ReviewNeurology(R) neuroimmunology & neuroinflammation2020
An argument for broad use of high efficacy treatments in early multiple sclerosis.
Review in Neurology(R) neuroimmunology & neuroinflammation, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04550455 (A Prospective Biomarker Study in Active Secondary Progressive Multiple Sclerosis), which is not on this map. Cited by 39 papers, 1 of them a synthesis that pooled 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.
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.
A Prospective Biomarker Study in Active Secondary Progressive Multiple Sclerosis (SPMS)Subjects Treated With Cladribine Tablets
Who cites it
39 citing papers in PubMed, 1 synthesis or guideline pooled it, 81 citations in OpenAlex.
- Effects of High Efficacy Multiple Sclerosis Disease Modifying Drugs on the Immune Synapse: A Systematic Review.Current pharmaceutical design · 2024Pooled it
- Shared Genetic Effects and Antagonistic Pleiotropy Between Multiple Sclerosis and Common Cancers.Annals of clinical and translational neurology · 2026Article
- Patient profiling in relapsing multiple sclerosis: insights from a real-world observational study into the unmet medical needs of patients on disease-modifying therapy.Journal of neurology · 2026Observational
- Comparative Effectiveness of Cladribine and S1P Receptor Modulators in Treatment-Naive Relapsing-Remitting MS.JAMA network open · 2025Article
- Performance of Composite Endpoints Defining Progression Independent of Relapse Activity in Multiple Sclerosis.Annals of clinical and translational neurology · 2025Article
- Surveillance of drug prescribing: why outliers miss their targets - a qualitative study.BMC health services research · 2025Article
- Twenty years of natalizumab in multiple sclerosis: lessons learned and future outlook.Therapeutic advances in neurological disorders · 2025Review
- Evaluating natalizumab first-line and later-line use in multiple sclerosis: a US claims database analysis.Therapeutic advances in neurological disorders · 2025Article
- Long-term efficacy and safety of alemtuzumab in participants with highly active MS: TOPAZ clinical trial and interim analysis of TREAT-MS real-world study.Therapeutic advances in neurological disorders · 2025Article
- Ten Years ofNeurology(R) neuroimmunology & neuroinflammation · 2025Article
- Predictors of therapy switching to high-efficacy disease-modifying therapies in patients with multiple sclerosis: a single center, retrospective, observational study.Frontiers in neurology · 2025Article
- Benefits of early highly effective versus escalation treatment strategies in relapsing multiple sclerosis estimated using a treatment-sequence model.Multiple sclerosis (Houndmills, Basingstoke, England) · 2024Article
- Early use of high-efficacy therapies in multiple sclerosis in the United States: benefits, barriers, and strategies for encouraging adoption.Journal of neurology · 2024Review
- Treatment switches of disease-modifying therapies in people with multiple sclerosis: long-term experience from the German MS Registry.Therapeutic advances in neurological disorders · 2024Article
- Identification of alemtuzumab-suitable multiple sclerosis patients in Slovakia and sequencing of post-alemtuzumab immunomodulatory treatment.Therapeutic advances in neurological disorders · 2024Article
- Shifting from the treat-to-target to the early highly effective treatment approach in patients with multiple sclerosis - real-world evidence from Germany.Therapeutic advances in neurological disorders · 2024Article
- Beyond lines of treatment: embracing early high-efficacy disease-modifying treatments for multiple sclerosis management.Therapeutic advances in neurological disorders · 2024Review
- Predictors of treatment switching in the Big Multiple Sclerosis Data Network.Frontiers in neurology · 2023Article
- Accounting for uncertainty in training data to improve machine learning performance in predicting new disease activity in early multiple sclerosis.Frontiers in neurology · 2023Article
- Practical Guidance on the Use of Cladribine Tablets in the Management or Relapsing Multiple Sclerosis: Expert Opinion from Qatar.Degenerative neurological and neuromuscular disease · 2023Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Two different treatment paradigms are most often used in multiple sclerosis (MS). An escalation or induction approach is considered when treating a patient early in the disease course. An escalator prioritizes safety, whereas an inducer would favor efficacy. Our understanding of MS pathophysiology has evolved with novel in vivo and in vitro observations. The treatment landscape has also shifted significantly with the approval of over 10 new medications over the past decade alone. Here, we re-examine the treatment approach in light of these recent developments. We believe that recent work suggests that early prediction of the disease course is fraught, the amount of damage to the brain that MS causes is underappreciated, and its impact on patient function oftentimes is underestimated. These concerns, coupled with the recent availability of agents that allow a better therapeutic effect without compromising safety, lead us to believe that initiating higher efficacy treatments early is the best way to achieve the best possible long-term outcomes for people with MS.
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What OpenQuestion holds
Registered trials
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.