scholarly journals A Novel Digital Care Management Platform to Monitor Clinical and Subclinical Disease Activity in Multiple Sclerosis

2021 ◽  
Vol 11 (9) ◽  
pp. 1171
Author(s):  
Wim Van Hecke ◽  
Lars Costers ◽  
Annabel Descamps ◽  
Annemie Ribbens ◽  
Guy Nagels ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Disease Activity ◽  
Care Management ◽  
Brain Magnetic Resonance Imaging ◽  
Clinical Disease ◽  
Digital Tools ◽  
Early Detection Of Disease ◽  
Clinical Disease Activity ◽  
Management Platform ◽  
Patient Reported

In multiple sclerosis (MS), the early detection of disease activity or progression is key to inform treatment changes and could be supported by digital tools. We present a novel CE-marked and FDA-cleared digital care management platform consisting of (1) a patient phone/web application and healthcare professional portal (icompanion) including validated symptom, disability, cognition, and fatigue patient-reported outcomes; and (2) clinical brain magnetic resonance imaging (MRI) quantifications (icobrain ms). We validate both tools using their ability to detect (sub)clinical disease activity (known-groups validity) and real-world data insights. Surveys showed that 95.6% of people with MS (PwMS) were interested in using an MS app, and 98.2% were interested in knowing about MRI changes. The icompanion measures of disability (p < 0.001) and symptoms (p = 0.005) and icobrain ms MRI parameters were sensitive to (sub)clinical differences between MS subtypes. icobrain ms also decreased intra- and inter-rater lesion count variability and increased sensitivity for detecting disease activity/progression from 24% to 76% compared to standard radiological reading. This evidence shows PwMS’ interest, the digital care platform’s potential to improve the detection of (sub)clinical disease activity and care management, and the feasibility of linking different digital tools into one overarching MS care pathway.

A comparison of multiple sclerosis clinical disease activity between patients treated with natalizumab and fingolimod

2016 ◽  
Vol 23 (2) ◽  
pp. 234-241 ◽  
Author(s):  
Nils Koch-Henriksen ◽  
Melinda Magyari ◽  
Finn Sellebjerg ◽  
Per Soelberg Sørensen
Keyword(s):  
Multiple Sclerosis ◽  
Propensity Score ◽  
Disease Activity ◽  
Propensity Score Matching ◽  
Relapse Rate ◽  
Real Life ◽  
Clinical Disease ◽  
Clinical Disease Activity ◽  
Magnetic Resonance Imaging Mri ◽  
Treatment Register

Background: Natalizumab and fingolimod were approved for treatment of active relapsing-remitting multiple sclerosis (RRMS) in Denmark in 2006 and 2011, respectively. There have been no randomized head-to-head studies comparing the two drugs. Objective: To compare the clinical efficacy of natalizumab and fingolimod. Methods: Data on all Danish RRMS patients who started their first second-line treatment with natalizumab or fingolimod from July 2011 to March 2015 were prospectively recorded in the Danish Multiple Sclerosis (MS) Treatment Register. The two treatment arms were 1:1 propensity score matched by baseline covariates using ‘nearest neighbour’ method. Results: Propensity score matching left 928 of 1309 RRMS cases, 464 in each treatment group. The on-treatment annualized relapse rate was 0.296 (95% confidence interval (CI): 0.26–0.34) for natalizumab and 0.307 (95% CI: 0.27–0.35) for fingolimod. The adjusted relapse rate ratio was 0.93 (95% CI: 0.74–1.17; p = 0.53). Mean time to first relapse was 2.55 and 2.56 years, respectively ( p = 0.76). There was no difference in change of Expanded Disability Status Scale (EDSS). Conclusion: We found no differences in clinical disease activity between natalizumab- and fingolimod-treated RRMS patients in this real-life observational study. However, the lack of magnetic resonance imaging (MRI) data for the propensity score matching may conceal a higher efficacy of natalizumab.

scholarly journals “No evident disease activity”: The use of combined assessments in the management of patients with multiple sclerosis

2017 ◽  
Vol 23 (9) ◽  
pp. 1179-1187 ◽  
Author(s):  
Gavin Giovannoni ◽  
Davorka Tomic ◽  
Jeremy R Bright ◽  
Eva Havrdová
Keyword(s):  
Multiple Sclerosis ◽  
Disease Activity ◽  
Brain Magnetic Resonance Imaging ◽  
Individual Patient Level ◽  
Patient Reported ◽  
Magnetic Resonance Imaging Mri ◽  
The Individual ◽  
The Brain

Using combined endpoints to define no evident disease activity (NEDA) is becoming increasingly common when setting targets for treatment outcomes in multiple sclerosis (MS). Historically, NEDA has taken account of the occurrence of relapses, brain magnetic resonance imaging (MRI) lesions and disability worsening, but this approach places emphasis on inflammatory activity in the brain and mostly overlooks ongoing neurodegenerative damage. Combined assessments of NEDA which take account of changes in brain volume or neuropsychological outcomes such as cognitive function may begin to address this imbalance, and such assessments may also consider blood or spinal-fluid neurofilament levels or patient-reported outcomes and quality of life measures. If a combined NEDA assessment can be validated in prospective studies as indicative of long-term disease remission at the individual patient level, treating to achieve NEDA could become the goal of clinical practice and achieving NEDA may become the “new normal” state of disease control for patients with MS.

Sign in / Sign up

Export Citation Format

Share Document