Evidence map›Paper›PMID 31720848›Full record

ArticleJournal of neurology2020

Exit strategies for "needle fatigue" in multiple sclerosis: a propensity score-matched comparison study.

Luca Prosperini, Antonio Cortese, Matteo Lucchini, Laura Boffa, Giovanna Borriello, Maria Chiara Buscarinu, Fioravante Capone, Diego Centonze, Chiara De Fino, Daniela De Pascalis and 20 more

Abstract readComparative StudyMulticenter Study
PubMed Publisher
In one paragraph

Article in Journal of neurology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 2 pooled it
–field-weighted citation impact
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

4 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Dimethyl Fumarate or Teriflunomide for Relapsing-Remitting Multiple Sclerosis: A Meta-analysis of Post-marketing Studies.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2023
    Pooled it
  2. Pooled it
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

30 authors.

Luca ProsperiniDepartment of Neurosciences, S. Camillo-Forlanini Hospital, C.ne Gianicolense 87, 00152, Rome, Italy. luca.prosperini@gmail.com.ORCID http://orcid.org/0000-0003-3237-6267
Antonio CorteseSan Filippo Neri Hospital, ASL Roma 1, Via G. Martinotti 20, 00135, Rome, Italy.
Matteo LucchiniFondazione Policlinico Universitario 'A. Gemelli' IRCCS, Largo A. Gemelli 8, 00168, Rome, Italy.
Laura BoffaMS Clinical and Research Unit, Department of Systems Medicine, Tor Vergata University, Viale Oxford 81, 00133, Rome, Italy.
Giovanna BorrielloMS Centre, S. Andrea Hospital, Viale di Grottarossa 1035, 00189, Rome, Italy.
Maria Chiara BuscarinuDepartment of Neurosciences, Mental Health and Sensory Organs (NESMOS), S. Andrea Hospital, Sapienza University, Viale di Grottarossa 1035, 00189, Rome, Italy.
Fioravante CaponeUnit of Neurology Neurophysiology, Department of Medicine, Campus Bio-Medico University, Via Álvaro del Portillo 21, 00128, Rome, Italy.
Diego CentonzeIRCCS Neuromed, Via Atinense 18, 86077, Pozzilli, IS, Italy.
Chiara De FinoFondazione Policlinico Universitario 'A. Gemelli' IRCCS, Largo A. Gemelli 8, 00168, Rome, Italy.
Daniela De PascalisNeurology Unit/Stroke Unit, Department of Emergency, MS Centre, S. Eugenio Hospital, P.le dell'Umanesimo 10, 00144, Rome, Italy.
Roberta FantozziIRCCS Neuromed, Via Atinense 18, 86077, Pozzilli, IS, Italy.
Elisabetta FerraroSan Filippo Neri Hospital, ASL Roma 1, Via G. Martinotti 20, 00135, Rome, Italy.
Maria FilippiFatebenefratelli Foundation for Health Research and Education, AFaR Division, Via di Ponte Quattro Capi 39, 00186, Rome, Italy.
Simonetta GalganiDepartment of Neurosciences, S. Camillo-Forlanini Hospital, C.ne Gianicolense 87, 00152, Rome, Italy.
Claudio GasperiniDepartment of Neurosciences, S. Camillo-Forlanini Hospital, C.ne Gianicolense 87, 00152, Rome, Italy.
Shalom HaggiagDepartment of Neurosciences, S. Camillo-Forlanini Hospital, C.ne Gianicolense 87, 00152, Rome, Italy.
Doriana LandiMS Clinical and Research Unit, Department of Systems Medicine, Tor Vergata University, Viale Oxford 81, 00133, Rome, Italy.
Girolama MarfiaMS Clinical and Research Unit, Department of Systems Medicine, Tor Vergata University, Viale Oxford 81, 00133, Rome, Italy.
Giorgia MataluniMS Clinical and Research Unit, Department of Systems Medicine, Tor Vergata University, Viale Oxford 81, 00133, Rome, Italy.
Enrico MillefioriniDepartment of Human Neurosciences, Sapienza University, Viale dell'Università 30, 00185, Rome, Italy.
Massimiliano MirabellaFondazione Policlinico Universitario 'A. Gemelli' IRCCS, Largo A. Gemelli 8, 00168, Rome, Italy.
