Isfahan University of Medical Sciences

Science Communicator Platform

Stay connected! Follow us on X network (Twitter):
Share this content! On (X network) By
Comparative Effectiveness in Multiple Sclerosis: A Methodological Comparison Publisher Pubmed



Roos I1, 96 ; Diouf I1 ; Sharmin S1 ; Horakova D2 ; Havrdova EK2 ; Patti F3, 100 ; Shaygannejad V4 ; Ozakbas S5 ; Izquierdo G8 ; Eichau S8 ; Onofrj M9 ; Lugaresi A12 ; Alroughani R15 ; Prat A16 Show All Authors
Authors
  1. Roos I1, 96
  2. Diouf I1
  3. Sharmin S1
  4. Horakova D2
  5. Havrdova EK2
  6. Patti F3, 100
  7. Shaygannejad V4
  8. Ozakbas S5
  9. Izquierdo G8
  10. Eichau S8
  11. Onofrj M9
  12. Lugaresi A12
  13. Alroughani R15
  14. Prat A16
  15. Girard M16
  16. Duquette P16
  17. Terzi M17
  18. Boz C18
  19. Grandmaison F19
  20. Sola P20
  21. Ferraro D20
  22. Grammond P21
  23. Turkoglu R24
  24. Buzzard K25, 98, 99
  25. Skibina O25, 90
  26. Yamou B26
  27. Altintas A27
  28. Gerlach O28, 87
  29. Van Pesch V29, 101
  30. Blanco Y30
  31. Maimone D31
  32. Lechnerscott J32, 95
  33. Bergamaschi R33
  34. Karabudak R34
  35. Mcguigan C35
  36. Cartechini E38
  37. Barnett M41
  38. Hughes S42
  39. Sa MJ43
  40. Solaro C44, 97
  41. Ramotello C45
  42. Hodgkinson S46
  43. Spitaleri D47
  44. Soysal A48
  45. Petersen T49
  46. Granella F50, 104
  47. De Gans K51
  48. Mccombe P52, 92
  49. Ampapa R53
  50. Van Wijmeersch B54
  51. Van Der Walt A57, 89
  52. Butzkueven H57, 89
  53. Prevost J58
  54. Sanchezmenoyo JL63
  55. Laureys G64
  56. Gouider R65
  57. Castillotrivino T66
  58. Gray O69
  59. Agueramorales E70
  60. Alasmi A71
  61. Shaw C72
  62. Deri N73
  63. Alharbi T74
  64. Fragoso Y75
  65. Csepany T76
  66. Sempere AP77
  67. Trevinofrenk I78
  68. Schepel J85
  69. Moore F86
  70. Malpas C1, 96
  71. Kalincik T1, 96
Show Affiliations
Authors Affiliations
  1. 1. CORe, Department of Medicine, University of Melbourne, Melbourne, VIC, Australia
  2. 2. Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University in Prague and General University Hospital, Prague, Czech Republic
  3. 3. Department of Medical and Surgical Sciences and Advanced Technologies, G.F. Ingrassia, Catania, Italy
  4. 4. Isfahan University of Medical Sciences, Isfahan, Iran
  5. 5. Dokuz Eylul University, &
  6. 6. #x0130
  7. 7. zmir, Turkey
  8. 8. Hospital Universitario Virgen Macarena, Sevilla, Spain
  9. 9. University G. d&
  10. 10. #x2019
  11. 11. Annunzio, Chieti, Italy
  12. 12. Dipartimento di Scienze Biomediche e Neuromotorie, Universit&
  13. 13. #x00E0
  14. 14. di Bologna, Bologna, Italy
  15. 15. Division of Neurology, Department of Medicine, Amiri Hospital, Sharq, Kuwait
  16. 16. CHUM MS Center and Universite de Montreal, Montreal, QC, Canada
  17. 17. 19 Mayis University, Samsun, Turkey
  18. 18. KTU Medical Faculty Farabi Hospital, Trabzon, Turkey
  19. 19. Neuro Rive-Sud, Greenfield Park, QC, Canada
  20. 20. Department of Neuroscience, Azienda Ospedaliera Universitaria, Modena, Italy
  21. 21. CISSS Chaudi&
  22. 22. #x00E8
  23. 23. re-Appalache, Levis, QC, Canada
  24. 24. Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
  25. 25. Department of Neurology, Box Hill Hospital, Melbourne, VIC, Australia
  26. 26. Nehme and Therese Tohme Multiple Sclerosis Center, American University of Beirut Medical Center, Beirut, Lebanon
  27. 27. Department of Neurology, School of Medicine and Koc University Research Center for Translational Medicine (KUTTAM), Koc University, Istanbul, Turkey
  28. 28. Zuyderland Medical Center, Sittard-Geleen, Netherlands
  29. 29. Cliniques Universitaires Saint-Luc, Brussels, Belgium
  30. 30. Center of Neuroimmunology, Service of Neurology, Hospital Clinic de Barcelona, Barcelona, Spain
  31. 31. Centro Sclerosi Multipla, UOC Neurologia, ARNAS Garibaldi, Catania, Italy
  32. 32. School of Medicine and Public Health, University Newcastle, Newcastle, NSW, Australia
  33. 33. IRCCS Mondino Foundation, Pavia, Italy
