Evidence map›Paper›PMID 40908119›Full record

Observational studyJournal of neurology, neurosurgery, and psychiatry2026

Target trial emulation to replicate randomised clinical trials using registry data in multiple sclerosis.

Antoine Gavoille, Mikail Nourredine, Fabien Rollot, Romain Casey, Guillaume Mathey, Anne Kerbrat, Jonathan Ciron, Jérôme De Sèze, Bruno Stankoff, Elisabeth Maillart and 31 more

Abstract readObservational StudyMulticenter Study
In one paragraph

Observational study in Journal of neurology, neurosurgery, and psychiatry, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 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

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. 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

41 authors.

Antoine GavoilleHospices Civils de Lyon, Service de Neurologie, sclérose en plaques, pathologies de la myéline et neuroinflammation, Bron, France antoine.gavoille@chu-lyon.fr.ORCID http://orcid.org/0000-0002-9118-0849
Mikail NourredineUniversité Lyon 1, CNRS, Laboratoire de Biométrie et Biologie Évolutive UMR 5558, Villeurbanne, France.
Fabien RollotHospices Civils de Lyon, Service de Neurologie, sclérose en plaques, pathologies de la myéline et neuroinflammation, Bron, France.
Romain CaseyHospices Civils de Lyon, Service de Neurologie, sclérose en plaques, pathologies de la myéline et neuroinflammation, Bron, France.
Guillaume MatheyDepartment of Neurology, Nancy University Hospital, Nancy, Lorraine, France.ORCID http://orcid.org/0000-0002-5747-9169
Anne KerbratDepartment of Neurology, University Hospital of Rennes, Rennes, France.
Jonathan CironCHU de Toulouse, CRC-SEP, department of Neurology, Toulouse Cedex 9, France.ORCID http://orcid.org/0000-0002-3386-6308
Jérôme De SèzeCHU de Strasbourg, Department of Neurology and Clinical Investigation Center, CIC 1434, INSERM 1434, Strasbourg, France.
Bruno StankoffSorbonne Universités, UPMC Paris 06, Brain and Spine Institute, ICM, Hôpital de la Pitié Salpêtrière, Inserm UMR S 1127, CNRS UMR 7225, and Department of Neurology, AP-HP, Paris, France.ORCID http://orcid.org/0000-0002-9631-4674
Elisabeth MaillartDépartement de neurologie, Hôpital Pitié-Salpêtrière, APHP, F-75013 Paris; Centre de Ressources et de Compétences SEP, Paris, Île-de-France, France.ORCID http://orcid.org/0000-0001-7699-0328
Aurelie RuetDepartment of Neurology, Service Pathologies inflammatoires du système nerveux central, CRC-SEP, University Hospital of Bordeaux, Bordeaux, France.
Pierre LabaugeCHU de Montpellier, MS Unit, F-34295 Montpellier Cedex 5, France; University of Montpellier (MUSE), Montpellier, France.
Arnaud KwiatkowskiHôpital Saint Vincent de Paul, Department of Neurology, Lille, France.
Helene ZephirCHU Lille, CRCSEP Lille, Univ Lille, U1172, Lille, France.
Caroline PapeixHôpital Fondation A. de Rothschild, Department of Neurology, F-75000 Paris, France; Université Paris-Cité, Paris, France.
Gilles DeferCHU de Caen, MS expert centre, Department of Neurology, Normandy University, Caen, France.
Christine Lebrun-FrenayDepartment of Neurology, Centre Hospitalier Universitaire Pasteur2, Université Nice Côte d'Azur, UR2CA_URRIS, Nice, France.ORCID http://orcid.org/0000-0002-3713-2416
Thibault MoreauCHU de Dijon, Department of Neurology, EA4184, Dijon, France.
David-Axel LaplaudNantes Université, CHU Nantes, INSERM, Center for Research in Transplantation and Translational Immunology, UMR 1064, CIC INSERM 1413, Service de Neurologie, Nantes, France.
Eric BergerCHU de Besançon, Service de Neurologie, Besançon, France.
Pierre ClavelouCHU Clermont-Ferrand, Department of Neurology, Clermont-Ferrand, France.
Eric ThouvenotDepartment of Neurology, Nimes University Hospital, Nimes Cedex 9, France.
Olivier HeinzlefHôpital de Poissy, Department of Neurology, CRC SEP-IDF-Ouest, Poissy, France.ORCID http://orcid.org/0000-0002-4634-8542
Jean PelletierAix Marseille Univ, APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, Marseille, France.
Abdullatif Al KhedrCHU d'Amiens, Department of Neurology, Amiens, France.
Olivier CasezCHU Grenoble Alpes, Department of Neurology, Neurology MS Clinic Grenoble, Grenoble Alpes university hospital, La Tronche, France.
Bertrand BourreCHU de Rouen, Department of Neurology, Rouen, France.ORCID http://orcid.org/0000-0002-2459-2480
Abir WahabAPHP, Hôpital Henri Mondor, Department of neurology, Créteil, France.
Laurent MagyCHU de Limoges, Hôpital Dupuytren, Department of Neurology, Limoges, France.
Solène MoulinCHU de Reims, CRC-SEP, Department of neurology, Reims Cedex, France.
Jean-Philippe CamdessanchéCHU de Saint-Étienne, Hôpital Nord, Department of Neurology, Saint-Étienne, France.ORCID http://orcid.org/0000-0002-5282-6707
Ines DoghriCHU de Tours, Hôpital Bretonneau, CRC SEP and Department of Neurology, Tours, France.
Mariana SarovAPHP, Hôpital Kremlin Bicêtre, Department of Neurology, Le Kremlin Bicêtre, France.
Karolina HankiewiczDepartment of neurology, Hôpital Pierre Delafontaine, Centre Hospitalier de Saint-Denis, Saint-Denis, France.
Corinne PottierHôpital NOVO, site Pontoise, Department of Neurology, Pontoise, France.
Amélie Dos SantosCHU La Milétrie, Hôpital Jean Bernard, Department of neurology, Poitiers, France.
Eric ManchonCH de Gonesse, Department of neurology, Gonesse, France.
Maia TchikviladzeHôpital Foch, Department of neurology, Suresnes, France.
Muriel RabilloudUniversité Lyon 1, CNRS, Laboratoire de Biométrie et Biologie Évolutive UMR 5558, Villeurbanne, France.
Fabien SubtilUniversité Lyon 1, CNRS, Laboratoire de Biométrie et Biologie Évolutive UMR 5558, Villeurbanne, France.
Sandra VukusicHospices Civils de Lyon, Service de Neurologie, sclérose en plaques, pathologies de la myéline et neuroinflammation, Bron, France.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BackgroundTarget trial emulation (TTE) offers a formal framework for causal inference using observational data, but its validity must be evaluated in each research domain by replicating randomised clinical trials (RCTs). We aimed to replicate eight RCTs evaluating the efficacy of disease-modifying therapies (DMTs) in multiple sclerosis (MS) using French registry data.

