A propensity-matched comparison of long-term disability worsening in patients with multiple sclerosis treated with dimethyl fumarate or fingolimod

Background: Although the aggregate of data among patients with multiple sclerosis (MS) have shown similar efficacy between dimethyl fumarate (DMF) and fingolimod (FTY), most studies have not assessed long-term worsening of disability. We compared long-term disability worsening over 5 years, as assessed by the Patient-Determined Disease Steps (PDDS), among participants with MS treated with DMF or FTY. Methods: We identified individuals in the North American Research Committee on Multiple Sclerosis (NARCOMS) registry who had relapsing-remitting MS (RRMS), residing in the United States (Spring 2011 to Spring 2018), who initiated treatment with DMF ( n = 689) or FTY ( n = 565) and had ⩾1 year follow-up on index treatment. Participants receiving DMF who were previously treated with FTY and those on FTY previously treated with DMF were excluded. Propensity score matching at baseline was used to match FTY-treated to DMF-treated participants. Time to 6-month confirmed disability worsening (⩾1-point increase on PDDS, sustained for ⩾6 months) was estimated using Cox regression. A sensitivity analysis was conducted to account for differences in the duration of index exposure between DMF and FTY groups. Results: After propensity score matching, 468 DMF-treated participants were matched with 468 FTY-treated participants. Median treatment duration was 3.0 years for DMF and 4.0 years for FTY. At 5 years, 68.3% [95% confidence interval (CI): 62.4–73.5] of DMF-treated participants and 63.3% (95% CI: 59.6–70.1) treated with FTY were free from 6-month confirmed PDDS worsening [hazard ratio (HR) 1.01 (95% CI: 0.79–1.28); p = 0.95]. Results were similar in the sensitivity analysis: 70.5% (95% CI: 61.8–77.6) of DMF-treated participants and 72.7% (95% CI: 65.4–78.6) of FTY-treated participants were free from 6-month confirmed PDDS worsening [HR: 1.04 (95% CI: 0.71–1.51); p = 0.84]. Conclusions: In participants with MS from the NARCOMS registry, there was no significant difference in confirmed disability (PDDS) worsening over 5 years between those treated with DMF versus FTY.

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Relationship between formulaic breast volume and risk of breast cancer based on linear measurement

10.21203/rs.3.rs-23397/v3 ◽

2020 ◽

Author(s):

xiaoxia li ◽

Chunlan Zhou ◽

Yanni Wu ◽

Xiaohong Chen

Keyword(s):

Breast Cancer ◽

Logistic Regression ◽

Propensity Score ◽

Propensity Score Matching ◽

Cox Regression ◽

Conditional Logistic Regression ◽

Control Group ◽

Breast Volume ◽

Linear Measurements ◽

Significant Difference

Abstract Background: Whether breast volume is a risk factor for breast cancer is controversial. This study aimed to evaluate whether a significant association between breast volume and risk of breast cancer, based on linear measurements,was present by applying propensity score matching (PSM).Methods: The study was designed as a hospital-based case-control study. Between March 2018 and May 2019, 208 cases and 340 controls were retrospectively reviewed. Information on menarche, smoking, feeding mode, oral contraceptives, reproductive history and family history was obtained through a structured questionnaire. Breast volume was calculated using a formula based on linear measurements of breast parameters. Cox regression and PSM were used to estimate odds ratios and 95% confidence intervals for breast cancer using risk factors adjusted for potential confounders. Results: There was a significant difference in breast volume between the two groups before propensity score matching(P = 0.014) . Binary logistic regression showed that the risk of breast cancer was slightly higher in the case group with larger breast volumes than in the control group（P = 0.009, OR = 1.002， 95%CI：1.000~1.003). However, there was no significant statistical difference between the two groups using an independent sample Mann-Whitney U test (P = 0.438) or conditional logistic regression (P = 0.446). Conclusions: After PSM for potential confounding factors, the breast volume of cases did not differ from that of controls. The risk of breast cancer may not be related to breast volume in Chinese women.

