MS Briefs

Key clinical point: Ocrelizumab is a potential stabilizing treatment option for both treatment-naïve and pretreated patients with multiple sclerosis (MS).

Major finding: Among all patients, 24% were treatment naïve and 76% had previously received immune therapies. After initiating ocrelizumab, 13% of patients with relapsing-remitting multiple sclerosis (RRMS) or active secondary progressive multiple sclerosis (aSPMS) had a relapse (annualized relapse rate, 0.17). Among all patients with MS, 5% experienced a 12-week confirmed disability progression. Side effects were mostly mild and reported in 22% of the patients.

Study details: A retrospective analysis of real-world data on patients with MS who had received 2 ocrelizumab (300 mg) cycles at 2-week intervals. Of 210 patients, 55 had primary progressive MS and 155 had RRMS or aSPMS.

Disclosures: This study was supported by the German Research Council. The authors reported relationships with multiple pharmaceutical companies.

Citation: Nicholas J et al. J Med Econ. 2020 Apr 26. doi: 10.1212/NXI.0000000000000719.

Key clinical point: Ocrelizumab is a potential stabilizing treatment option for both treatment-naïve and pretreated patients with multiple sclerosis (MS).

Major finding: Among all patients, 24% were treatment naïve and 76% had previously received immune therapies. After initiating ocrelizumab, 13% of patients with relapsing-remitting multiple sclerosis (RRMS) or active secondary progressive multiple sclerosis (aSPMS) had a relapse (annualized relapse rate, 0.17). Among all patients with MS, 5% experienced a 12-week confirmed disability progression. Side effects were mostly mild and reported in 22% of the patients.

Study details: A retrospective analysis of real-world data on patients with MS who had received 2 ocrelizumab (300 mg) cycles at 2-week intervals. Of 210 patients, 55 had primary progressive MS and 155 had RRMS or aSPMS.

Disclosures: This study was supported by the German Research Council. The authors reported relationships with multiple pharmaceutical companies.

Citation: Nicholas J et al. J Med Econ. 2020 Apr 26. doi: 10.1212/NXI.0000000000000719.

Key clinical point: Ocrelizumab is a potential stabilizing treatment option for both treatment-naïve and pretreated patients with multiple sclerosis (MS).

Major finding: Among all patients, 24% were treatment naïve and 76% had previously received immune therapies. After initiating ocrelizumab, 13% of patients with relapsing-remitting multiple sclerosis (RRMS) or active secondary progressive multiple sclerosis (aSPMS) had a relapse (annualized relapse rate, 0.17). Among all patients with MS, 5% experienced a 12-week confirmed disability progression. Side effects were mostly mild and reported in 22% of the patients.

Study details: A retrospective analysis of real-world data on patients with MS who had received 2 ocrelizumab (300 mg) cycles at 2-week intervals. Of 210 patients, 55 had primary progressive MS and 155 had RRMS or aSPMS.

Disclosures: This study was supported by the German Research Council. The authors reported relationships with multiple pharmaceutical companies.

Citation: Nicholas J et al. J Med Econ. 2020 Apr 26. doi: 10.1212/NXI.0000000000000719.

Key clinical point: Long-term exposure to fingolimod is associated with lower disability progression in patients with relapsing multiple sclerosis (MS).

Major finding: The high (≥8 years) vs. low (<8 years) exposure groups showed a smaller increase in the mean Expanded Disability Status Scale (+0.55 vs. +1.21) and lower frequencies of disability progression (34.7% vs. 56.1%; P less than .01) and wheelchair use (4.9% vs. 16.9%; P less than .0276) at 10 years.

Study details: ACROSS was a cross-sectional follow-up study of patients with relapsing MS enrolled in a phase 2 proof-of-concept study. Disability outcomes were assessed in patients grouped as per fingolimod exposure: high exposure (n=104) and low exposure (n=71).

