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Optimization of treatment with interferon beta in multiple sclerosis. Usefulness of automatic system application criteria

Author(s): Ruiz-Peña Juan | Duque Pablo | Izquierdo Guillermo

Journal: BMC Neurology
ISSN 1471-2377

Volume: 8;
Issue: 1;
Start page: 3;
Date: 2008;
Original page

Abstract Background A software based tool has been developed (Optem) to allow automatize the recommendations of the Canadian Multiple Sclerosis Working Group for optimizing MS treatment in order to avoid subjective interpretation. Methods Treatment Optimization Recommendations (TORs) were applied to our database of patients treated with IFN β1a IM. Patient data were assessed during year 1 for disease activity, and patients were assigned to 2 groups according to TOR: "change treatment" (CH) and "no change treatment" (NCH). These assessments were then compared to observed clinical outcomes for disease activity over the following years. Results We have data on 55 patients. The "change treatment" status was assigned to 22 patients, and "no change treatment" to 33 patients. The estimated sensitivity and specificity according to last visit status were 73.9% and 84.4%. During the following years, the Relapse Rate was always higher in the "change treatment" group than in the "no change treatment" group (5 y; CH: 0.7, NCH: 0.07; p < 0.001, 12 m – last visit; CH: 0.536, NCH: 0.34). We obtained the same results with the EDSS (4 y; CH: 3.53, NCH: 2.55, annual progression rate in 12 m – last visit; CH: 0.29, NCH: 0.13). Conclusion Applying TOR at the first year of therapy allowed accurate prediction of continued disease activity in relapses and disability progression.

Tango Jona
Tangokurs Rapperswil-Jona

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