  34. 34. Hacettepe University, Ankara, Turkey
  35. 35. St. Vincent&
  36. 36. #x2019
  37. 37. s University Hospital, Dublin, Ireland
  38. 38. UOC Neurologia, Azienda Sanitaria Unica Regionale Marche&
  39. 39. #x2013
  40. 40. AV3, Macerata, Italy
  41. 41. Brain and Mind Centre, Sydney, NSW, Australia
  42. 42. Royal Victoria Hospital, Belfast, United Kingdom
  43. 43. Department of Neurology, Centro Hospitalar Universitario de Sao Joao, Porto, Portugal
  44. 44. Department of Neurology, ASL3 Genovese, Genova, Italy
  45. 45. Hospital Germans Trias i Pujol, Badalona, Spain
  46. 46. Immune Tolerance Laboratory, Ingham Institute and Department of Medicine, University of New South Wales, Sydney, NSW, Australia
  47. 47. Azienda Ospedaliera di Rilievo Nazionale San Giuseppe Moscati Avellino, Avellino, Italy
  48. 48. Bakirkoy Education and Research Hospital for Psychiatric and Neurological Diseases, Istanbul, Turkey
  49. 49. Aarhus University Hospital, Aarhus, Denmark
  50. 50. Department of Medicine and Surgery, University of Parma, Parma, Italy
  51. 51. Groene Hart Ziekenhuis, Gouda, Netherlands
  52. 52. The University of Queensland, Brisbane, QLD, Australia
  53. 53. Nemocnice Jihlava, Jihlava, Czech Republic
  54. 54. Rehabilitation &
  55. 55. #x0026
  56. 56. MS Centre, University MS Centre, Noorderhart Hospital, Pelt, Belgium
  57. 57. Department of Neurology, The Alfred Hospital, Melbourne, VIC, Australia
  58. 58. CSSS Saint-J&
  59. 59. #x00E9
  60. 60. r&
  61. 61. #x00F4
  62. 62. me, Saint-Jerome, QC, Canada
  63. 63. Hospital de Galdakao-Usansolo, Galdakao, Spain
  64. 64. Department of Neurology, University Hospital Ghent, Ghent, Belgium
  65. 65. Department of Neurology, Razi Hospital, Manouba, Tunisia
  66. 66. Hospital Universitario Donostia and IIS Biodonostia, San Sebasti&
  67. 67. #x00E1
  68. 68. n, Spain
  69. 69. South Eastern HSC Trust, Belfast, United Kingdom
  70. 70. University Hospital Reina Sofia, Cordoba, Spain
  71. 71. Department of Medicine, Sultan Qaboos University Hospital, Al-Khodh, Oman
  72. 72. Geelong Hospital, Geelong, VIC, Australia
  73. 73. Hospital Fernandez, Capital Federal, Buenos Aires, Argentina
  74. 74. Neurology Department, King Fahad Specialist Hospital-Dammam, Khobar, Saudi Arabia
  75. 75. Universidade Metropolitana de Santos, Santos, Brazil
  76. 76. Department of Neurology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
  77. 77. Hospital General Universitario de Alicante, Alicante, Spain
  78. 78. Instituto Nacional de Ciencias M&
  79. 79. #x00E9
  80. 80. dicas y Nutrici&
  81. 81. #x00F3
  82. 82. n Salvador Zubir&
  83. 83. #x00E1
  84. 84. n, Mexico City, Mexico
  85. 85. Waikato Hospital, Hamilton, New Zealand
  86. 86. Jewish General Hospital, Montreal, QC, Canada
  87. 87. School for Mental Health and Neuroscience, Maastricht University, Maastricht, Netherlands
  88. 88. IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
  89. 89. Central Clinical School, Monash University, Clayton, VIC, Australia
  90. 90. The Alfred Hospital, Melbourne, VIC, Australia
  91. 91. Pelt and Hasselt University, Hasselt, Belgium
  92. 92. Royal Brisbane and Women&
  93. 93. #x2019
  94. 94. s Hospital, Herston, QLD, Australia
  95. 95. Department of Neurology, John Hunter Hospital, Hunter New England Health, Newcastle, NSW, Australia
  96. 96. Neuroimmunology Centre, Department of Neurology, Royal Melbourne Hospital, Melbourne, VIC, Australia
  97. 97. Department of Rehabilitation, M.L. Novarese Hospital Moncrivello, Moncrivello, Italy
  98. 98. Monash University, Melbourne, VIC, Australia
  99. 99. Neuroimmunology Centre, Royal Melbourne Hospital, Melbourne, VIC, Australia
  100. 100. Multiple Sclerosis Center, University of Catania, Catania, Italy
  101. 101. Universit&
  102. 102. #x00E9
  103. 103. Catholique de Louvain, Ottignies-Louvain-la-Neuve, Belgium
  104. 104. Department of Emergency and General Medicine, Parma University Hospital, Parma, Italy