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Long-Term Oncological Outcome Comparison between Intermediate- and High-Dose Radioactive Iodine Ablation in Patients with Differentiated Thyroid Carcinoma: A Propensity Score Matching Study

International Journal of Endocrinology ◽

10.1155/2021/6642971 ◽

2021 ◽

Vol 2021 ◽

pp. 1-10

Author(s):

Kwangsoon Kim ◽

Ja Seong Bae ◽

Jeong Soo Kim

Keyword(s):

Propensity Score ◽

Thyroid Carcinoma ◽

Propensity Score Matching ◽

Radioactive Iodine ◽

Differentiated Thyroid Carcinoma ◽

High Dose ◽

Preoperative Serum ◽

Significant Difference ◽

Intermediate Dose

Background. Radioactive iodine (RAI) ablation is recommended for most patients with differentiated thyroid carcinoma (DTC) after total thyroidectomy (TT). We aimed to compare long-term outcomes between intermediate-dose (100 mCi) and high-dose (150 mCi) RAI ablation therapy in patients with DTC using propensity score matching analysis. Methods. This was a retrospective study of 1448 patients with DTC who underwent RAI ablation after TT. Propensity score matching was performed using the extent of operation, tumor size, extrathyroidal extension, multifocality, lymphatic invasion, vascular invasion, perineural invasion, number of positive lymph nodes (LNs), ATA risk stratification system, T stage, N stage, TNM stage, preoperative serum Tg and TgAb levels, and post-RAI serum Tg and TgAb levels. Results. Recurrence rates in the intermediate- and high-dose groups were 3.1% and 5.6%, respectively. After propensity score matching, LN ratio >0.22 (HR, 2.915; 95% CI, 1.228–6.918; p = 0.015 ) and serum Tg >10 ng/mL after RAI (HR, 3.976; 95% CI, 1.839–8.595; p < 0.001 ) were significant predictors of recurrence. Kaplan–Meier analysis showed no significant difference in DFS before or after propensity score matching ( p = 0.074 and p = 0.378 , respectively). Conclusions. Intermediate-dose RAI ablation for the adjuvant treatment of DTC is sufficient as compared to high-dose RAI ablation. Further prospective or multicenter studies should be conducted to clarify the prognosis of intermediate-dose RAI ablation.

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Relationship Between Formulaic Breast Volume And Risk Of Breast Cancer Based On Linear Measurement

10.21203/rs.3.rs-23397/v1 ◽

2020 ◽

Author(s):

xiaoxia li ◽

Chunlan Zhou ◽

Yanni Wu ◽

Xiaohong Chen

Keyword(s):

Breast Cancer ◽

Logistic Regression ◽

Propensity Score ◽

Propensity Score Matching ◽

Cox Regression ◽

Conditional Logistic Regression ◽

Linear Measurement ◽

Control Group ◽

Breast Volume ◽

Significant Difference

Abstract Background: Whether breast volume is a risk factor for breast cancer has been controversial. This study aimed to evaluate whether or not the significant association between breast volume and risk of breast cancer based on linear measurement by applying Propensity Score Matching (PSM) was present. Methods: The study was designed as a hospital-based case-control study. Between March 2018 and May 2019, 208 cases and 340 controls were retrospectively reviewed. Information on menarche, smoking, feeding mode, oral contraceptives, reproductive history and family history was obtained through a structured questionnaire. Calculate breast volume using formula based on the linear measurement of breast parameters. Cox regression and PSM were used to estimate odds ratios and 95% confidence intervals for breast cancer by risk factors adjusted for potential confounders. Results: There was a significant difference in breast volume between two groups before Propensity Score Matching(P=0.014) : P=0.009, OR=1.002, 95% CI: 1.000~1.003). Binary logistic regression showed that the risk of breast cancer was slightly higher in the case group with larger breast volume than in the control group（P=0.009, OR=1.002， 95%CI：1.000～1.003). However, there was no significant statistical difference between two groups in independent sample Mann-Whitney U test (P=0.438) and in conditional logistic regression (P=0.446). Conclusions: After PSM for the potential confounders factors, the breast volume of cases did not differ from that of controls. The risk of breast cancer may not related to breast volume in Chinese women.

