Vahid, Herbert, Joseph, Vucic, Steve, Needham, Merilee, Petkovska-Boskova, Tatjana, Sirbu, Carmen-Adella, Duquette, Pierre, Girard, Marc, Grammond, Pierre, Boz, Cavit, Giuliani, Giorgio, Rio, Maria Edite, Barnett, Michael, Flechter, Shlomo, Moore, Fraser, Singhal, Bhim, Bacile, Elizabeth Alejandra, Saladino, Maria Laura, Shaw, Cameron, Skromne, Eli, Poehlau, Dieter, Vella, Norbert, Spelman, Timothy, Liew, Danny, Kilpatrick, Trevor J, Butzkueven, Helmut, UCL - SSS/IONS/CEMO - Pôle Cellulaire et moléculaire, UCL - (SLuc) Service de neurologie, Kalincik, Tomas, Vivek, Vino, Jokubaitis, Vilija, Lechner-Scott, Jeannette, Trojano, Maria, Izquierdo, Guillermo, Lugaresi, Alessandra, Grand'maison, Francois, Hupperts, Raymond, Oreja-Guevara, Celia, Bergamaschi, Roberto, Iuliano, Gerardo, Alroughani, Raed, Van Pesch, Vincent, Amato, Maria Pia, Slee, Mark, Verheul, Freek, Fernandez-Bolanos, Ricardo, Fiol, Marcela, Spitaleri, Daniele La, Cristiano, Edgardo, Gray, Orla, Cabrera-Gomez, Jose Antonio, Shaygannejad, Vahid, Herbert, Joseph, Vucic, Steve, Needham, Merilee, Petkovska-Boskova, Tatjana, Sirbu, Carmen-Adella, Duquette, Pierre, Girard, Marc, Grammond, Pierre, Boz, Cavit, Giuliani, Giorgio, Rio, Maria Edite, Barnett, Michael, Flechter, Shlomo, Moore, Fraser, Singhal, Bhim, Bacile, Elizabeth Alejandra, Saladino, Maria Laura, Shaw, Cameron, Skromne, Eli, Poehlau, Dieter, Vella, Norbert, Spelman, Timothy, Liew, Danny, Kilpatrick, Trevor J, and Butzkueven, Helmut

Abstract

The aim of this work was to evaluate sex differences in the incidence of multiple sclerosis relapses; assess the relationship between sex and primary progressive disease course; and compare effects of age and disease duration on relapse incidence. Annualized relapse rates were calculated using the MSBase registry. Patients with incomplete data or <1 year of follow-up were excluded. Patients with primary progressive multiple sclerosis were only included in the sex ratio analysis. Relapse incidences over 40 years of multiple sclerosis or 70 years of age were compared between females and males with Andersen-Gill and Tweedie models. Female-to-male ratios stratified by annual relapse count were evaluated across disease duration and patient age and compared between relapse-onset and primary progressive multiple sclerosis. The study cohort consisted of 11 570 eligible patients with relapse-onset and 881 patients with primary progressive multiple sclerosis. Among the relapse-onset patients (82 552 patient-years), 48 362 relapses were recorded. Relapse frequency was 17.7% higher in females compared with males. Within the initial 5 years, the female-to-male ratio increased from 2.3:1 to 3.3:1 in patients with 0 versus ≥4 relapses per year, respectively. The magnitude of this sex effect increased at longer disease duration and older age (P < 10(-12)). However, the female-to-male ratio in patients with relapse-onset multiple sclerosis and zero relapses in any given year was double that of the patients with primary progressive multiple sclerosis. Patient age was a more important determinant of decline in relapse incidence than disease duration (P < 10(-12)). Females are predisposed to higher relapse activity than males. However, this difference does not explain the markedly lower female-to-male sex ratio in primary progressive multiple sclerosis. Decline in relapse activity over time is more closely related to patient age than disease duration.

Published
2013

19. Persistence on therapy and propensity matched outcome comparison of two subcutaneous interferon beta 1a dosages for multiple sclerosis

Author

Kalincik, Tomas, Spelman, Timothy, Trojano, Maria, Duquette, Pierre, Izquierdo, Guillermo, Grammond, Pierre, Lugaresi, Alessandra, Hupperts, Raymond, Cristiano, Edgardo, Van Pesch, Vincent, Grand'Maison, Francois, La Spitaleri, Daniele, Rio, Maria Edite, Flechter, Shlomo, Oreja-Guevara, Celia, Giuliani, Giorgio, Savino, Aldo, Amato, Maria Pia, Peterson, Thor, Fernandez-Bolanos, Ricardo, Bergamaschi, Roberto, Iuliano, Gerardo, Boz, Cavit, Lechner-Scott, Jeannette, Deri, Norma, Gray, Orla, Verheul, Freek, Fiol, Marcela, Barnett, Michael, van Munster, Erik, Santiago, Vetere, Moore, Fraser, Slee, Mark, Saladino, Maria Laura, Alroughani, Raed, Shaw, Cameron, Kasa, Krisztian, Petkovska-Boskova, Tatjana, den Braber-Moerland, Leontien, Chapman, Joab, Skromne, Eli, Herbert, Joseph, Peohlau, Dieter, Needham, Merrilee, Bacile, Elizabeth Alejandra, Oleschko Arruda, Walter, Paine, Mark, Singhal, Bhim, Vucic, Steve, Cabrera-Gomez, Jose Antonio, Butkueven, Helmut, Kalincik, Tomas, Spelman, Timothy, Trojano, Maria, Duquette, Pierre, Izquierdo, Guillermo, Grammond, Pierre, Lugaresi, Alessandra, Hupperts, Raymond, Cristiano, Edgardo, Van Pesch, Vincent, Grand'Maison, Francois, La Spitaleri, Daniele, Rio, Maria Edite, Flechter, Shlomo, Oreja-Guevara, Celia, Giuliani, Giorgio, Savino, Aldo, Amato, Maria Pia, Peterson, Thor, Fernandez-Bolanos, Ricardo, Bergamaschi, Roberto, Iuliano, Gerardo, Boz, Cavit, Lechner-Scott, Jeannette, Deri, Norma, Gray, Orla, Verheul, Freek, Fiol, Marcela, Barnett, Michael, van Munster, Erik, Santiago, Vetere, Moore, Fraser, Slee, Mark, Saladino, Maria Laura, Alroughani, Raed, Shaw, Cameron, Kasa, Krisztian, Petkovska-Boskova, Tatjana, den Braber-Moerland, Leontien, Chapman, Joab, Skromne, Eli, Herbert, Joseph, Peohlau, Dieter, Needham, Merrilee, Bacile, Elizabeth Alejandra, Oleschko Arruda, Walter, Paine, Mark, Singhal, Bhim, Vucic, Steve, Cabrera-Gomez, Jose Antonio, and Butkueven, Helmut

