Evidence map›Paper›PMID 31848231›Full record

ArticleNeurology(R) neuroimmunology & neuroinflammation2020

Relapse recovery: The forgotten variable in multiple sclerosis clinical trials.

Orhun H Kantarci, Burcu Zeydan, Elizabeth J Atkinson, Brittani L Conway, Carmen Castrillo-Viguera, Moses Rodriguez

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Neurology(R) neuroimmunology & neuroinflammation, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.

0numbers the graph read from it
0cells of the map it votes in
13citing papers in PubMed
1.2field-weighted citation impact, top 20% 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

13 citing papers in PubMed, 20 citations in OpenAlex.

  1. Trial
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  4. Review
  5. Article
  6. Article
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  8. Review
  9. Superoxide dismutase (SOD), advanced oxidation protein products (AOPP), and disease-modifying treatment are related to better relapse recovery after corticosteroid treatment in multiple sclerosis.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2021
    Article
  10. Article
  11. Impact of Age on Multiple Sclerosis Disease Activity and Progression.Current neurology and neuroscience reports · 2020
    Review
  12. Relapse recovery in multiple sclerosis: Effect of treatment and contribution to long-term disability.Multiple sclerosis journal - experimental, translational and clinical
    Article
  13. 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

6 authors at 3 institutions in 2 countries.

Orhun H KantarciFrom the Department of Neurology (O.H.K., B.Z., M.R.), Mayo Clinic College of Medicine, Mayo Clinic Center for Multiple Sclerosis and CNS Demyelinating Diseases; Department of Health Sciences Research (E.J.A.), Mayo Clinic College of Medicine; Department of Radiology (B.Z.), Mayo Clinic College of Medicine; Department of Neurology (B.L.C.), Formerly a Clinical Fellow at the Mayo Clinic College of Medicine, Mayo Clinic Center for Multiple Sclerosis and CNS Demyelinating Diseases, Rochester, MN; HealthPartners Neuroscience Center (B.L.C.), Saint Paul, MN; and US Medical (C.C-.V.), Biogen Inc., Boston, MA. kantarci.orhun@mayo.edu.
Burcu ZeydanFrom the Department of Neurology (O.H.K., B.Z., M.R.), Mayo Clinic College of Medicine, Mayo Clinic Center for Multiple Sclerosis and CNS Demyelinating Diseases; Department of Health Sciences Research (E.J.A.), Mayo Clinic College of Medicine; Department of Radiology (B.Z.), Mayo Clinic College of Medicine; Department of Neurology (B.L.C.), Formerly a Clinical Fellow at the Mayo Clinic College of Medicine, Mayo Clinic Center for Multiple Sclerosis and CNS Demyelinating Diseases, Rochester, MN; HealthPartners Neuroscience Center (B.L.C.), Saint Paul, MN; and US Medical (C.C-.V.), Biogen Inc., Boston, MA.
Elizabeth J AtkinsonFrom the Department of Neurology (O.H.K., B.Z., M.R.), Mayo Clinic College of Medicine, Mayo Clinic Center for Multiple Sclerosis and CNS Demyelinating Diseases; Department of Health Sciences Research (E.J.A.), Mayo Clinic College of Medicine; Department of Radiology (B.Z.), Mayo Clinic College of Medicine; Department of Neurology (B.L.C.), Formerly a Clinical Fellow at the Mayo Clinic College of Medicine, Mayo Clinic Center for Multiple Sclerosis and CNS Demyelinating Diseases, Rochester, MN; HealthPartners Neuroscience Center (B.L.C.), Saint Paul, MN; and US Medical (C.C-.V.), Biogen Inc., Boston, MA.
Brittani L ConwayFrom the Department of Neurology (O.H.K., B.Z., M.R.), Mayo Clinic College of Medicine, Mayo Clinic Center for Multiple Sclerosis and CNS Demyelinating Diseases; Department of Health Sciences Research (E.J.A.), Mayo Clinic College of Medicine; Department of Radiology (B.Z.), Mayo Clinic College of Medicine; Department of Neurology (B.L.C.), Formerly a Clinical Fellow at the Mayo Clinic College of Medicine, Mayo Clinic Center for Multiple Sclerosis and CNS Demyelinating Diseases, Rochester, MN; HealthPartners Neuroscience Center (B.L.C.), Saint Paul, MN; and US Medical (C.C-.V.), Biogen Inc., Boston, MA.
Carmen Castrillo-VigueraFrom the Department of Neurology (O.H.K., B.Z., M.R.), Mayo Clinic College of Medicine, Mayo Clinic Center for Multiple Sclerosis and CNS Demyelinating Diseases; Department of Health Sciences Research (E.J.A.), Mayo Clinic College of Medicine; Department of Radiology (B.Z.), Mayo Clinic College of Medicine; Department of Neurology (B.L.C.), Formerly a Clinical Fellow at the Mayo Clinic College of Medicine, Mayo Clinic Center for Multiple Sclerosis and CNS Demyelinating Diseases, Rochester, MN; HealthPartners Neuroscience Center (B.L.C.), Saint Paul, MN; and US Medical (C.C-.V.), Biogen Inc., Boston, MA.
Moses RodriguezFrom the Department of Neurology (O.H.K., B.Z., M.R.), Mayo Clinic College of Medicine, Mayo Clinic Center for Multiple Sclerosis and CNS Demyelinating Diseases; Department of Health Sciences Research (E.J.A.), Mayo Clinic College of Medicine; Department of Radiology (B.Z.), Mayo Clinic College of Medicine; Department of Neurology (B.L.C.), Formerly a Clinical Fellow at the Mayo Clinic College of Medicine, Mayo Clinic Center for Multiple Sclerosis and CNS Demyelinating Diseases, Rochester, MN; HealthPartners Neuroscience Center (B.L.C.), Saint Paul, MN; and US Medical (C.C-.V.), Biogen Inc., Boston, MA.
Department of Medical Sciences · BYHealthPartners · USMayo Clinic in Arizona · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo determine whether basing the decision to initiate immediate vs delayed disease-modifying therapy (DMT) on extent of recovery after initial relapse affects long-term disability accumulation in a multiple sclerosis (MS) evidence-based setting.

