ArticleFrontiers in neurology
Predictors of initiating high-efficacy vs. platform therapies as first-line disease-modifying treatment in multiple sclerosis.
Article in Frontiers in neurology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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
1 citing paper in PubMed.
- Horizon Scanning of Multiple Sclerosis Expenditure in Italy (2025-2029): Updated Insights from the Oracle Model.Neurology and therapy · 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
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: The therapeutic landscape of multiple sclerosis (MS) is rapidly evolving, with increasing emphasis on early initiation of high-efficacy disease-modifying therapies (heDMTs). However, real-world data on predictors of first-line heDMT use and its outcomes remain scarce in the Middle East. Objectives: To identify demographic and clinical factors influencing the choice of first-line heDMT vs. platform therapy in relapsing-remitting MS (RRMS) and to evaluate whether initial treatment class impacts disability outcomes and treatment persistence. Methods: We conducted a retrospective cohort study of 826 RRMS patients treated at a tertiary center in Saudi Arabia between 2016 and 2024. Predictors of initiating heDMT were identified using multivariable logistic regression. Disability status (EDSS category) was analyzed using ordinal logistic regression. Treatment persistence and causes of discontinuation were examined using Kaplan-Meier survival analysis, Cox proportional hazards modeling, and Fine-Gray competing-risks regression. Results: Of 826 patients, 330 (40%) received heDMTs as first-line therapy. Initiation in the later treatment era (2019-2024) strongly predicted heDMT use compared with the early treatment era (2008-2013; OR = 48.8; Conclusions: First-line use of heDMTs in Saudi Arabia has increased substantially over recent years, particularly among patients with cerebellar onset. While disability outcomes were similar between treatment groups, initiating heDMTs conferred clear advantages in persistence and tolerability. These findings reinforce the paradigm shift toward early intensive MS management and highlight the need for broader access and guideline-driven implementation of heDMTs in the region.
Indexed as
Identifiers
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.