Disclosures: The study was funded by Novartis Pharma AG, Basel, Switzerland. Amin Azmon and Davorka Tomic are employees of Novartis. The other authors reported relationships with multiple pharmaceutical companies.

Citation: Derfuss T et al. Mult Scler J Exp Transl Clin. 2020 Mar 30. doi: 10.1177/2055217320907951.

Key clinical point: Long-term exposure to fingolimod is associated with lower disability progression in patients with relapsing multiple sclerosis (MS).

Major finding: The high (≥8 years) vs. low (<8 years) exposure groups showed a smaller increase in the mean Expanded Disability Status Scale (+0.55 vs. +1.21) and lower frequencies of disability progression (34.7% vs. 56.1%; P less than .01) and wheelchair use (4.9% vs. 16.9%; P less than .0276) at 10 years.

Study details: ACROSS was a cross-sectional follow-up study of patients with relapsing MS enrolled in a phase 2 proof-of-concept study. Disability outcomes were assessed in patients grouped as per fingolimod exposure: high exposure (n=104) and low exposure (n=71).

Disclosures: The study was funded by Novartis Pharma AG, Basel, Switzerland. Amin Azmon and Davorka Tomic are employees of Novartis. The other authors reported relationships with multiple pharmaceutical companies.

Citation: Derfuss T et al. Mult Scler J Exp Transl Clin. 2020 Mar 30. doi: 10.1177/2055217320907951.

Key clinical point: Long-term exposure to fingolimod is associated with lower disability progression in patients with relapsing multiple sclerosis (MS).

Major finding: The high (≥8 years) vs. low (<8 years) exposure groups showed a smaller increase in the mean Expanded Disability Status Scale (+0.55 vs. +1.21) and lower frequencies of disability progression (34.7% vs. 56.1%; P less than .01) and wheelchair use (4.9% vs. 16.9%; P less than .0276) at 10 years.

Study details: ACROSS was a cross-sectional follow-up study of patients with relapsing MS enrolled in a phase 2 proof-of-concept study. Disability outcomes were assessed in patients grouped as per fingolimod exposure: high exposure (n=104) and low exposure (n=71).

Disclosures: The study was funded by Novartis Pharma AG, Basel, Switzerland. Amin Azmon and Davorka Tomic are employees of Novartis. The other authors reported relationships with multiple pharmaceutical companies.

Citation: Derfuss T et al. Mult Scler J Exp Transl Clin. 2020 Mar 30. doi: 10.1177/2055217320907951.

Key clinical point: Elevated body mass index (BMI) is independently associated with an accelerated rate of ganglion cell+inner plexiform layer (GCIPL) atrophy in patients with multiple sclerosis (MS).

Major findings: Obese (n=146; BMI, ≥30 kg/m²) vs. normal weight (n=214; BMI, 18.5-24.9 kg/m²) patients showed accelerated rate of GCIPL atrophy (−0.57%/year vs. −0.42%/year; P = .012). Atrophy rates were not significantly different between overweight (n=153; BMI, 25-29.9 kg/m²) and normal weight patients (−0.47%/year vs. −0.42%/year; P = .41). GCIPL atrophy rate accelerated by −0.011% per year with each 1 kg/m² higher BMI (P =.003).

Study details: This observational study included 522 patients with MS from Johns Hopkins MS Center who were followed with retinal imaging for a median of 4.4 years.

Disclosures: The study was funded by the National MS Society, Race to Erase MS, and NIH/NINDS. The presenting author had no disclosures. One coauthor reported receiving support from the Race to Erase MS foundation.

Citation: Filippatou AG et al. Mult Scler. 2020 Apr 16. doi: 10.1177/1352458519900942.

Key clinical point: Elevated body mass index (BMI) is independently associated with an accelerated rate of ganglion cell+inner plexiform layer (GCIPL) atrophy in patients with multiple sclerosis (MS).