methodsThis multicentre, retrospective, observational study was conducted using data extracted in December 2023 from the

results14 111 patients were included in eight emulated trials: ASSESS (fingolimod vs glatiramer acetate), BEYOND (interferon beta vs glatiramer acetate), CONFIRM (dimethyl fumarate (DMF) vs glatiramer acetate), OPERA (ocrelizumab vs interferon beta), REGARD (interferon beta vs glatiramer acetate), RIFUND-MS (rituximab vs DMF), TENERE (teriflunomide vs interferon beta) and TRANSFORMS (fingolimod vs interferon beta). Treatment effects estimated in emulated trials were concordant with RCT findings in seven of eight trials for relapse rate, and in all six trials assessing disability progression. Radiological outcomes were more challenging to replicate; concordance was achieved in three of five trials for new T2-lesions, and one of four trials for new gadolinium-enhanced T1-lesions.

conclusionThe combined use of a TTE methodology and high-quality registry data is a valid tool to evaluate treatment effectiveness in MS.

Indexed as

Immunosuppressive AgentsMultiple SclerosisRegistriesAdultAntibodies, Monoclonal, HumanizedCrotonatesDisease ProgressionFemaleFingolimod HydrochlorideGlatiramer AcetateHumansImmunologic FactorsInterferon-betaMagnetic Resonance ImagingMaleMiddle AgedAntibodies, Monoclonal, HumanizedCrotonatesFingolimod HydrochlorideGlatiramer AcetateImmunologic FactorsImmunosuppressive AgentsInterferon-betaMULTIPLE SCLEROSISNEUROEPIDEMIOLOGYSTATISTICS

Identifiers

PMID40908119
PMCPMC12911643

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Registered trials

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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.