Source: Multiple Sclerosis Journal Published:2023


Abstract

Background: In the absence of evidence from randomised controlled trials, observational data can be used to emulate clinical trials and guide clinical decisions. Observational studies are, however, susceptible to confounding and bias. Among the used techniques to reduce indication bias are propensity score matching and marginal structural models. Objective: To use the comparative effectiveness of fingolimod vs natalizumab to compare the results obtained with propensity score matching and marginal structural models. Methods: Patients with clinically isolated syndrome or relapsing remitting MS who were treated with either fingolimod or natalizumab were identified in the MSBase registry. Patients were propensity score matched, and inverse probability of treatment weighted at six monthly intervals, using the following variables: age, sex, disability, MS duration, MS course, prior relapses, and prior therapies. Studied outcomes were cumulative hazard of relapse, disability accumulation, and disability improvement. Results: 4608 patients (1659 natalizumab, 2949 fingolimod) fulfilled inclusion criteria, and were propensity score matched or repeatedly reweighed with marginal structural models. Natalizumab treatment was associated with a lower probability of relapse (PS matching: HR 0.67 [95% CI 0.62-0.80]; marginal structural model: 0.71 [0.62-0.80]), and higher probability of disability improvement (PS matching: 1.21 [1.02 -1.43]; marginal structural model 1.43 1.19 -1.72]). There was no evidence of a difference in the magnitude of effect between the two methods. Conclusions: The relative effectiveness of two therapies can be efficiently compared by either marginal structural models or propensity score matching when applied in clearly defined clinical contexts and in sufficiently powered cohorts. © The Author(s), 2023.
Experts (# of related papers)
Other Related Docs
35. Early Predictors of Conversion to Secondary Progressive Multiple Sclerosis, Multiple Sclerosis and Related Disorders (2021)
36. Disability Accrual in Primary and Secondary Progressive Multiple Sclerosis, Journal of Neurology, Neurosurgery and Psychiatry (2023)
46. Effect of Fingolimod on Platelet Count Among Multiple Sclerosis Patients, International Journal of Preventive Medicine (2015)