Abstract

To compare treatment persistence between two dosages of interferon β-1a in a large observational multiple sclerosis registry and assess disease outcomes of first line MS treatment at these dosages using propensity scoring to adjust for baseline imbalance in disease characteristics. Treatment discontinuations were evaluated in all patients within the MSBase registry who commenced interferon β-1a SC thrice weekly (n = 4678). Furthermore, we assessed 2-year clinical outcomes in 1220 patients treated with interferon β-1a in either dosage (22 µg or 44 µg) as their first disease modifying agent, matched on propensity score calculated from pre-treatment demographic and clinical variables. A subgroup analysis was performed on 456 matched patients who also had baseline MRI variables recorded. Overall, 4054 treatment discontinuations were recorded in 3059 patients. The patients receiving the lower interferon dosage were more likely to discontinue treatment than those with the higher dosage (25% vs. 20% annual probability of discontinuation, respectively). This was seen in discontinuations with reasons recorded as “lack of efficacy” (3.3% vs. 1.7%), “scheduled stop” (2.2% vs. 1.3%) or without the reason recorded (16.7% vs. 13.3% annual discontinuation rate, 22 µg vs. 44 µg dosage, respectively). Propensity score was determined by treating centre and disability (score without MRI parameters) or centre, sex and number of contrast-enhancing lesions (score including MRI parameters). No differences in clinical outcomes at two years (relapse rate, time relapse-free and disability) were observed between the matched patients treated with either of the interferon dosages. Treatment discontinuations were more common in interferon β-1a 22 µg SC thrice weekly. However, 2-year clinical outcomes did not differ between patients receiving the different dosages, thus replicating in a registry dataset derived from &ldquo

Published
2013

20. Geographical variations in sex ratio trends over time in multiple sclerosis

Author

UCL - SSS/IONS/CEMO - Pôle Cellulaire et moléculaire, UCL - (SLuc) Service de neurologie, Trojano, Maria, Lucchese, Guglielmo, Graziano, Giusi, Taylor, Bruce V, Simpson, Steve, Lepore, Vito, Grand'maison, Francois, Duquette, Pierre, Izquierdo, Guillermo, Grammond, Pierre, Amato, Maria Pia, Bergamaschi, Roberto, Giuliani, Giorgio, Boz, Cavit, Hupperts, Raymond, Van Pesch, Vincent, Lechner-Scott, Jeannette, Cristiano, Edgardo, Fiol, Marcela, Oreja-Guevara, Celia, Saladino, Maria Laura, Verheul, Freek, Slee, Mark, Paolicelli, Damiano, Tortorella, Carla, D'Onghia, Mariangela, Iaffaldano, Pietro, Direnzo, Vita, Butzkueven, Helmut, UCL - SSS/IONS/CEMO - Pôle Cellulaire et moléculaire, UCL - (SLuc) Service de neurologie, Trojano, Maria, Lucchese, Guglielmo, Graziano, Giusi, Taylor, Bruce V, Simpson, Steve, Lepore, Vito, Grand'maison, Francois, Duquette, Pierre, Izquierdo, Guillermo, Grammond, Pierre, Amato, Maria Pia, Bergamaschi, Roberto, Giuliani, Giorgio, Boz, Cavit, Hupperts, Raymond, Van Pesch, Vincent, Lechner-Scott, Jeannette, Cristiano, Edgardo, Fiol, Marcela, Oreja-Guevara, Celia, Saladino, Maria Laura, Verheul, Freek, Slee, Mark, Paolicelli, Damiano, Tortorella, Carla, D'Onghia, Mariangela, Iaffaldano, Pietro, Direnzo, Vita, and Butzkueven, Helmut

Abstract

Background: A female/male (F/M) ratio increase over time in multiple sclerosis (MS) patients was demonstrated in many countries around the world. So far, a direct comparison of sex ratio time-trends among MS populations from different geographical areas was not carried out. Objective: In this paper we assessed and compared sex ratio trends, over a 60-year span, in MS populations belonging to different latitudinal areas. Methods: Data of a cohort of 15,996 (F = 11,290; M = 4,706) definite MS with birth years ranging from 1930 to 1989 were extracted from the international MSBase registry and the New Zealand MS database. Gender ratios were calculated by six decades based on year of birth and were adjusted for the F/M born-alive ratio derived from the respective national registries of births. Results: Adjusted sex ratios showed a significant increase from the first to the last decade in the whole MS sample (from 2.35 to 2.73; p = 0.03) and in the subgroups belonging to the areas between 83° N and 45° N (from 1.93 to 4.55; p<0.0001) and between 45° N to 35° N (from 1.46 to 2.30; p<0.05) latitude, while a sex ratio stability over time was found in the subgroup from areas between 12° S and 55° S latitude. The sex ratio increase mainly affected relapsing-remitting (RR) MS. Conclusions: Our results confirm a general sex ratio increase over time in RRMS and also demonstrate a latitudinal gradient of this increase. These findings add useful information for planning case-control studies aimed to explore sex-related factors responsible for MS development.