Major findings: Obese (n=146; BMI, ≥30 kg/m²) vs. normal weight (n=214; BMI, 18.5-24.9 kg/m²) patients showed accelerated rate of GCIPL atrophy (−0.57%/year vs. −0.42%/year; P = .012). Atrophy rates were not significantly different between overweight (n=153; BMI, 25-29.9 kg/m²) and normal weight patients (−0.47%/year vs. −0.42%/year; P = .41). GCIPL atrophy rate accelerated by −0.011% per year with each 1 kg/m² higher BMI (P =.003).

Study details: This observational study included 522 patients with MS from Johns Hopkins MS Center who were followed with retinal imaging for a median of 4.4 years.

Disclosures: The study was funded by the National MS Society, Race to Erase MS, and NIH/NINDS. The presenting author had no disclosures. One coauthor reported receiving support from the Race to Erase MS foundation.

Citation: Filippatou AG et al. Mult Scler. 2020 Apr 16. doi: 10.1177/1352458519900942.

Key clinical point: Elevated body mass index (BMI) is independently associated with an accelerated rate of ganglion cell+inner plexiform layer (GCIPL) atrophy in patients with multiple sclerosis (MS).

Major findings: Obese (n=146; BMI, ≥30 kg/m²) vs. normal weight (n=214; BMI, 18.5-24.9 kg/m²) patients showed accelerated rate of GCIPL atrophy (−0.57%/year vs. −0.42%/year; P = .012). Atrophy rates were not significantly different between overweight (n=153; BMI, 25-29.9 kg/m²) and normal weight patients (−0.47%/year vs. −0.42%/year; P = .41). GCIPL atrophy rate accelerated by −0.011% per year with each 1 kg/m² higher BMI (P =.003).

Study details: This observational study included 522 patients with MS from Johns Hopkins MS Center who were followed with retinal imaging for a median of 4.4 years.

Disclosures: The study was funded by the National MS Society, Race to Erase MS, and NIH/NINDS. The presenting author had no disclosures. One coauthor reported receiving support from the Race to Erase MS foundation.

Citation: Filippatou AG et al. Mult Scler. 2020 Apr 16. doi: 10.1177/1352458519900942.

Key clinical point: Low fish consumption is associated with an increased risk of developing multiple sclerosis (MS); vitamin D does not mediate this association.

Major finding: Regardless of sun exposure habits, MS risk was higher with low fish consumption, including both lean and fatty fish (odds ratio, 1.2; 95% confidence interval, 1.1-1.4). The mediation analysis revealed that the effect mediated by vitamin D deficiency on this association was very small. A significant interaction was noted between DRB1*15:01 allele and both low sun exposure and low fish consumption.

Study details: The data come from 2 Swedish population-based case-control studies (6,914 patients with MS and 6,590 control participants).

Disclosures: The study was supported by grants from the Swedish Medical Research Council, the Swedish Research Council for Health, Working Life and Welfare, the Swedish Brain Foundation, and the Swedish Society for Medical Research. Dr Olsson reported receiving grants from the Swedish Research Council, the Knut and Alice Wallenberg Foundation, and the Swedish Brain Foundation. Dr Alfredsson reported receiving grants from the Swedish Research Council, the Swedish

Research Council for Health Working Life and Welfare, and the Swedish Brain Foundation.

Citation: Hedström AK et al. Neurol Neuroimmunol Neuroinflamm. 2020 Apr 10. doi: 10.1212/NXI.0000000000000717.

Key clinical point: Low fish consumption is associated with an increased risk of developing multiple sclerosis (MS); vitamin D does not mediate this association.

Major finding: Regardless of sun exposure habits, MS risk was higher with low fish consumption, including both lean and fatty fish (odds ratio, 1.2; 95% confidence interval, 1.1-1.4). The mediation analysis revealed that the effect mediated by vitamin D deficiency on this association was very small. A significant interaction was noted between DRB1*15:01 allele and both low sun exposure and low fish consumption.

Study details: The data come from 2 Swedish population-based case-control studies (6,914 patients with MS and 6,590 control participants).