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Clinical outcome of out-of-hospital vs. in-hospital cardiac arrest survivors presenting with ventricular tachyarrhythmias

Heart and Vessels ◽

10.1007/s00380-021-01976-y ◽

2021 ◽

Author(s):

Julian Müller ◽

Michael Behnes ◽

Tobias Schupp ◽

Linda Reiser ◽

Gabriel Taton ◽

...

Keyword(s):

Cardiac Arrest ◽

Propensity Score ◽

Propensity Score Matching ◽

Cox Regression ◽

Prognostic Impact ◽

Ventricular Tachyarrhythmias ◽

Increased Risk ◽

All Cause Mortality ◽

Hospital Cardiac Arrest

AbstractLimited data regarding the prognostic impact of ventricular tachyarrhythmias related to out-of-hospital (OHCA) compared to in-hospital cardiac arrest (IHCA) is available. A large retrospective single-center observational registry with all patients admitted due to ventricular tachyarrhythmias was used including all consecutive patients with ventricular tachycardia (VT) and fibrillation (VF) on admission from 2002 to 2016. Survivors discharged after OHCA were compared to those after IHCA using multivariable Cox regression models and propensity-score matching for evaluation of the primary endpoint of long-term all-cause mortality at 2.5 years. Secondary endpoints were all-cause mortality at 6 months and cardiac rehospitalization at 2.5 years. From 2.422 consecutive patients with ventricular tachyarrhythmias, a total of 524 patients survived cardiac arrest and were discharged from hospital (OHCA 62%; IHCA 38%). In about 50% of all cases, acute myocardial infarction was the underlying disease leading to ventricular tachyarrhythmias with consecutive aborted cardiac arrest. Survivors of IHCA were associated with increased long-term all-cause mortality compared to OHCA even after multivariable adjustment (28% vs. 16%; log rank p = 0.001; HR 1.623; 95% CI 1.002–2.629; p = 0.049) and after propensity-score matching (28% vs. 19%; log rank p = 0.045). Rates of cardiac rehospitalization rates at 2.5 years were equally distributed between OHCA and IHCA survivors. In patients presenting with ventricular tachyarrhythmias, survivors of IHCA were associated with increased risk for all-cause mortality at 2.5 years compared to OHCA survivors.

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The long-term efficacy of one-shot neoadjuvant intra-arterial chemotherapy combined with radical cystectomy versus radical cystectomy alone for bladder cancer: a propensity-score matching study

BMC Urology ◽

10.1186/s12894-019-0552-7 ◽

2019 ◽

Vol 19 (1) ◽

Author(s):

Wasilijiang Wahafu ◽

Sai Liu ◽

Wenbin Xu ◽

Mengtong Wang ◽

Qingbao He ◽

...

Keyword(s):

Bladder Cancer ◽

Propensity Score ◽

Propensity Score Matching ◽

Radical Cystectomy ◽

Survival Outcomes ◽

High Morbidity ◽

Term Efficacy ◽

Tumor Stages ◽

Significant Difference

Abstract Background Bladder cancer is a complex disease associated with high morbidity and mortality. Management of bladder cancer before radical cystectomy continues to be controversial. We compared the long-term efficacy of one-shot neoadjuvant intra-arterial chemotherapy (IAC) versus no IAC (NIAC) before radical cystectomy (RC) for bladder cancer. Methods We performed a retrospective review of patients who underwent either one-shot IAC or NIAC before RC between October 2006 and November 2015. A propensity-score matching (1:3) was performed based on key characters. The Kaplan-Meier method was utilized to estimate survival probabilities, and the log-rank test was used to compare survival outcomes between different groups. A multivariable Cox proportional hazard model was used to estimate survival outcomes. Results Twenty-six patients were treated using IAC before RC, and 123 NIAC patients also underwent RC. After matching, there was no significant difference between groups in baseline characteristics, perioperative variables, complication outcomes or tumor characteristics. Compared with clinical tumor stages, pathological tumor stages demonstrated a significant decrease (P = 0.002) in the IAC group. There was no significant difference in overall survival (OS, p = 0.354) or cancer-specific survival (CSS, p = 0.439) between the groups. Among all patients, BMI significantly affected OS (p = 0.004), and positive lymph nodes (PLN) significantly affected both OS (p<0.001) and CSS (p = 0.010). Conclusions One-shot neoadjuvant IAC before RC shows safety and tolerability and provides a significant advantage in pathological downstaging but not in OS or CSS. Further study of neoadjuvant combination therapeutic strategies with RC is needed.