Published
2012

21. Increasing age at disability milestones among MS patients in the MSBase Registry.

Author

UCL - SSS/IONS/CEMO - Pôle Cellulaire et moléculaire, UCL - (SLuc) Service de neurologie, Kister, Ilya, Chamot, Eric, Cutter, Gary, Bacon, Tamar E, Jokubaitis, Vilija G, Hughes, Stella E, Gray, Orla M, Trojano, Maria, Izquierdo, Guillermo, Grand'Maison, Francois, Duquette, Pierre, Lugaresi, Alessandra, Grammond, Pierre, Boz, Cavit, Hupperts, Raymond, Petersen, Thor, Giuliani, Giorgio, Oreja-Guevara, Celia, Iuliano, Gerardo, Lechner-Scott, Jeannette, Bergamaschi, Roberto, Rio, Maria Edite, Verheul, Freek, Fiol, Marcela, Van Pesch, Vincent, Slee, Mark, Butzkueven, Helmut, Herbert, Joseph, UCL - SSS/IONS/CEMO - Pôle Cellulaire et moléculaire, UCL - (SLuc) Service de neurologie, Kister, Ilya, Chamot, Eric, Cutter, Gary, Bacon, Tamar E, Jokubaitis, Vilija G, Hughes, Stella E, Gray, Orla M, Trojano, Maria, Izquierdo, Guillermo, Grand'Maison, Francois, Duquette, Pierre, Lugaresi, Alessandra, Grammond, Pierre, Boz, Cavit, Hupperts, Raymond, Petersen, Thor, Giuliani, Giorgio, Oreja-Guevara, Celia, Iuliano, Gerardo, Lechner-Scott, Jeannette, Bergamaschi, Roberto, Rio, Maria Edite, Verheul, Freek, Fiol, Marcela, Van Pesch, Vincent, Slee, Mark, Butzkueven, Helmut, and Herbert, Joseph

Abstract

The more recent MSBase enrollees in each of the mild-to-moderate disability strata were significantly older than earlier enrollees. Possible explanations for this phenomenon are discussed.

Published
2012

22. Country, sex, EDSS change and therapy choice independently predict treatment discontinuation in multiple sclerosis and clinically isolated syndrome

Author

Meyniel, Claire, Spelman, Timothy, Jokubaitis, Vilija G, Trojano, Maria, Izquierdo, Guillermo, Grand'Maison, Francois, Oreja-Guevara, Celia, Boz, Cavit, Lugaresi, Alessandra, Girard, Marc, Grammond, Pierre, Iuliano, Gerardo, Fiol, Marcela, Cabrera-Gomez, Jose Antonio, Fernandez-Bolanos, Ricardo, Giuliani, Giorgio, Lechner-Scott, Jeannette, Cristiano, Edgardo, Herbert, Joseph, Petkovska-Boskova, Tatjana, Bergamaschi, Roberto, van Pesch, Vincent, Moore, Fraser, Vella, Norbert, Slee, Mark, Santiago, Vetere, Barnett, Michael, Havrdova, Eva, Young, Carolyn, Sirbu, Carmen-Adella, Tanner, Mary, Rutherford, Michelle, Butzkueven, Helmut, MSBasis Study Group, Shaw, Cameron, Meyniel, Claire, Spelman, Timothy, Jokubaitis, Vilija G, Trojano, Maria, Izquierdo, Guillermo, Grand'Maison, Francois, Oreja-Guevara, Celia, Boz, Cavit, Lugaresi, Alessandra, Girard, Marc, Grammond, Pierre, Iuliano, Gerardo, Fiol, Marcela, Cabrera-Gomez, Jose Antonio, Fernandez-Bolanos, Ricardo, Giuliani, Giorgio, Lechner-Scott, Jeannette, Cristiano, Edgardo, Herbert, Joseph, Petkovska-Boskova, Tatjana, Bergamaschi, Roberto, van Pesch, Vincent, Moore, Fraser, Vella, Norbert, Slee, Mark, Santiago, Vetere, Barnett, Michael, Havrdova, Eva, Young, Carolyn, Sirbu, Carmen-Adella, Tanner, Mary, Rutherford, Michelle, Butzkueven, Helmut, MSBasis Study Group, and Shaw, Cameron

Abstract

OBJECTIVES: We conducted a prospective study, MSBASIS, to assess factors leading to first treatment discontinuation in patients with a clinically isolated syndrome (CIS) and early relapsing-remitting multiple sclerosis (RRMS). METHODS: The MSBASIS Study, conducted by MSBase Study Group members, enrols patients seen from CIS onset, reporting baseline demographics, cerebral magnetic resonance imaging (MRI) features and Expanded Disability Status Scale (EDSS) scores. Follow-up visits report relapses, EDSS scores, and the start and end dates of MS-specific therapies. We performed a multivariable survival analysis to determine factors within this dataset that predict first treatment discontinuation. RESULTS: A total of 2314 CIS patients from 44 centres were followed for a median of 2.7 years, during which time 1247 commenced immunomodulatory drug (IMD) treatment. Ninety percent initiated IMD after a diagnosis of MS was confirmed, and 10% while still in CIS status. Over 40% of these patients stopped their first IMD during the observation period. Females were more likely to cease medication than males (HR 1.36, p = 0.003). Patients treated in Australia were twice as likely to cease their first IMD than patients treated in Spain (HR 1.98, p = 0.001). Increasing EDSS was associated with higher rate of IMD cessation (HR 1.21 per EDSS unit, p<0.001), and intramuscular interferon-β-1a (HR 1.38, p = 0.028) and subcutaneous interferon-β-1a (HR 1.45, p = 0.012) had higher rates of discontinuation than glatiramer acetate, although this varied widely in different countries. Onset cerebral MRI features, age, time to treatment initiation or relapse on treatment were not associated with IMD cessation. CONCLUSION: In this multivariable survival analysis, female sex, country of residence, EDSS change and IMD choice independently predicted time to first IMD cessation.