Disclosures: The study was supported by grants from the Swedish Medical Research Council, the Swedish Research Council for Health, Working Life and Welfare, the Swedish Brain Foundation, and the Swedish Society for Medical Research. Dr Olsson reported receiving grants from the Swedish Research Council, the Knut and Alice Wallenberg Foundation, and the Swedish Brain Foundation. Dr Alfredsson reported receiving grants from the Swedish Research Council, the Swedish

Research Council for Health Working Life and Welfare, and the Swedish Brain Foundation.

Citation: Hedström AK et al. Neurol Neuroimmunol Neuroinflamm. 2020 Apr 10. doi: 10.1212/NXI.0000000000000717.

Key clinical point: Low fish consumption is associated with an increased risk of developing multiple sclerosis (MS); vitamin D does not mediate this association.

Major finding: Regardless of sun exposure habits, MS risk was higher with low fish consumption, including both lean and fatty fish (odds ratio, 1.2; 95% confidence interval, 1.1-1.4). The mediation analysis revealed that the effect mediated by vitamin D deficiency on this association was very small. A significant interaction was noted between DRB1*15:01 allele and both low sun exposure and low fish consumption.

Study details: The data come from 2 Swedish population-based case-control studies (6,914 patients with MS and 6,590 control participants).

Disclosures: The study was supported by grants from the Swedish Medical Research Council, the Swedish Research Council for Health, Working Life and Welfare, the Swedish Brain Foundation, and the Swedish Society for Medical Research. Dr Olsson reported receiving grants from the Swedish Research Council, the Knut and Alice Wallenberg Foundation, and the Swedish Brain Foundation. Dr Alfredsson reported receiving grants from the Swedish Research Council, the Swedish

Research Council for Health Working Life and Welfare, and the Swedish Brain Foundation.

Citation: Hedström AK et al. Neurol Neuroimmunol Neuroinflamm. 2020 Apr 10. doi: 10.1212/NXI.0000000000000717.

Key clinical point: Mercury-containing dental amalgam fillings (AMF) are not associated with the risk of developing multiple sclerosis (MS).

Major finding: The risk of MS with AMF did not differ significantly between patients and control participants (adjusted odds ratio [aOR], 0.823; 95% confidence interval [CI], 0.648-1.046). MS was not associated with AMF irrespective of gender (women: aOR, 0.743; 95% CI, 0.552-1.000; men: aOR, 1.006; 95% CI, 0.670-1.509).

Study details: The data come from a Taiwanese population-based case-control study of 612 participants with MS and 612 matched participants without MS.

Disclosures: No study sponsor was identified. The authors declared no conflicts of interest.

Citation: Tseng CF et al. Int J Environ Res Public Health. 2020 Apr 12. doi: 10.3390/ijerph17082637.

Key clinical point: Mercury-containing dental amalgam fillings (AMF) are not associated with the risk of developing multiple sclerosis (MS).

Major finding: The risk of MS with AMF did not differ significantly between patients and control participants (adjusted odds ratio [aOR], 0.823; 95% confidence interval [CI], 0.648-1.046). MS was not associated with AMF irrespective of gender (women: aOR, 0.743; 95% CI, 0.552-1.000; men: aOR, 1.006; 95% CI, 0.670-1.509).

Study details: The data come from a Taiwanese population-based case-control study of 612 participants with MS and 612 matched participants without MS.

Disclosures: No study sponsor was identified. The authors declared no conflicts of interest.

Citation: Tseng CF et al. Int J Environ Res Public Health. 2020 Apr 12. doi: 10.3390/ijerph17082637.

Key clinical point: Mercury-containing dental amalgam fillings (AMF) are not associated with the risk of developing multiple sclerosis (MS).

Major finding: The risk of MS with AMF did not differ significantly between patients and control participants (adjusted odds ratio [aOR], 0.823; 95% confidence interval [CI], 0.648-1.046). MS was not associated with AMF irrespective of gender (women: aOR, 0.743; 95% CI, 0.552-1.000; men: aOR, 1.006; 95% CI, 0.670-1.509).