Fabrizia MonteleoneMS Clinical and Research Unit, Department of Systems Medicine, Tor Vergata University, Viale Oxford 81, 00133, Rome, Italy.
Viviana NocitiFondazione Policlinico Universitario 'A. Gemelli' IRCCS, Largo A. Gemelli 8, 00168, Rome, Italy.
Simona PontecorvoDepartment of Human Neurosciences, Sapienza University, Viale dell'Università 30, 00185, Rome, Italy.
Silvia RomanoDepartment of Neurosciences, Mental Health and Sensory Organs (NESMOS), S. Andrea Hospital, Sapienza University, Viale di Grottarossa 1035, 00189, Rome, Italy.
Serena RuggieriDepartment of Neurosciences, S. Camillo-Forlanini Hospital, C.ne Gianicolense 87, 00152, Rome, Italy.
Marco SalvettiDepartment of Neurosciences, Mental Health and Sensory Organs (NESMOS), S. Andrea Hospital, Sapienza University, Viale di Grottarossa 1035, 00189, Rome, Italy.
Carla TortorellaDepartment of Neurosciences, S. Camillo-Forlanini Hospital, C.ne Gianicolense 87, 00152, Rome, Italy.
Silvana ZanninoDepartment of Clinical Experimental Oncology, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00128, Rome, Italy.
Giancarlo Di BattistaSan Filippo Neri Hospital, ASL Roma 1, Via G. Martinotti 20, 00135, Rome, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Patients with multiple sclerosis on long-term injectable therapies may suffer from the so-called "needle fatigue", i.e., a waning commitment to continue with the prescribed injectable treatment. Therefore, alternative treatment strategies to enhance patients' adherence are warranted. In this independent, multicentre post-marketing study, we sought to directly compare switching to either teriflunomide (TFN), dimethyl fumarate (DMF), or pegylated interferon (PEG) on treatment persistence and time to first relapse over a 12-month follow-up. We analyzed a total of 621 patients who were free of relapses and gadolinium-enhancing lesions in the year prior to switching to DMF (n = 265), TFN (n = 160), or PEG (n = 196). Time to discontinuation and time to first relapse were explored in the whole population by Cox regression models adjusted for baseline variables and after a 1:1:1 ratio propensity score (PS)-based matching procedure. Treatment discontinuation was more frequent after switching to PEG (28.6%) than DMF (14.7%; hazard ratio [HR] = 0.25, p < 0.001) and TFN (16.9%; HR = 0.27, p < 0.001). We found similar results even in the re-sampled cohort of 222 patients (74 per group) derived by the PS-based matching procedure. The highest discontinuation rate observed in PEG recipient was mainly due to poor tolerability (p = 0.005) and pregnancy planning (p = 0.04). The low number of patients who relapsed over the 12-month follow-up (25 out of 621, approximately 4%) prevented any analysis on the short-term risk of relapse. This real-world study suggests that oral drugs are a better switching option than low-frequency interferon for promoting the short-term treatment persistence in stable patients who do not tolerate injectable drugs.

Indexed as

Drug SubstitutionMedication AdherenceAdministration, OralAdultCrotonatesDimethyl FumarateFemaleHumansHydroxybutyratesImmunosuppressive AgentsInjections, SubcutaneousInterferon-alphaInterferon alpha-2MaleMiddle AgedMultiple Sclerosis, Relapsing-RemittingCrotonatesDimethyl FumarateHydroxybutyratesImmunosuppressive AgentsInterferon-alphaInterferon alpha-2Nitrilespeginterferon alfa-2bPolyethylene GlycolsRecombinant ProteinsteriflunomideToluidinesMultiple sclerosisNeedle fatigueOral drugsTreatment persistence

Identifiers

PMID31720848

What OpenQuestion holds

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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.