Published
2012

23. The Multiple Sclerosis Severity Score re-examined: Expanded Disability Status Scale rank stability in the MSBase dataset increases five years after onset of multiple sclerosis

Author

UCL - (SLuc) Service de neurologie, UCL - Cliniques universitaires Saint-Luc, UCL, Butzkueven, Helmut, Van Pesch, Vincent, Jolley, Damien, Trojano, Maria, Zwanikken, Cees, Maison, Francois Grand, Duquette, Pierre, Grammond, Pierre, Bergamaschi, Roberto, Giuliani, Giorgio, Timmermans, Bertine, Boz, Cavit, Rio, Maria Edite, Petersen, Thor, Poehlau, Dieter, Cristiatio, Edgardo, Lechner-Scott, Jeannette, Fiol, Marcela, Arruda, Walter Oleschko, Izquierdo, Guillernio, Flechter, Shlomo, Paine, Mark, Deri, Norma, Savino, Aldo, Cabrera-Gomez, Jose Antonio, 13th Annnual Meeting of the Amer-Comm-for-Treatment-and-Res-in-Multiple-Sclerosis/24th Congress of the European-Comm-for-Treatment-and-Res-in-Multiple-Sclerosis/5th Congress of the Latin-Amer-Comm-for-Treatment-and-Res-in-Multiple-Sclerosis, UCL - (SLuc) Service de neurologie, UCL - Cliniques universitaires Saint-Luc, UCL, Butzkueven, Helmut, Van Pesch, Vincent, Jolley, Damien, Trojano, Maria, Zwanikken, Cees, Maison, Francois Grand, Duquette, Pierre, Grammond, Pierre, Bergamaschi, Roberto, Giuliani, Giorgio, Timmermans, Bertine, Boz, Cavit, Rio, Maria Edite, Petersen, Thor, Poehlau, Dieter, Cristiatio, Edgardo, Lechner-Scott, Jeannette, Fiol, Marcela, Arruda, Walter Oleschko, Izquierdo, Guillernio, Flechter, Shlomo, Paine, Mark, Deri, Norma, Savino, Aldo, Cabrera-Gomez, Jose Antonio, and 13th Annnual Meeting of the Amer-Comm-for-Treatment-and-Res-in-Multiple-Sclerosis/24th Congress of the European-Comm-for-Treatment-and-Res-in-Multiple-Sclerosis/5th Congress of the Latin-Amer-Comm-for-Treatment-and-Res-in-Multiple-Sclerosis

Published
2008

24. The Kurtzke EDSS rank stability increases 4 years after the onset of multiple sclerosis: results from the MSBase Registry

Author

Hughes, Stella, primary, Spelman, Timothy, additional, Trojano, Maria, additional, Lugaresi, Alessandra, additional, Izquierdo, Guillermo, additional, Grand'Maison, Francois, additional, Duquette, Pierre, additional, Girard, Marc, additional, Grammond, Pierre, additional, Oreja-Guevara, Celia, additional, Hupperts, Raymond, additional, Boz, Cavit, additional, Bergamaschi, Roberto, additional, Giuliani, Giorgio, additional, Rio, Maria Edite, additional, Lechner-Scott, Jeannette, additional, van Pesch, Vincent, additional, Iuliano, Gerardo, additional, Fiol, Marcela, additional, Verheul, Freek, additional, Barnett, Michael, additional, Slee, Mark, additional, Herbert, Joseph, additional, Kister, Ilya, additional, Vella, Norbert, additional, Moore, Fraser, additional, Petkovska-Boskova, Tatjana, additional, Shaygannejad, Vahid, additional, Jokubaitis, Vilija, additional, McDonnell, Gavin, additional, Hawkins, Stanley, additional, Kee, Frank, additional, Gray, Orla, additional, and Butzkueven, Helmut, additional

Published
2011
Full Text
View/download PDF

28. Predictors of disability worsening in clinically isolated syndrome.

Author

Jokubaitis, Vilija G., Spelman, Tim, Kalincik, Tomas, Izquierdo, Guillermo, Grand'Maison, François, Duquette, Pierre, Girard, Marc, Lugaresi, Alessandra, Grammond, Pierre, Hupperts, Raymond, Cabrera‐Gomez, José, Oreja‐Guevara, Celia, Boz, Cavit, Giuliani, Giorgio, Fernández‐Bolaños, Ricardo, Iuliano, Gerardo, Lechner‐Scott, Jeannette, Verheul, Freek, Pesch, Vincent, and Petkovska‐Boskova, Tatjana

Subjects
NEUROLOGIC manifestations of general diseases, MAGNETIC resonance imaging, MULTIPLE sclerosis, AGE factors in disease, DISEASE risk factors
Abstract

Objective To assess demographic, clinical, magnetic resonance imaging, and treatment exposure predictors of time to 3 or 12-month confirmed disability worsening in clinically isolated syndrome (CIS) and early multiple sclerosis (MS). Methods We utilized the MSBase Incident Study ( MSBasis), a prospective cohort study of outcome after CIS. Predictors of time to first 3 and 12-month confirmed expanded disability status scale worsening were analyzed using Cox proportional hazards regression. Results About 1989 patients were analyzed, the largest seen-from-onset cohort reported to-date. A total of 391 patients had a first 3-month confirmed disability worsening event, of which 307 were sustained for 12 months. Older age at CIS onset (adjusted hazard ratio: aHR 1.17, 95% 1.06, 1.30), pyramidal ( aHR 1.45, 95% CI 1.13, 1.89) and ambulation ( HR 1.60, 95% CI 1.09, 2.34) system dysfunction, annualized relapse rate ( aHR 1.20, 95% CI 1.18, 1.22), and lower proportion of observation time on treatment were associated with 3-month confirmed worsening. Predictors of time to 12-month sustained worsening included pyramidal system dysfunction (Hazard ratio: aHR 1.38, 95% CI 1.05, 1.83), and older age at CIS onset ( aHR 1.17, 95% CI 1.04, 1.31). Greater proportion of follow-up time exposed to treatment was associated with greater reductions in the rate of worsening. Interpretation This study provides class IV evidence for a strong protective effect of disease-modifying treatment to reduce disability worsening events in patients with CIS and early MS, and confirms age and pyramidal dysfunction at onset as risk factors. [ABSTRACT FROM AUTHOR]