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The long-term efficacy of one-shot neoadjuvant intra-arterial chemotherapy combined with radical cystectomy versus radical cystectomy alone for bladder cancer: a propensity-score matching study

10.21203/rs.2.11853/v4 ◽

2019 ◽

Author(s):

Wasilijiang Wahafu ◽

Sai Liu ◽

Wenbin Xu ◽

Mengtong Wang ◽

Qingbao He ◽

...

Keyword(s):

Bladder Cancer ◽

Propensity Score ◽

Propensity Score Matching ◽

Radical Cystectomy ◽

Survival Outcomes ◽

High Morbidity ◽

Term Efficacy ◽

Tumor Stages ◽

Significant Difference

Abstract Background: Bladder cancer is a complex disease associated with high morbidity and mortality. Management of bladder cancer before radical cystectomy continues to be controversial. We compared the long-term efficacy of one-shot neoadjuvant intra-arterial chemotherapy (IAC)versus no IAC (NIAC) before radical cystectomy (RC) for bladder cancer. Methods: We performed a retrospective review of patients who underwent either one-shot IAC or NIAC before RC between October 2006 and November 2015. A propensity-score matching (1:3) was performed based on key characters. The Kaplan-Meier method was utilized to estimate survival probabilities, and the log-rank test was used to compare survival outcomes between different groups. A multivariable Cox proportional hazard model was used to estimate survival outcomes. Results: Twenty-six patients were treated using IAC before RC, and 123 NIAC patients also underwent RC. After matching, there was no significant difference between groups in baseline characteristics, perioperative variables, complication outcomes or tumor characteristics. Compared with clinical tumor stages, pathological tumor stages demonstrated a significant decrease (P=0.002) in the IAC group. There was no significant difference in overall survival (OS, p=0.354) or cancer-specific survival (CSS, p=0.439) between the groups. Among all patients, BMI significantly affected OS (p=0.004), and positive lymph nodes (PLN) significantly affected both OS (p＜0.001) and CSS(p=0.010). Conclusions: One-shot neoadjuvant IAC before RC shows safety and tolerability and provides a significant advantage in pathological downstaging but not in OS or CSS. Further study of neoadjuvant combination therapeutic strategies with RC is needed.

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The long-term efficacy of one-shot neoadjuvant intra-arterial chemotherapy combined with radical cystectomy versus radical cystectomy alone for bladder cancer: a propensity-score matching study

10.21203/rs.2.11853/v3 ◽

2019 ◽

Author(s):

Wasilijiang Wahafu ◽

Sai Liu ◽

Wenbin Xu ◽

Mengtong Wang ◽

Qingbao He ◽

...

Keyword(s):

Bladder Cancer ◽

Propensity Score ◽

Propensity Score Matching ◽

Radical Cystectomy ◽

Rank Test ◽

Survival Outcomes ◽

High Morbidity ◽

Term Efficacy ◽

Significant Difference

Abstract Background: Bladder cancer is a complex disease associated with high morbidity and mortality. The management of bladder cancer before radical cystectomy continues to be controversial. We compared the long-term efficacy of one-shot neoadjuvant intra-arterial chemotherapy (IAC)versus no IAC (NIAC) before radical cystectomy (RC) for bladder cancer. Methods: We performed a retrospective review of patients who underwent either one-shot IAC or NIAC before RC between October 2006 and November 2015. Propensity-score matching (1:3) was performed based on key characteristics. The Kaplan-Meier method was utilized to estimate survival probabilities, and the log-rank test was used to compare survival outcomes between different groups. A multivariable Cox proportional hazards model was used to estimate survival outcomes. Results: Twenty-six patients were treated using IAC before RC, and 123 NIAC patients also underwent RC. After matching, there was no significant difference between the groups in baseline characteristics, perioperative variables, complication outcomes or tumour characteristics. Compared with the clinical tumour stages, the pathological tumour stages demonstrated a significant decrease (P=0.002) in the IAC group. There was no significant difference in overall survival (OS, p=0.354) or cancer-specific survival (CSS, p=0.439) between the groups. Among all patients, BMI significantly affected OS (p=0.004), and positive lymph nodes (PLN) significantly affected both OS(p＜0.001) and CSS (p=0.010). Conclusions: One-shot neoadjuvant IAC before RC shows safety and tolerability and provides a significant advantage in pathological downstaging but not in OS or CSS. Further study of neoadjuvant combination therapeutic strategies with RC is needed.