Study details: The data come from a Taiwanese population-based case-control study of 612 participants with MS and 612 matched participants without MS.

Disclosures: No study sponsor was identified. The authors declared no conflicts of interest.

Citation: Tseng CF et al. Int J Environ Res Public Health. 2020 Apr 12. doi: 10.3390/ijerph17082637.

Key clinical point: Periconceptional rituximab is a highly effective and safe treatment for women with suboptimally controlled multiple sclerosis (MS).

Major finding: Among 38 live births, 3 deliveries were preterm (including 1 set of twins), 1 baby was admitted for perinatal ischemic stroke, and 1 twin died after 6 days from an intraventricular hemorrhage. Fifteen women reported at least one first-trimester miscarriage, of whom 8 had a history of infertility. No stillbirths, chorioamnionitis, or major malformations were recorded. Only 2 women experienced relapses, one during pregnancy and the other postpartum.

Study details: The data come from a study of 55 women with MS (74 pregnancies) treated with at least 1 dose of rituximab infusion before conception.

Disclosures: This study was supported in part by the Patient-Centered Outcomes Research Institute.

Some of the investigators reported receiving research grants from multiple pharmaceutical companies.

Citation: Smith JB et al. Neurol Neuroimmunol Neuroinflamm. 2020 May 01. doi: 10.1212/NXI.0000000000000734.

Key clinical point: Periconceptional rituximab is a highly effective and safe treatment for women with suboptimally controlled multiple sclerosis (MS).

Major finding: Among 38 live births, 3 deliveries were preterm (including 1 set of twins), 1 baby was admitted for perinatal ischemic stroke, and 1 twin died after 6 days from an intraventricular hemorrhage. Fifteen women reported at least one first-trimester miscarriage, of whom 8 had a history of infertility. No stillbirths, chorioamnionitis, or major malformations were recorded. Only 2 women experienced relapses, one during pregnancy and the other postpartum.

Study details: The data come from a study of 55 women with MS (74 pregnancies) treated with at least 1 dose of rituximab infusion before conception.

Disclosures: This study was supported in part by the Patient-Centered Outcomes Research Institute.

Some of the investigators reported receiving research grants from multiple pharmaceutical companies.

Citation: Smith JB et al. Neurol Neuroimmunol Neuroinflamm. 2020 May 01. doi: 10.1212/NXI.0000000000000734.

Key clinical point: Periconceptional rituximab is a highly effective and safe treatment for women with suboptimally controlled multiple sclerosis (MS).

Major finding: Among 38 live births, 3 deliveries were preterm (including 1 set of twins), 1 baby was admitted for perinatal ischemic stroke, and 1 twin died after 6 days from an intraventricular hemorrhage. Fifteen women reported at least one first-trimester miscarriage, of whom 8 had a history of infertility. No stillbirths, chorioamnionitis, or major malformations were recorded. Only 2 women experienced relapses, one during pregnancy and the other postpartum.

Study details: The data come from a study of 55 women with MS (74 pregnancies) treated with at least 1 dose of rituximab infusion before conception.

Disclosures: This study was supported in part by the Patient-Centered Outcomes Research Institute.

Some of the investigators reported receiving research grants from multiple pharmaceutical companies.

Citation: Smith JB et al. Neurol Neuroimmunol Neuroinflamm. 2020 May 01. doi: 10.1212/NXI.0000000000000734.

Key clinical point: Patients with multiple sclerosis (MS) are at an increased risk of cardiovascular and cerebrovascular diseases that traditional risk factors do not fully explain.

Major finding: Compared with people without MS, patients with MS had increased risks for coronary syndrome (hazard ratio [HR], 1.28), cerebrovascular disease (HR, 1.59), any macrovascular disease (HR, 1.32), all-cause mortality (HR, 3.46), and cardiovascular disease mortality (HR, 1.47).

Study details: This population-based, retrospective matched cohort study conducted in England included 12,251 patients with MS and 72,572 people without MS.