Published
2015
Full Text
View/download PDF

31. Risk of relapse phenotype recurrence in multiple sclerosis.

Author

Kalincik, Tomas, Buzzard, Katherine, Jokubaitis, Vilija, Trojano, Maria, Duquette, Pierre, Izquierdo, Guillermo, Girard, Marc, Lugaresi, Alessandra, Grammond, Pierre, Grand’Maison, Francois, Oreja-Guevara, Celia, Boz, Cavit, Hupperts, Raymond, Petersen, Thor, Giuliani, Giorgio, Iuliano, Gerardo, Lechner-Scott, Jeannette, Barnett, Michael, Bergamaschi, Roberto, and Van Pesch, Vincent

Subjects
DISEASE relapse, MULTIPLE sclerosis, LOGISTIC regression analysis, DEMOGRAPHIC characteristics, PHENOTYPES, PATIENTS
Abstract

The article presents a study which analyzes risk of relapse phenotype recurrence in patients with multiple sclerosis (MS). MSBase, an international observational registry, was used and the association between relapse phenotypes and history of similar relapses were tested through multivariable logistic regression models. The study found that relapse phenotype was associated with demographic and clinical characteristics and phenotypic recurrence significantly more common.

Published
2014
Full Text
View/download PDF

32. Predictors and dynamics of postpartum relapses in women with multiple sclerosis.

Author

Hughes, Stella E, Spelman, Tim, Gray, Orla M, Boz, Cavit, Trojano, Maria, Lugaresi, Alessandra, Izquierdo, Guillermo, Duquette, Pierre, Girard, Marc, Grand’Maison, Francois, Grammond, Pierre, Oreja-Guevara, Celia, Hupperts, Raymond, Bergamaschi, Roberto, Giuliani, Giorgio, Lechner-Scott, Jeannette, Barnett, Michael, Edite Rio, Maria, van Pesch, Vincent, and Amato, Maria Pia

Subjects
PREGNANCY complications, POSTPARTUM depression, MULTIPLE sclerosis, DISEASE relapse, DISEASES in women
Abstract

The article focuses on the study which discusses the effect of pregnancy and postpartum relapses in women with multiple sclerosis (MS) using large international MSBase Registry. It states the observational case-control study performed on pregnancies post-MS. It mentions the favorable effect on relapses as the pregnancy proceeds and peak of early postpartum.

Published
2014
Full Text
View/download PDF

33. Fingolimod after natalizumab and the risk of short-term relapse.

Author

Jokubaitis, Vilija G, Li, Vivien, Kalincik, Tomas, Izquierdo, Guillermo, Hodgkinson, Suzanne, Alroughani, Raed, Lechner-Scott, Jeannette, Lugaresi, Alessandra, Duquette, Pierre, Girard, Marc, Barnett, Michael, Grand'maison, Francois, Trojano, Maria, Slee, Mark, Giuliani, Giorgio, Shaw, Cameron, Boz, Cavit, Spitaleri, Daniele L A, Verheul, Freek, and Haartsen, Jodi

Published
2014
Full Text
View/download PDF

35. Geographical Variations in Sex Ratio Trends over Time in Multiple Sclerosis.

Author

Trojano, Maria, Lucchese, Guglielmo, Graziano, Giusi, Taylor, Bruce V., Simpson, Steve Jr., Lepore, Vito, Grand'Maison, Francois, Duquette, Pierre, Izquierdo, Guillermo, Grammond, Pierre, Amato, Maria Pia, Bergamaschi, Roberto, Giuliani, Giorgio, Boz, Cavit, Hupperts, Raymond, Van Pesch, Vincent, Lechner-Scott, Jeannette, Cristiano, Edgardo, Fiol, Marcela, and Oreja-Guevara, Celia

Subjects
SEX ratio, MULTIPLE sclerosis research, SEX (Biology), DEMYELINATION, MYELIN sheath diseases, VIRUS diseases
Abstract

Background:A female/male (F/M) ratio increase over time in multiple sclerosis (MS) patients was demonstrated in many countries around the world. So far, a direct comparison of sex ratio time-trends among MS populations from different geographical areas was not carried out. Objective: In this paper we assessed and compared sex ratio trends, over a 60-year span, in MS populations belonging to different latitudinal areas. Methods: Data of a cohort of 15,996 (F = 11,290; M = 4,706) definite MS with birth years ranging from 1930 to 1989 were extracted from the international MSBase registry and the New Zealand MS database. Gender ratios were calculated by six decades based on year of birth and were adjusted for the F/M born-alive ratio derived from the respective national registries of births. Results: Adjusted sex ratios showed a significant increase from the first to the last decade in the whole MS sample (from 2.35 to 2.73; p = 0.03) and in the subgroups belonging to the areas between 83° N and 45° N (from 1.93 to 4.55; p<0.0001) and between 45° N to 35° N (from 1.46 to 2.30; p<0.05) latitude, while a sex ratio stability over time was found in the subgroup from areas between 12° S and 55° S latitude. The sex ratio increase mainly affected relapsing-remitting (RR) MS. Conclusions: Our results confirm a general sex ratio increase over time in RRMS and also demonstrate a latitudinal gradient of this increase. These findings add useful information for planning case-control studies aimed to explore sex-related factors responsible for MS development. [ABSTRACT FROM AUTHOR]

Published
2012
Full Text
View/download PDF

36. Interobserver Agreement in the Diagnosis of Multiple Sclerosis

Author

Solari, Alessandra, Filippini, Graziella, Gagliardi, Luigi, Bevilacqua, Luciana, Amantini, Aldo, Giuliani, Giorgio, Messina, Corrado, Rossi, Giorgio, Savettieri, Giovanni, Tredici, Giovanni, and Duca, Pier Giorgio

Abstract

• Interobserver agreement in the clinical diagnosis of multiple sclerosis (MS) among six neurologists was evaluated. Three of them participated in a study of the clinical diagnosis of MS, the Italian Multicenter Study (IMS). The raters examined the clinical forms of MS of 50 patients randomly selected from among 430 patients recruited from the IMS. For each patient, neurologists were asked to make a diagnosis according to the McDonald-Halliday classification system of MS. The overall agreement on the diagnosis (MS present or absent) was fair, with no difference noted between the two groups of raters. Considering the six diagnostic levels instead, the reliability was higher for the neurologists participating in the IMS program. These neurologists agreed particularly on the Clinically Definite and Progressive Possible classifications. Complete disagreement was observed for the Early Probable or Latent and Progressive Probable classifications. Because of the different level of agreement on diagnosis, we suggest separate consideration of Clinically Definite and Progressive Probable MS cases in clinical trials and epidemiologic studies of this disease.

