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- Title
Quantifying the risk of disease reactivation after interferon and glatiramer acetate discontinuation in multiple sclerosis: The VIAADISC score.
- Authors
Bsteh, Gabriel; Hegen, Harald; Riedl, Katharina; Altmann, Patrick; Auer, Michael; Berek, Klaus; Di Pauli, Franziska; Ehling, Rainer; Kornek, Barbara; Monschein, Tobias; Rinner, Walter; Schmied, Christiane; Wurth, Sebastian; Zebenholzer, Karin; Zinganell, Anne; Zrzavy, Tobias; Zulehner, Gudrun; Deisenhammer, Florian; Rommer, Paulus; Leutmezer, Fritz
- Abstract
Background and purpose: There is a lack of evidence guiding discontinuation of disease‐modifying therapy (DMT) in relapsing multiple sclerosis (RMS). Thus, the objective of this study was to generate and validate a risk score for disease reactivation after DMT discontinuation in RMS. Methods: We drew a generation and validation dataset from two separate prospectively collected observational databases including RMS patients who received interferon‐β or glatiramer acetate for ≥12 months, then discontinued DMT for ≥6 months and had ≥2 years of follow‐up available. In the generation sample (n = 168), regression analysis was performed to identify clinical or magnetic resonance imaging (MRI) variables independently predicting disease reactivation after DMT discontinuation. A predictive score was calculated using the variables included in the multivariable model and applied to the validation sample (n = 98). Results: The variables included in the final model as independent predictors of disease reactivation were age at discontinuation, MRI activity at discontinuation, and duration of clinical stability (all p < 0.001). The resulting score was able to robustly identify patients at high (83%–85%), moderate (36%–38%), and low risk (7%) of disease reactivation within 5 years after DMT discontinuation in both cohorts. Conclusions: The composite VIAADISC score is a valuable tool to inform and support patients and neurologists in the process of decision making to discontinue injectable DMTs.
- Subjects
GLATIRAMER acetate; MAGNETIC resonance imaging; MULTIPLE sclerosis; INTERFERONS; DECISION making
- Publication
European Journal of Neurology, 2021, Vol 28, Issue 5, p1609
- ISSN
1351-5101
- Publication type
Article
- DOI
10.1111/ene.14705