Evidence map›Paper›PMID 28556498›Full record

Trial reportAnnals of neurology2017

Sodium intake and multiple sclerosis activity and progression in BENEFIT.

Kathryn C Fitzgerald, Kassandra L Munger, Hans-Peter Hartung, Mark S Freedman, Xavier Montalbán, Gilles Edan, Eva-Maria Wicklein, Ernst-Wilhelm Radue, Ludwig Kappos, Christoph Pohl and 2 more

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Annals of neurology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 46 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
46citing papers in PubMed, 2 pooled it
7.7field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

46 citing papers in PubMed, 2 syntheses or guidelines pooled it, 93 citations in OpenAlex.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

12 authors at 9 institutions in 6 countries.

Kathryn C FitzgeraldDepartment of Neurology and Neuroimmunology, Johns Hopkins School of Medicine, Baltimore, MA.
Kassandra L MungerDepartment of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA.
Hans-Peter HartungDepartment of Neurology, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany.
Mark S FreedmanOttawa Hospital Research Institute, Ottawa, Ontario, Canada.
Xavier MontalbánVall d'Hebron University Hospital, Barcelona, Spain.
Gilles EdanPontchaillou University Hospital Center, Rennes, France.
Eva-Maria WickleinBayer AG, Berlin, Germany.
Ernst-Wilhelm RadueMedical Image Analysis Center, University Hospital Basel, Basel, Switzerland.
Ludwig KapposNeurological Clinic and Polyclinic, Departments of Medicine, Clinical Research, and Biomedicine and Biomedical Engineering, University Hospital Basel, Basel, Switzerland.
Christoph PohlBayer AG, Berlin, Germany.
Alberto AscherioDepartment of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA.
BENEFIT Study Group
Bayer (Germany) · DEHarvard University · USDepartment of Biomedicine Basel · CHHeinrich Heine University Düsseldorf · DEHôpital Pontchaillou · FRJohns Hopkins Medicine · USOttawa Hospital Research InstituteUniversity Hospital of Basel · CHVall d'Hebron Hospital Universitari · ES

Funding

Vitamin D, cigarette smoking, EBV infection and risk of MS progressionR01NS071082 · NINDS · HARVARD SCHOOL OF PUBLIC HEALTH · PI ASCHERIO, ALBERTO · 2010 to 2014
$695k
NINDS NIH HHS R01 NS071082
6 · The paper itself

Abstract

objectiveTo assess whether a high-salt diet, as measured by urinary sodium concentration, is associated with faster conversion from clinically isolated syndrome (CIS) to multiple sclerosis (MS) and MS activity and disability.

methodsBENEFIT was a randomized clinical trial comparing early versus delayed interferon beta-1b treatment in 465 patients with a CIS. Each patient provided a median of 14 (interquartile range = 13-16) spot urine samples throughout the 5-year follow-up. We estimated 24-hour urine sodium excretion level at each time point using the Tanaka equations, and assessed whether sodium levels estimated from the cumulative average of the repeated measures were associated with clinical (conversion to MS, Expanded Disability Status Scale [EDSS]) and magnetic resonance imaging (MRI) outcomes.

resultsAverage 24-hour urine sodium levels were not associated with conversion to clinically definite MS over the 5-year follow-up (hazard ratio [HR] = 0.91, 95% confidence interval [CI] = 0.67-1.24 per 1g increase in estimated daily sodium intake), nor were they associated with clinical or MRI outcomes (new active lesions after 6 months: HR = 1.05, 95% CI = 0.97-1.13; relative change in T2 lesion volume: -0.11, 95% CI = -0.25 to 0.04; change in EDSS: -0.01, 95% CI = -0.09 to 0.08; relapse rate: HR = 0.78, 95% CI = 0.56-1.07). Results were similar in categorical analyses using quintiles.

interpretationOur results, based on multiple assessments of urine sodium excretion over 5 years and standardized clinical and MRI follow-up, suggest that salt intake does not influence MS disease course or activity. Ann Neurol 2017;82:20-29.

Indexed as

AdultBrainDemyelinating DiseasesDisability EvaluationDisease ProgressionFemaleHumansInterferon beta-1bMagnetic Resonance ImagingMaleMultiple SclerosisNeuroimagingSodium, DietaryYoung AdultInterferon beta-1bSodium, Dietary

Identifiers

PMID28556498
PMCPMC5555227
OpenAlexW2618358981

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.