Published
1989
Full Text
View/download PDF

41. RUOLO DELL’ARTROCENTESI NEL TRATTAMENTO DELLA PATOLOGIA TEMPORO- MANDIBOLARE

Author

PAPARO, FRANCESCO, IANNETTI, GIORGIO, and GIULIANI, GIORGIO

Subjects
Scienze mediche::CHIRURGIA MAXILLOFACCIALE [Settori Disciplinari MIUR], DISFUNZIONE TEMPORO-MANDIBOLARE, ARTROCENTESI
Abstract

Studio sul ruolo dell'artrocentesi nel trattamento dei disordini intra- capsulari dell'articolazione temporo-mandibolare

Published
2011

42. Comparative efficacy of first-line natalizumab vs IFN-β or glatiramer acetate in relapsing MS.

Author

Spelman T, Kalincik T, Jokubaitis V, Zhang A, Pellegrini F, Wiendl H, Belachew S, Hyde R, Verheul F, Lugaresi A, Havrdová E, Horáková D, Grammond P, Duquette P, Prat A, Iuliano G, Terzi M, Izquierdo G, Hupperts RM, Boz C, Pucci E, Giuliani G, Sola P, Spitaleri DL, Lechner-Scott J, Bergamaschi R, Grand'Maison F, Granella F, Kappos L, Trojano M, and Butzkueven H

Abstract

Background: We compared efficacy and treatment persistence in treatment-naive patients with relapsing-remitting multiple sclerosis (RRMS) initiating natalizumab compared with interferon-β (IFN-β)/glatiramer acetate (GA) therapies, using propensity score-matched cohorts from observational multiple sclerosis registries., Methods: The study population initiated IFN-β/GA in the MSBase Registry or natalizumab in the Tysabri Observational Program, had ≥3 months of on-treatment follow-up, and had active RRMS, defined as ≥1 gadolinium-enhancing lesion on cerebral MRI at baseline or ≥1 relapse within the 12 months prior to baseline. Baseline demographics and disease characteristics were balanced between propensity-matched groups. Annualized relapse rate (ARR), time to first relapse, treatment persistence, and disability outcomes were compared between matched treatment arms in the total population (n = 366/group) and subgroups with higher baseline disease activity., Results: First-line natalizumab was associated with a 68% relative reduction in ARR from a mean (SD) of 0.63 (0.92) on IFN-β/GA to 0.20 (0.63) ( p [signed-rank] < 0.0001), a 64% reduction in the rate of first relapse (hazard ratio [HR] 0.36, 95% confidence interval [CI] 0.28-0.47; p < 0.001), and a 27% reduction in the rate of discontinuation (HR 0.73, 95% CI 0.58-0.93; p = 0.01), compared with first-line IFN-β/GA therapy. Confirmed disability progression and area under the Expanded Disability Status Scale-time curve analyses were not significant. Similar relapse and treatment persistence results were observed in each of the higher disease activity subgroups., Conclusions: This study provides Class IV evidence that first-line natalizumab for RRMS improves relapse and treatment persistence outcomes compared to first-line IFN-β/GA. This needs to be balanced against the risk of progressive multifocal leukoencephalopathy in natalizumab-treated patients., Classification of Evidence: This study provides Class IV evidence that first-line natalizumab for RRMS improves relapse rates and treatment persistence outcomes compared to first-line IFN-β/GA.

Published
2016
Full Text
View/download PDF

43. Risk of relapse phenotype recurrence in multiple sclerosis.

Author

Kalincik T, Buzzard K, Jokubaitis V, Trojano M, Duquette P, Izquierdo G, Girard M, Lugaresi A, Grammond P, Grand'Maison F, Oreja-Guevara C, Boz C, Hupperts R, Petersen T, Giuliani G, Iuliano G, Lechner-Scott J, Barnett M, Bergamaschi R, Van Pesch V, Amato MP, van Munster E, Fernandez-Bolanos R, Verheul F, Fiol M, Cristiano E, Slee M, Rio ME, Spitaleri D, Alroughani R, Gray O, Saladino ML, Flechter S, Herbert J, Cabrera-Gomez JA, Vella N, Paine M, Shaw C, Moore F, Vucic S, Savino A, Singhal B, Petkovska-Boskova T, Parratt J, Sirbu CA, Rozsa C, Liew D, and Butzkueven H

Subjects
Adult, Age Factors, Aged, Disability Evaluation, Disease Progression, Female, Humans, Male, Middle Aged, Phenotype, Prognosis, Recurrence, Risk, Multiple Sclerosis, Relapsing-Remitting diagnosis, Multiple Sclerosis, Relapsing-Remitting physiopathology
Abstract

Objectives: The aim was to analyse risk of relapse phenotype recurrence in multiple sclerosis and to characterise the effect of demographic and clinical features on this phenotype., Methods: Information about relapses was collected using MSBase, an international observational registry. Associations between relapse phenotypes and history of similar relapses or patient characteristics were tested with multivariable logistic regression models. Tendency of relapse phenotypes to recur sequentially was assessed with principal component analysis., Results: Among 14,969 eligible patients (89,949 patient-years), 49,279 phenotypically characterised relapses were recorded. Visual and brainstem relapses occurred more frequently in early disease and in younger patients. Sensory relapses were more frequent in early or non-progressive disease. Pyramidal, sphincter and cerebellar relapses were more common in older patients and in progressive disease. Women presented more often with sensory or visual symptoms. Men were more prone to pyramidal, brainstem and cerebellar relapses. Importantly, relapse phenotype was predicted by the phenotypes of previous relapses. (OR = 1.8-5, p = 10(-14)). Sensory, visual and brainstem relapses showed better recovery than other relapse phenotypes. Relapse severity increased and the ability to recover decreased with age or more advanced disease., Conclusion: Relapse phenotype was associated with demographic and clinical characteristics, with phenotypic recurrence significantly more common than expected by chance., (© The Author(s), 2014.)