methodsWe analyzed the double-blind, placebo-controlled interferon beta-1a 30 mc once a week in clinically isolated syndrome and 10-year-follow-up extension trial. Good recovery after presenting relapse was defined as (1) full early recovery within 28 days of symptom onset (Expanded Disability Status Scale [EDSS] score of 0 at enrollment maintained ≥6 months) and (2) delayed good recovery (EDSS score > 0 at enrollment and improvement from peak deficit to 6th-month or 1-year visit ≥ median). Time from recovery assignment to future disability (EDSS score ≥ 2.5 or ≥4.0) was studied on a relapse-recovery-stratified age axis and immediate vs 3-year delayed treatment initiation with Kaplan-Meier statistics and hazard ratios (HRs).

resultsOne hundred seventy-five/328 patients had good recovery (94 immediate and 81 delayed treatment); 153 did not have good recovery (77 immediate and 76 delayed treatment). HRs for EDSS score ≥2.5 outcome were: delayed treatment without good recovery as reference (HR = 1.0), delayed treatment with good recovery (HR

conclusionsIn patients with MS presenting without good recovery after the initial relapse, immediate DMT initiation favorably influences the likelihood of more ambulatory-benign disease akin to patients with good recovery after the initial relapse. CLASSIFICATION OF EVIDENCE: This study provides Class III evidence that for patients with MS without good recovery after the initial relapse, immediate DMT initiation increases the likelihood of a benign disease course.

Indexed as

Clinical Decision-MakingDisease ProgressionOutcome Assessment, Health CareRandomized Controlled Trials as TopicSeverity of Illness IndexAdolescentAdultFemaleFollow-Up StudiesHumansImmunologic FactorsInterferon-betaMaleMiddle AgedMulticenter Studies as TopicMultiple SclerosisImmunologic FactorsInterferon-beta

Identifiers

PMID31848231
PMCPMC6943367
OpenAlexW2994859165

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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.