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The long-term efficacy of one-shot neoadjuvant intra-arterial chemotherapy combined with radical cystectomy versus radical cystectomy alone for bladder cancer: a propensity-score matching study

10.21203/rs.2.11853/v1 ◽

2019 ◽

Author(s):

Wasilijiang Wahafu ◽

Sai Liu ◽

Wenbin Xu ◽

Mengtong Wang ◽

Qingbao He ◽

...

Keyword(s):

Bladder Cancer ◽

Propensity Score ◽

Propensity Score Matching ◽

Radical Cystectomy ◽

Survival Outcomes ◽

High Morbidity ◽

Term Efficacy ◽

Tumor Stages ◽

Significant Difference

Abstract Background: Bladder cancer is a complex disease associated with high morbidity and mortality. Management of bladder cancer before radical cystectomy continues to be controversial. We compared the long-term efficacy of one-shot neoadjuvant intra-arterial chemotherapy (IAC) versus no IAC (NIAC) before radical cystectomy (RC) for bladder cancer. Methods: We performed a retrospective review of patients who underwent either one-shot IAC or NIAC before RC between October 2006 and November 2015. A propensity-score matching (1:3) was performed based on key characters. The Kaplan-Meier method was utilized to estimate survival probabilities, and the log-rank test was used to compare survival outcomes between different groups. A multivariable Cox proportional hazard model was used to estimate survival outcomes. Results: Twenty-six patients were treated using IAC before RC, and 123 NIAC patients also underwent RC. After matching, there was no significant difference between groups in baseline characteristics, perioperative variables, complication outcomes or tumor characteristics. Compared with clinical tumor stages, pathological tumor stages demonstrated a significant decrease (P=0.002) in the IAC group. There was no significant difference in overall survival (OS, p=0.354) or cancer-specific survival (CSS, p=0.439) between the groups. Among all patients and in the NIAC group, BMI significantly affected OS (p=0.004 and p=0.014, respectively), and positive lymph nodes significantly affected both OS (p＜0.001, both) and CSS (p=0.010 and p=0.017, respectively). Only diabetes involvement at the time of IAC was significantly associated with worse overall mortality (p=0.004). Conclusions: One-shot neoadjuvant IAC before RC shows safety and tolerability and provides a significant advantage in pathological downstaging but not in OS or CSS. Further study of neoadjuvant combination therapeutic strategies with RC is needed.

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Parathyroidectomy Versus Cinacalcet for the Treatment of Secondary Hyperparathyroidism in Hemodialysis Patients

World Journal of Surgery ◽

10.1007/s00268-022-06439-7 ◽

2022 ◽

Author(s):

Luis Alvarado ◽

Nishtha Sharma ◽

Roxann Lerma ◽

Alok Dwivedi ◽

Adeel Ahmad ◽

...

Keyword(s):