Published
2014
Full Text
View/download PDF

44. Predictors and dynamics of postpartum relapses in women with multiple sclerosis.

Author

Hughes SE, Spelman T, Gray OM, Boz C, Trojano M, Lugaresi A, Izquierdo G, Duquette P, Girard M, Grand'Maison F, Grammond P, Oreja-Guevara C, Hupperts R, Bergamaschi R, Giuliani G, Lechner-Scott J, Barnett M, Edite Rio M, van Pesch V, Amato MP, Iuliano G, Slee M, Verheul F, Cristiano E, Fernández-Bolaños R, Poehlau D, Saladino ML, Deri N, Cabrera-Gomez J, Vella N, Herbert J, Skromne E, Savino A, Shaw C, Moore F, Vucic S, Petkovska-Boskova T, McDonnell G, Hawkins S, Kee F, and Butzkueven H

Subjects
Adult, Aged, Case-Control Studies, Disability Evaluation, Female, Humans, Middle Aged, Multiple Sclerosis, Relapsing-Remitting physiopathology, Pregnancy, Risk, Multiple Sclerosis, Relapsing-Remitting diagnosis, Postpartum Period
Abstract

Background: Several studies have shown that pregnancy reduces multiple sclerosis (MS) relapses, which increase in the early postpartum period. Postpartum relapse risk has been predicted by pre-pregnancy disease activity in some studies., Objective: To re-examine effect of pregnancy on relapses using the large international MSBase Registry, examining predictors of early postpartum relapse., Methods: An observational case-control study was performed including pregnancies post-MS onset. Annualised relapse rate (ARR) and median Expanded Disability Status Scale (EDSS) scores were compared for the 24 months pre-conception, pregnancy and 24 months postpartum periods. Clustered logistic regression was used to investigate predictors of early postpartum relapses., Results: The study included 893 pregnancies in 674 females with MS. ARR (standard error) pre-pregnancy was 0.32 (0.02), which fell to 0.13 (0.03) in the third trimester and rose to 0.61 (0.06) in the first three months postpartum. Median EDSS remained unchanged. Pre-conception ARR and disease-modifying treatment (DMT) predicted early postpartum relapse in a multivariable model., Conclusion: Results confirm a favourable effect on relapses as pregnancy proceeds, and an early postpartum peak. Pre-conception DMT exposure and low ARR were independently protective against postpartum relapse. This novel finding could provide clinicians with a strategy to minimise postpartum relapse risk in women with MS planning pregnancy.

Published
2014
Full Text
View/download PDF

45. Persistence on therapy and propensity matched outcome comparison of two subcutaneous interferon beta 1a dosages for multiple sclerosis.

Author

Kalincik T, Spelman T, Trojano M, Duquette P, Izquierdo G, Grammond P, Lugaresi A, Hupperts R, Cristiano E, Van Pesch V, Grand'maison F, La Spitaleri D, Rio ME, Flechter S, Oreja-Guevara C, Giuliani G, Savino A, Amato MP, Petersen T, Fernandez-Bolanos R, Bergamaschi R, Iuliano G, Boz C, Lechner-Scott J, Deri N, Gray O, Verheul F, Fiol M, Barnett M, van Munster E, Santiago V, Moore F, Slee M, Saladino ML, Alroughani R, Shaw C, Kasa K, Petkovska-Boskova T, den Braber-Moerland L, Chapman J, Skromne E, Herbert J, Poehlau D, Needham M, Bacile EA, Arruda WO, Paine M, Singhal B, Vucic S, Cabrera-Gomez JA, and Butzkueven H

Subjects
Adult, Demography, Dose-Response Relationship, Drug, Drug Administration Schedule, Female, Humans, Injections, Subcutaneous, Interferon beta-1a, Interferon-beta pharmacology, Kaplan-Meier Estimate, Likelihood Functions, Magnetic Resonance Imaging, Male, Reproducibility of Results, Treatment Outcome, Withholding Treatment, Interferon-beta administration & dosage, Interferon-beta therapeutic use, Medication Adherence, Multiple Sclerosis drug therapy, Propensity Score
Abstract

Objectives: To compare treatment persistence between two dosages of interferon β-1a in a large observational multiple sclerosis registry and assess disease outcomes of first line MS treatment at these dosages using propensity scoring to adjust for baseline imbalance in disease characteristics., Methods: Treatment discontinuations were evaluated in all patients within the MSBase registry who commenced interferon β-1a SC thrice weekly (n = 4678). Furthermore, we assessed 2-year clinical outcomes in 1220 patients treated with interferon β-1a in either dosage (22 µg or 44 µg) as their first disease modifying agent, matched on propensity score calculated from pre-treatment demographic and clinical variables. A subgroup analysis was performed on 456 matched patients who also had baseline MRI variables recorded., Results: Overall, 4054 treatment discontinuations were recorded in 3059 patients. The patients receiving the lower interferon dosage were more likely to discontinue treatment than those with the higher dosage (25% vs. 20% annual probability of discontinuation, respectively). This was seen in discontinuations with reasons recorded as "lack of efficacy" (3.3% vs. 1.7%), "scheduled stop" (2.2% vs. 1.3%) or without the reason recorded (16.7% vs. 13.3% annual discontinuation rate, 22 µg vs. 44 µg dosage, respectively). Propensity score was determined by treating centre and disability (score without MRI parameters) or centre, sex and number of contrast-enhancing lesions (score including MRI parameters). No differences in clinical outcomes at two years (relapse rate, time relapse-free and disability) were observed between the matched patients treated with either of the interferon dosages., Conclusions: Treatment discontinuations were more common in interferon β-1a 22 µg SC thrice weekly. However, 2-year clinical outcomes did not differ between patients receiving the different dosages, thus replicating in a registry dataset derived from "real-world" database the results of the pivotal randomised trial. Propensity score matching effectively minimised baseline covariate imbalance between two directly compared sub-populations from a large observational registry.

