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    Aging and efficacy of disease-modifying therapies in multiple sclerosis: a meta-analysis of clinical trials

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    Author
    Zhang, Yinan
    Gonzalez Caldito, Natalia
    Shirani, Afsaneh
    Salter, Amber
    Cutter, Gary
    Culpepper, William
    Wallin, Mitchell
    Kosa, Peter
    Bielekova, Bibiana
    Lublin, Fred
    Stϋve, Olaf
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    Date
    2020-01-01
    Journal
    Therapeutic Advances in Neurological Disorders
    Publisher
    SAGE Publications Inc.
    Type
    Article
    
    Metadata
    Show full item record
    See at
    https://doi.org/10.1177/1756286420969016
    Abstract
    Background: Disease-modifying therapies (DMTs) for multiple sclerosis (MS) are approved for the treatment of disease activity and are effective in reducing relapses and new magnetic resonance imaging (MRI) lesions. However, disease activity generally subsides with time, and age-dependent changes in DMT efficacy are not well-established. We aimed to investigate whether age impacts the efficacy of DMTs in treating disease activity in patients with relapsing–remitting MS (RRMS). Methods: DMT efficacy related to age was assessed through a meta-analysis of clinical trials that evaluated the efficacy of DMTs in RRMS patients as measured by reductions in the annualized relapse rate (ARR), new T2 lesions, and gadolinium-enhanced lesions on MRI. Using the mean baseline patient age from each trial, a weighted linear regression was fitted to determine whether age was associated with treatment efficacy on a group level. Results: Group-level data from a total of 28,082 patients from 26 trials of 14 different DMTs were included in the meta-analysis. There were no statistically significant associations between age and reductions in ARR, new T2 lesions, and gadolinium-enhanced lesions of the treatment group compared with placebo. Conclusion: DMTs for RRMS show efficacy in treating disease activity independent of age as demonstrated by group-level data from DMT clinical trials. Nevertheless, clinical trials select for patients with baseline disease activity regardless of age, thereby not representing real-world patients with RRMS, where disease activity declines with age.
    Sponsors
    Sanofi Genzyme
    Keyword
    aging
    clinical trials
    disease-modifying therapies
    multiple sclerosis
    Identifier to cite or link to this item
    http://hdl.handle.net/10713/14021
    ae974a485f413a2113503eed53cd6c53
    10.1177/1756286420969016
    Scopus Count
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    UMB Open Access Articles 2020

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