Disclosures: The presenting author had no disclosures. Two coauthors received research funding/support from various organizations.

Citation: Palladino R et al. JAMA Neurol. 2020 May 04. doi: 10.1001/jamaneurol.2020.0664. 

Key clinical point: Patients with multiple sclerosis (MS) are at an increased risk of cardiovascular and cerebrovascular diseases that traditional risk factors do not fully explain.

Major finding: Compared with people without MS, patients with MS had increased risks for coronary syndrome (hazard ratio [HR], 1.28), cerebrovascular disease (HR, 1.59), any macrovascular disease (HR, 1.32), all-cause mortality (HR, 3.46), and cardiovascular disease mortality (HR, 1.47).

Study details: This population-based, retrospective matched cohort study conducted in England included 12,251 patients with MS and 72,572 people without MS.

Disclosures: The presenting author had no disclosures. Two coauthors received research funding/support from various organizations.

Citation: Palladino R et al. JAMA Neurol. 2020 May 04. doi: 10.1001/jamaneurol.2020.0664. 

Key clinical point: Patients with multiple sclerosis (MS) are at an increased risk of cardiovascular and cerebrovascular diseases that traditional risk factors do not fully explain.

Major finding: Compared with people without MS, patients with MS had increased risks for coronary syndrome (hazard ratio [HR], 1.28), cerebrovascular disease (HR, 1.59), any macrovascular disease (HR, 1.32), all-cause mortality (HR, 3.46), and cardiovascular disease mortality (HR, 1.47).

Study details: This population-based, retrospective matched cohort study conducted in England included 12,251 patients with MS and 72,572 people without MS.

Disclosures: The presenting author had no disclosures. Two coauthors received research funding/support from various organizations.

Citation: Palladino R et al. JAMA Neurol. 2020 May 04. doi: 10.1001/jamaneurol.2020.0664. 

Key clinical point: Relapse rates are comparable for patients with relapsing-remitting multiple sclerosis (RRMS) treated with fingolimod, dimethyl fumarate, or teriflunomide.

Major finding: After 2 years of treatment initiation, the estimated mean annualized relapse rates were 0.13 (95% confidence interval, 0.04-0.43) for fingolimod, 0.09 (95% confidence interval, 0.03-0.26) for dimethyl fumarate, and 0.11 (95% confidence interval, 0.04-0.35) for teriflunomide.

Study details: The study used inverse probability weighing to compare the efficacy of fingolimod (n=295), dimethyl fumarate (n=227), and teriflunomide (n=107) treatment for at least 24 months in patients with RRMS identified from the Austrian MS Treatment Registry.

Disclosures: The study was funded by Kepler Universitätsklinikum Linz. S Kalcher and E Kvas declared no conflicts of interest. Other authors reported ties with one or more pharmaceutical companies.

Citation: Guger M et al. J Neurol. 2020 Apr 3. doi: 10.1007/s00415-020-09811-6.

Key clinical point: Relapse rates are comparable for patients with relapsing-remitting multiple sclerosis (RRMS) treated with fingolimod, dimethyl fumarate, or teriflunomide.

Major finding: After 2 years of treatment initiation, the estimated mean annualized relapse rates were 0.13 (95% confidence interval, 0.04-0.43) for fingolimod, 0.09 (95% confidence interval, 0.03-0.26) for dimethyl fumarate, and 0.11 (95% confidence interval, 0.04-0.35) for teriflunomide.

Study details: The study used inverse probability weighing to compare the efficacy of fingolimod (n=295), dimethyl fumarate (n=227), and teriflunomide (n=107) treatment for at least 24 months in patients with RRMS identified from the Austrian MS Treatment Registry.

Disclosures: The study was funded by Kepler Universitätsklinikum Linz. S Kalcher and E Kvas declared no conflicts of interest. Other authors reported ties with one or more pharmaceutical companies.