Propensity Score ◽

Secondary Hyperparathyroidism ◽

Propensity Score Matching ◽

Cox Regression ◽

The United States ◽

Hemodialysis Patients ◽

Cox Regression Analysis ◽

Pathologic Fractures ◽

Stage Renal Disease ◽

End Stage

Abstract Background Secondary hyperparathyroidism in patients with end stage renal disease on dialysis is associated with bone pain and fractures in addition to cardiovascular morbidity. Cinacalcet is the most commonly used drug to treat such patients, but it has never been compared to surgery. The goal of this study is to compare the long-term outcomes and survival between cinacalcet and parathyroidectomy in the treatment of secondary hyperparathyroidism in hemodialysis patients. Methods Adult patients on hemodialysis who were treated with cinacalcet or parathyroidectomy in the United States Renal Data System were included. Patients treated with surgery (n = 2023) were compared using 1:1 propensity score matching ratio to a cohort of patients treated with cinacalcet. A Cox regression analysis was conducted to compare the overall mortality. Results The propensity score matching successfully created two groups with similar demographics. Patients in the surgery group had a higher mean peak PTH level prior to therapy (2066.8 vs 1425.4, P < 0.001). No difference was observed in the development of new-onset coronary artery disease (7.7% vs 7.9%, P = 0.8) or cerebrovascular disease (7% vs 6.7%, P = 0.8). Surgical patients had a higher rate of pathologic fractures (27.8% vs 24.9%, P = 0.04). Survival analysis showed that patients undergoing surgery had a better 5-year survival (65.6% vs 57.8%) and were less likely to die within the study period (HR 0.77, 95% CI 0.7–0.85, P < 0.0001). Conclusions Patients on dialysis undergoing parathyroidectomy for the treatment of secondary hyperparathyroidism have a better overall survival than those treated with cinacalcet.

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Comparison of clinical outcomes after transcarotid and transsubclavian versus transfemoral TAVI: a propensity-matched analysis

European Heart Journal ◽

10.1093/ehjci/ehaa946.2684 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

A Villecourt ◽

L Faroux ◽

A Muneaux ◽

S Tassan-Mangina ◽

V Heroguelle ◽

...

Keyword(s):

Myocardial Infarction ◽

Propensity Score ◽

Propensity Score Matching ◽

P Value ◽

Long Term Outcomes ◽

Risk Of Death ◽

Acute Kidney Injury Stage ◽

Significant Difference ◽

All Cause Mortality

Abstract Transcarotid (TC) and transsubclavian (TSc) accesses are increasingly used as alternative approaches for TAVI when the transfemoral (TF) access is not suitable. However, concerns remain about the risk of peri-procedural stroke and long-term outcomes following TC or TSc TAVI. The present study sought to compare early- and long-term outcomes of TC/TSc vs. TF TAVI after propensity-score matching. 260 patients who underwent TAVI through a TF (n=220), TC (n=32) or TSc (n=8) approach at our institution during a 4 years period were identified. A 1:1 matching based on the propensity-score was performed, leading to a population of 40 TF and 40 TC/TSc. Primary endpoints were early complications whereas secondary endpoints were long-term outcomes. There was no difference in the baseline characteristics. At 30-day post-TAVI, there was no difference in mortality and stroke rates between TF and TC/TSc TAVI (5% vs. 5% mortality, p=1.0 and 2 vs. 1 stroke, p=1.0). After a median follow-up of 21 months, the risk of death (p=0.950), stroke (p=0.817) and myocardial infarction (p=0.155) did not differ between the 2 groups. After propensity-score matching, no significant difference in early and long-term outcomes was observed between TF and TSc/TSc TAVI. These findings should encourage Heart-Teams to consider a TC or TSc approach when TF access is not available. Table 1. 30-day and 1-year outcomes according to the arterial access (TF vs. TC/TSc) Variables TF-TAVI (n=40) TC/TSc-TAVI (n=40) p-value 30-day outcomes All-cause mortality 2 (5.0) 2 (5.0) 1.000 All-stroke 2 (5.0) 1 (2.5) 1.000 Life-threatening bleeding 4 (10.0) 1 (2.5) 0.375 Acute kidney injury stage 2 or 3 2 (5.0) 1 (2.5) 1.000 Major vascular complication 6 (15.0) 6 (15.0) 1.000 Coronary obstruction 0 0 – Early safety composite endpoint (VARC-2) 10 (25.0) 8 (20.0) 0.804 1-year outcomes All-cause mortality 6 (15.0) 7 (17.5) 1.000 Cardiovascular mortality 5 (12.5) 3 (7.5) 0.727 Stroke 3 (7.5) 2 (5.0) 1.000 Myocardial infarction 0 (0) 2 (5) 0.500 MACCE 8 (20.0) 9 (22.5) 1.000 Readmission for heart failure 6 (15.0) 2 (5) 0.219 Figure 1 Funding Acknowledgement Type of funding source: None

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