Published
2013
Full Text
View/download PDF

46. Country, sex, EDSS change and therapy choice independently predict treatment discontinuation in multiple sclerosis and clinically isolated syndrome.

Author

Meyniel C, Spelman T, Jokubaitis VG, Trojano M, Izquierdo G, Grand'Maison F, Oreja-Guevara C, Boz C, Lugaresi A, Girard M, Grammond P, Iuliano G, Fiol M, Cabrera-Gomez JA, Fernandez-Bolanos R, Giuliani G, Lechner-Scott J, Cristiano E, Herbert J, Petkovska-Boskova T, Bergamaschi R, van Pesch V, Moore F, Vella N, Slee M, Santiago V, Barnett M, Havrdova E, Young C, Sirbu CA, Tanner M, Rutherford M, and Butzkueven H

Subjects
Adult, Decision Making, Female, Humans, Immunologic Factors therapeutic use, Kaplan-Meier Estimate, Male, Prognosis, Proportional Hazards Models, Disability Evaluation, Geography, Multiple Sclerosis, Relapsing-Remitting drug therapy, Patient Preference, Sex Characteristics, Withholding Treatment
Abstract

Objectives: We conducted a prospective study, MSBASIS, to assess factors leading to first treatment discontinuation in patients with a clinically isolated syndrome (CIS) and early relapsing-remitting multiple sclerosis (RRMS)., Methods: The MSBASIS Study, conducted by MSBase Study Group members, enrols patients seen from CIS onset, reporting baseline demographics, cerebral magnetic resonance imaging (MRI) features and Expanded Disability Status Scale (EDSS) scores. Follow-up visits report relapses, EDSS scores, and the start and end dates of MS-specific therapies. We performed a multivariable survival analysis to determine factors within this dataset that predict first treatment discontinuation., Results: A total of 2314 CIS patients from 44 centres were followed for a median of 2.7 years, during which time 1247 commenced immunomodulatory drug (IMD) treatment. Ninety percent initiated IMD after a diagnosis of MS was confirmed, and 10% while still in CIS status. Over 40% of these patients stopped their first IMD during the observation period. Females were more likely to cease medication than males (HR 1.36, p = 0.003). Patients treated in Australia were twice as likely to cease their first IMD than patients treated in Spain (HR 1.98, p = 0.001). Increasing EDSS was associated with higher rate of IMD cessation (HR 1.21 per EDSS unit, p<0.001), and intramuscular interferon-β-1a (HR 1.38, p = 0.028) and subcutaneous interferon-β-1a (HR 1.45, p = 0.012) had higher rates of discontinuation than glatiramer acetate, although this varied widely in different countries. Onset cerebral MRI features, age, time to treatment initiation or relapse on treatment were not associated with IMD cessation., Conclusion: In this multivariable survival analysis, female sex, country of residence, EDSS change and IMD choice independently predicted time to first IMD cessation.

Published
2012
Full Text
View/download PDF

47. The OPTimization of interferon for MS study: 375 microg interferon beta-1b in suboptimal responders.

Author

Durelli L, Barbero P, Bergui M, Versino E, Bassano MA, Verdun E, Ferrero B, Rivoiro C, Ferrero C, Picco E, Ripellino P, Viglietti D, Giuliani G, Montanari E, and Clerico M

Subjects
Adjuvants, Immunologic administration & dosage, Adjuvants, Immunologic adverse effects, Adjuvants, Immunologic therapeutic use, Adolescent, Adult, Dose-Response Relationship, Drug, Drug Administration Schedule, Follow-Up Studies, Humans, Injections, Subcutaneous, Interferon beta-1b, Interferon-beta administration & dosage, Interferon-beta adverse effects, Magnetic Resonance Imaging methods, Middle Aged, Multiple Sclerosis, Relapsing-Remitting diagnosis, Prospective Studies, Single-Blind Method, Time Factors, Treatment Outcome, Young Adult, Interferon-beta therapeutic use, Multiple Sclerosis, Relapsing-Remitting drug therapy
Abstract

We aimed to evaluate the safety and MRI efficacy of interferon beta-1b (IFNbeta-1b) 375 microg (subcutaneously [sc] every other day [eod]) in relapsing-remitting multiple sclerosis (RRMS) patients with a suboptimal response to IFNbeta-1b 250 microg, i.e., with MRI activity or relapses. The OPTimization of Interferon for MS (OPTIMS) study was a prospective multicenter randomized phase 2 trial comprising a 6-month run-in phase (to identify suboptimal responders) and a 6-month randomized phase of open-label clinical and blinded MRI follow-up. During run-in all patients were treated with IFNbeta-1b 250 microg sc eod; during the study phase suboptimal treatment responders were randomized either to IFNbeta-1b 250 or 375 microg sc eod. Primary outcome was the proportion of patients without MRI activity during study Months 9-12 according to the intention-to-treat principle. 216 RRMS patients entered the study: 83 suboptimal responders were identified and randomized, 7 refused to continue treatment, 76 were included in the analysis. More patients treated with 375 microg had no MRI activity at Months 9-12 (30/36 vs.16/40; relative risk, 0.28; 95 % confidence interval, 0.08-0.47; p = 0.0001). Sensitivity analysis ("worst case scenario") confirmed the results. No new or unexpected adverse events were observed, but there was a trend towards more withdrawals in the 375 microg group. Increasing the dose of IFNbeta-1b from 250 microg to 375 microg is a successful strategy for reducing subclinical signs of disease activity in RRMS patients. Further studies are needed to show whether this dose may also improve clinical efficacy.

Published
2008
Full Text
View/download PDF

Catalog

Books, media, physical & digital resources
See catalog results