Citation: Guger M et al. J Neurol. 2020 Apr 3. doi: 10.1007/s00415-020-09811-6.

Key clinical point: Relapse rates are comparable for patients with relapsing-remitting multiple sclerosis (RRMS) treated with fingolimod, dimethyl fumarate, or teriflunomide.

Major finding: After 2 years of treatment initiation, the estimated mean annualized relapse rates were 0.13 (95% confidence interval, 0.04-0.43) for fingolimod, 0.09 (95% confidence interval, 0.03-0.26) for dimethyl fumarate, and 0.11 (95% confidence interval, 0.04-0.35) for teriflunomide.

Study details: The study used inverse probability weighing to compare the efficacy of fingolimod (n=295), dimethyl fumarate (n=227), and teriflunomide (n=107) treatment for at least 24 months in patients with RRMS identified from the Austrian MS Treatment Registry.

Disclosures: The study was funded by Kepler Universitätsklinikum Linz. S Kalcher and E Kvas declared no conflicts of interest. Other authors reported ties with one or more pharmaceutical companies.

Citation: Guger M et al. J Neurol. 2020 Apr 3. doi: 10.1007/s00415-020-09811-6.

Key clinical point: The correlation of muscle strength in the lower extremity and trunk with walking performance is stronger in patients with multiple sclerosis (MS) having mild disability than in those having moderate disability.

Major finding: The mild vs. moderate disability group exhibited stronger Pearson correlations of muscle strength to Timed 25-Foot Walk (P less than .001) and 6-minute walk test (P less than .001). For Timed 25-Foot Walk, ankle dorsiflexion (P = .002), knee extension (P = .001), and hip abduction (P = .046) had significantly higher beta coefficients in the mild than moderate disability group.

Study details: A cross-sectional study analyzed data of patients with MS having mild disability (Expanded Disability Status scale [EDSS], 0-3.5; n=36) and moderate disability (EDSS, 4.0-5.5; n=36).

Disclosures: Dr J Kittelson received consulting fees for work on advisory and steering committees for CPC Clinical Research, Bayer Healthcare, Janssen Pharmaceuticals, and Pfizer and for work on data and safety monitoring committees from the Cystic Fibrosis Foundation Therapeutics, Novo Nordisk, Pfizer, Genentech, and BioMarin Pharmaceuticals. Dr MM Mañago, J Callesen, U Dalgas, and M Schenkman declared no conflicts of interest. The study did not receive any external funding.

Citation: Mañago MM et al. Mult Scler Relat Disord. 2020 Mar 13. doi: 10.1016/j.msard.2020.102052

Key clinical point: The correlation of muscle strength in the lower extremity and trunk with walking performance is stronger in patients with multiple sclerosis (MS) having mild disability than in those having moderate disability.

Major finding: The mild vs. moderate disability group exhibited stronger Pearson correlations of muscle strength to Timed 25-Foot Walk (P less than .001) and 6-minute walk test (P less than .001). For Timed 25-Foot Walk, ankle dorsiflexion (P = .002), knee extension (P = .001), and hip abduction (P = .046) had significantly higher beta coefficients in the mild than moderate disability group.

Study details: A cross-sectional study analyzed data of patients with MS having mild disability (Expanded Disability Status scale [EDSS], 0-3.5; n=36) and moderate disability (EDSS, 4.0-5.5; n=36).

Disclosures: Dr J Kittelson received consulting fees for work on advisory and steering committees for CPC Clinical Research, Bayer Healthcare, Janssen Pharmaceuticals, and Pfizer and for work on data and safety monitoring committees from the Cystic Fibrosis Foundation Therapeutics, Novo Nordisk, Pfizer, Genentech, and BioMarin Pharmaceuticals. Dr MM Mañago, J Callesen, U Dalgas, and M Schenkman declared no conflicts of interest. The study did not receive any external funding.

Citation: Mañago MM et al. Mult Scler Relat Disord. 2020 Mar 13. doi: 10.1016/j.msard.2020.102052

Key clinical point: The correlation of muscle strength in the lower extremity and trunk with walking performance is stronger in patients with multiple sclerosis (MS) having mild disability than in those having moderate disability.

