Evidence map›Paper›PMID 34949130›Full record

ArticleMultiple sclerosis (Houndmills, Basingstoke, England)2022

Disease-modifying drugs for multiple sclerosis and subsequent health service use.

Huah Shin Ng, Feng Zhu, Elaine Kingwell, Yinshan Zhao, Shenzhen Yao, Okechukwu Ekuma, Lawrence W Svenson, Charity Evans, John D Fisk, Ruth Ann Marrie and 1 more

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

Article in Multiple sclerosis (Houndmills, Basingstoke, England), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
0.9field-weighted citation impact, top 26% 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

6 citing papers in PubMed, 9 citations in OpenAlex.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors at 6 institutions in 2 countries.

Huah Shin NgDepartment of Medicine, Division of Neurology and the Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada.ORCID 0000-0001-8381-5253
Feng ZhuDepartment of Medicine, Division of Neurology and the Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada.
Elaine KingwellDepartment of Medicine, Division of Neurology and the Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada/Research Department of Primary Care & Population Health, University College London, London, UK.
Yinshan ZhaoDepartment of Medicine, Division of Neurology and the Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada.
Shenzhen YaoCollege of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK, Canada/Health Quality Council, Saskatoon, SK, Canada.
Okechukwu EkumaDepartment of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada.
Lawrence W SvensonAlberta Health, Edmonton, AB, Canada/Division of Preventive Medicine & School of Public Health, University of Alberta, Edmonton, AB, Canada/Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
Charity EvansCollege of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK, Canada.
John D FiskNova Scotia Health Authority and the Departments of Psychiatry, Psychology and Neuroscience, and Medicine, Dalhousie University, Halifax, NS, Canada.
Ruth Ann MarrieDepartments of Internal Medicine and Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada.ORCID 0000-0002-1855-5595
Helen TremlettDepartment of Medicine, Division of Neurology and the Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada/Division of Neurology, Department of Medicine, Faculty of Medicine, UBC Hospital, Vancouver, BC, Canada.ORCID 0000-0001-5804-2535
University of British Columbia · CAUniversity of Manitoba · CAUniversity of Saskatchewan · CAAlberta Health Services · CADalhousie University · CAUniversity of British Columbia Hospital · CA

Funding

Clinical Communication Following a Decision AidR03HS021764 · AHRQ · MICHIGAN STATE UNIVERSITY · PI HOLMES-ROVNER, MARGARET M · 2012 to 2012
$100k
AHRQ HHS R03 HS021764CIHR FDN-159934CIHR PJT-156363
6 · The paper itself

Abstract

objectiveWe assessed the relationship between the multiple sclerosis (MS) disease-modifying drugs (DMDs) and healthcare use.

methodsPersons with MS (aged ⩾18 years) were identified using linked population-based health administrative data in four Canadian provinces and were followed from the most recent of their first MS/demyelinating event or 1 January 1996 until the earliest of death, emigration, or study end (31 December 2017 or 31 March 2018). Prescription records captured DMD exposure, examined as any DMD, then by generation (first-generation (the injectables) or second-generation (orals/infusions)) and individual DMD. The associations with subsequent all-cause hospitalizations and physician visits were examined using proportional means model and negative binomial regression.

resultsOf 35,894 MS cases (72% female), mean follow-up was 12.0 years, with person-years of DMD exposure for any, or any first- or second-generation DMD being 63,290, 54,605 and 8685, respectively. Any DMD or any first-generation DMD exposure (versus non-exposure) was associated with a 24% lower hazard of hospitalization (adjusted hazard ratio, aHR: 0.76; 95% confidence intervals (CIs): 0.71-0.82), rising to 29% for the second-generation DMDs (aHR: 0.71; 95% CI: 0.58-0.88). This ranged from 18% for teriflunomide (aHR: 0.82; 95% CI: 0.67-1.00) to 44% for fingolimod (aHR: 0.56; 95% CI: 0.36-0.87). In contrast, DMD exposure was generally not associated with substantial differences in physician visits.

conclusionFindings provide real-world evidence of a beneficial relationship between DMD exposure and hospitalizations.

Indexed as

Multiple SclerosisAgedCanadaFemaleFingolimod HydrochlorideHospitalizationHumansMalePatient Acceptance of Health CareFingolimod HydrochlorideDisease-modifying drugshealth serviceshospitalizationmultiple sclerosisphysician services

Identifiers

PMID34949130
PMCPMC8958569
OpenAlexW4200021580

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.