ReviewJournal of neurology2024
Multiple sclerosis: time for early treatment with high-efficacy drugs.
Review in Journal of neurology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 56 papers, 4 of them syntheses 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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
56 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Clinical characteristics, management and outcomes in immune checkpoint inhibitor-induced central nervous system demyelinating disease.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2026Pooled it
- Early Prognostic Factors in Multiple Sclerosis: Clinical and Therapeutic Implications.Medicina (Kaunas, Lithuania) · 2026Pooled it
- Osteopontin as a diagnostic and NTZ-response biomarker of multiple sclerosis: a systematic review and meta-analysis.Frontiers in immunology · 2025Pooled it
- Rituximab in secondary progressive multiple sclerosis: a meta-analysis.Annals of clinical and translational neurology · 2024Pooled it
- Efficacy and safety of ofatumumab in participants with relapsing multiple sclerosis and breakthrough disease on oral fingolimod or fumarates: results from the ARTIOS study.Journal of neurology · 2026Trial
- Five Years of Ublituximab in Multiple Sclerosis: ULTIMATE I and II Open-Label Extension Study.JAMA neurology · 2026Trial
- Disease outcomes with ublituximab in treatment-naïve participants: subpopulation analyses of the phase 3 ULTIMATE I and II studies in participants with relapsing multiple sclerosis.Frontiers in immunology · 2026Trial
- A longitudinal analysis of real world symptom tracking and patient-reported outcomes in Brisa, a German Digital Health App for multiple sclerosis.PLOS digital health · 2026Article
- Beyond relapse control: motor and cognitive subclinical progression in RRMS -a real-world longitudinal study of ocrelizumab and interferon beta.Acta neurologica Belgica · 2026Article
- Knowledge graph-guided multiple sclerosis identification and therapeutic trend analysis: Real-world evidence from two large healthcare systems.PLOS digital health · 2026Article
- Early Versus Delayed Treatment with Ocrelizumab: A Multicenter, Real-World Observational Study in People with Multiple Sclerosis.Neurology and therapy · 2026Article
- Efficacy of Ublituximab in People with Highly Active Relapsing Multiple Sclerosis.Neurology and therapy · 2026Article
- Exit strategy patterns in second-line therapies for relapsing forms of multiple sclerosis.Acta neurologica Belgica · 2026Article
- Glatiramer Acetate Therapy Induces DNA Methylation Changes in Immune Cells of Multiple Sclerosis Patients: A Pilot Study.International journal of molecular sciences · 2026Article
- Kappa Index predicts disease activity and transition to high-efficacy therapies in multiple sclerosis.Clinical chemistry and laboratory medicine · 2026Article
- Immunotherapy-Mediated Modulation of the Gut Microbiota in Multiple Sclerosis: The Effects of High-Efficacy (Cladribine) and Moderate-Efficacy (Interferon Beta-1a) Treatments.International journal of molecular sciences · 2026Article
- A Long-Term Prospective Evaluation of the Predictive Value of Molecular Markers in Serum and Cerebrospinal Fluid in Patients in the Early Stage of Multiple Sclerosis.International journal of molecular sciences · 2026Article
- Long-Term Clinical and Psychological Efficacy and Safety of Ocrelizumab in People With Multiple Sclerosis: A Real-World Longitudinal Study.Health science reports · 2026Article
- Occupational balance, quality of life, occupational performance, and disease-related factors in people with multiple sclerosis: A case-control study.Australian occupational therapy journal · 2026Article
- A Comparative Study of Clinical and Demographic Profiles of Multiple Sclerosis Patients in Two Regional Centers in Denmark and Romania.Neurology international · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
This review addresses current changes in the approach to treating patients with multiple sclerosis (MS). The widely practiced approach of utilizing agents with lower treatment efficacy (LETA) at onset with subsequent escalation has been challenged by new data suggesting that MS patients derive greater benefit when therapy is initiated with high-efficacy treatment agents (HETA). Several recent studies compared treatment efficacy and safety of early administration of HETA versus LETA. The results of randomized, double blind, phase III studies with LETA as a control arm and population-based larger and longer studies using propensity scoring, marginal structural modeling and weighted cumulative exposure analysis support the benefit of early treatment with HETA. Patients initiating their treatment with HETA, regardless of prognostic factors and MRI burden at baseline, showed significantly lower annualized relapse rate (ARR) and reduced disability progression in follow-up periods of up to 10-15 years. Moreover, the safety profile of recently approved HETA ameliorates concerns about off-target effects associated with a number of earlier high-efficacy drugs. Patient perception has also changed with an increasing preference for medication profiles that both improve symptoms and prevent disease progression. Accumulating data from randomized studies and the results of large population-based studies demonstrating short-term and longer-term patient benefits support the view that HETA should be more widely used. The adoption of early treatment with HETA capitalizes on a window of opportunity for anti-inflammatory drugs to maximally impact disease pathology and heralds a sea change in clinical practice toward pro-active management and away from a philosophy routed in generating clinical benefit as a consequence of treatment failure.
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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.