Major finding: The mild vs. moderate disability group exhibited stronger Pearson correlations of muscle strength to Timed 25-Foot Walk (P less than .001) and 6-minute walk test (P less than .001). For Timed 25-Foot Walk, ankle dorsiflexion (P = .002), knee extension (P = .001), and hip abduction (P = .046) had significantly higher beta coefficients in the mild than moderate disability group.

Study details: A cross-sectional study analyzed data of patients with MS having mild disability (Expanded Disability Status scale [EDSS], 0-3.5; n=36) and moderate disability (EDSS, 4.0-5.5; n=36).

Disclosures: Dr J Kittelson received consulting fees for work on advisory and steering committees for CPC Clinical Research, Bayer Healthcare, Janssen Pharmaceuticals, and Pfizer and for work on data and safety monitoring committees from the Cystic Fibrosis Foundation Therapeutics, Novo Nordisk, Pfizer, Genentech, and BioMarin Pharmaceuticals. Dr MM Mañago, J Callesen, U Dalgas, and M Schenkman declared no conflicts of interest. The study did not receive any external funding.

Citation: Mañago MM et al. Mult Scler Relat Disord. 2020 Mar 13. doi: 10.1016/j.msard.2020.102052

Key clinical point: Patients with relapsing-remitting multiple sclerosis (RRMS) having poor prognostic factors at baseline who were initiated with induction therapy have a lower risk for disability in the long term.

Major finding: After propensity matching, the proportion of patients reaching the primary outcome (Expanded Disability Status Scale [EDSS], ≥6.0) was lower in the induction group (28.0%) than the escalation group (38.7%). The median final EDSS scores were 5.0 and 4.5 after escalation and induction, respectively (P less than .001).

Study details: This study evaluated the long-term effectiveness of initial treatment with induction (n=75) or escalation (n=738) approach in patients with RRMS identified from a multicenter, retrospective registry database in Italy.

Disclosures: The authors declared no conflicts of interest.

Citation: Prosperini et al. Neurotherapeutics. 2020 Mar 31. doi: 10.1007/s13311-020-00847-0.

Key clinical point: Patients with relapsing-remitting multiple sclerosis (RRMS) having poor prognostic factors at baseline who were initiated with induction therapy have a lower risk for disability in the long term.

Major finding: After propensity matching, the proportion of patients reaching the primary outcome (Expanded Disability Status Scale [EDSS], ≥6.0) was lower in the induction group (28.0%) than the escalation group (38.7%). The median final EDSS scores were 5.0 and 4.5 after escalation and induction, respectively (P less than .001).

Study details: This study evaluated the long-term effectiveness of initial treatment with induction (n=75) or escalation (n=738) approach in patients with RRMS identified from a multicenter, retrospective registry database in Italy.

Disclosures: The authors declared no conflicts of interest.

Citation: Prosperini et al. Neurotherapeutics. 2020 Mar 31. doi: 10.1007/s13311-020-00847-0.

Key clinical point: Patients with relapsing-remitting multiple sclerosis (RRMS) having poor prognostic factors at baseline who were initiated with induction therapy have a lower risk for disability in the long term.

Major finding: After propensity matching, the proportion of patients reaching the primary outcome (Expanded Disability Status Scale [EDSS], ≥6.0) was lower in the induction group (28.0%) than the escalation group (38.7%). The median final EDSS scores were 5.0 and 4.5 after escalation and induction, respectively (P less than .001).

Study details: This study evaluated the long-term effectiveness of initial treatment with induction (n=75) or escalation (n=738) approach in patients with RRMS identified from a multicenter, retrospective registry database in Italy.

Disclosures: The authors declared no conflicts of interest.

Citation: Prosperini et al. Neurotherapeutics. 2020 Mar 31. doi: 10.1007/s13311-020-00847-0.