Evidence map›Paper›PMID 38935148›Full record

ArticleJournal of neurology2024

A multi-centre longitudinal study analysing multiple sclerosis disease-modifying therapy prescribing patterns during the COVID-19 pandemic.

Anoushka P Lal, Yi Chao Foong, Paul G Sanfilippo, Tim Spelman, Louise Rath, David Levitz, Marzena Fabis-Pedrini, Matteo Foschi, Mario Habek, Tomas Kalincik and 45 more

Abstract readMulticenter Study
In one paragraph

Article in Journal of neurology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. Article
  5. Article
  6. Longitudinal Trajectories of Digital Cognitive Biomarkers for Multiple Sclerosis.Annals of clinical and translational neurology · 2025
    Observational
  7. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

55 authors.

Anoushka P Lal *Department of Neuroscience, Central Clinical School, The Alfred, Melbourne, VIC, Australia.
Yi Chao Foong *Department of Neuroscience, Central Clinical School, The Alfred, Melbourne, VIC, Australia.
Paul G SanfilippoDepartment of Neuroscience, Central Clinical School, The Alfred, Melbourne, VIC, Australia.
Tim SpelmanDepartment of Neuroscience, Central Clinical School, The Alfred, Melbourne, VIC, Australia.
Louise RathDepartment of Neuroscience, Central Clinical School, The Alfred, Melbourne, VIC, Australia.
David LevitzDepartment of Neuroscience, Central Clinical School, The Alfred, Melbourne, VIC, Australia.
Marzena Fabis-PedriniPerron Institute for Neurological and Translational Science, The University of Western Australia, Perth, Australia.
Matteo FoschiDepartment of Neuroscience, MS Center, Neurology Unit, S. Maria Delle Croci Hospital, AUSL Romagna, Ravenna, Italy.
Mario HabekDepartment of Neurology, University Hospital Center Zagreb, Zagreb, Croatia.
Tomas KalincikDepartment of Neurology, Neuroimmunology Centre, Royal Melbourne Hospital, Melbourne, Australia.
Izanne RoosDepartment of Neurology, Neuroimmunology Centre, Royal Melbourne Hospital, Melbourne, Australia.
Jeannette Lechner-ScottHunter Medical Research Institute, University Newcastle, Newcastle, Australia.
Nevin JohnDepartment of Medicine, School of Clinical Sciences, Monash University, Clayton, Australia.
Aysun SoysalBakirkoy Education and Research Hospital for Psychiatric and Neurological Diseases, Istanbul, Turkey.
Emanuele D'AmicoMedical and Surgical Sciences, Universita Di Foggia, Foggia, Italy.
Riadh GouiderDepartment of Neurology, LR 18SP03, Clinical Investigation Centre Neurosciences and Mental Health, Razi University Hospital, Tunis, Tunisia.
Saloua MrabetDepartment of Neurology, LR 18SP03, Clinical Investigation Centre Neurosciences and Mental Health, Razi University Hospital, Tunis, Tunisia.
Katrin Gross-PajuMultiple Sclerosis Centre, West-Tallinn Central Hospital, Tallinn, Estonia.
Simón Cárdenas-RobledoDepartment of Neurology, Centro de Esclerosis Múltiple (CEMHUN), Hospital Universitario Nacional de Colombia Bogota, Bogota, Colombia.
Abdorreza Naser MoghadasiMultiple Research Centre, Neuroscience Institute, Tehran University of Medical Science, Tehran, Iran.
Maria Jose SaDepartment of Neurology, Centro Hospitalar Universitario de Sao Joao, Porto, Portugal.
Orla GraySouth Eastern HSC Trust, Belfast, UK.
Jiwon OhSt. Michael's Hospital, Toronto, Canada.
Stephen ReddelDepartment of Neurology, Concord Repatriation General Hospital, Sydney, Australia.
Sudarshini RamanathanTranslational Neuroimmunology Group, Kids Neuroscience Centre and Brain and Mind Centre, Concord Hospital, Sydney, Australia.
Talal Al-HarbiNeurology Department, King Fahad Specialist Hospital-Dammam, Dammam, Saudi Arabia.
Ayse AltintasDepartment of Neurology, School of Medicine and Koc University Research Center for Translational Medicine (KUTTAM), İstanbul, Turkey.
Todd A HardyDepartment of Neurology, Concord Repatriation General Hospital, Sydney, Australia.
Serkan OzakbasIzmir University of Economics, Medical Point Hospital, Izmir, Turkey.
Raed AlroughaniDivision of Neurology, Department of Medicine, Amiri Hospital, Sharq, Kuwait.
Allan G KermodePerron Institute for Neurological and Translational Science, The University of Western Australia, Perth, Australia.
Andrea SurcinelliDepartment of Neuroscience, MS Center, Neurology Unit, S. Maria Delle Croci Hospital, AUSL Romagna, Ravenna, Italy.
Guy LaureysDepartment of Neurology, University Hospital Ghent, Ghent, Belgium.
Sara EichauDepartment of Neurology, Hospital Universitario Virgen Macarena, Seville, Spain.
Alexandre PratCHUM and Universite de Montreal, Montreal, Canada.
Marc GirardCHUM and Universite de Montreal, Montreal, Canada.
Pierre DuquetteCHUM and Universite de Montreal, Montreal, Canada.
Suzanne HodgkinsonImmune Tolerance Laboratory Ingham Institute and Department of Medicine, UNSW, Sydney, Australia.
Cristina Ramo-TelloDepartment of Neuroscience, Hospital Germans Trias I Pujol, Badalona, Spain.
Davide MaimoneCentro Sclerosi Multipla, UOC Neurologia, Azienda Ospedaliera Per L'Emergenza Cannizzaro, Catania, Italy.
Pamela McCombeUniversity of Queensland, Brisbane, Australia.
Daniele SpitaleriAzienda Ospedaliera Di Rilievo Nazionale San Giuseppe Moscati Avellino, Avellino, Italy.
Jose Luis Sanchez-MenoyoDepartment of Neurology, Galdakao-Usansolo University Hospital, Osakidetza-Basque Health Service, Galdakao, Spain.
Mehmet Fatih YetkinDepartment of Neurology, Erciyes University, Kayseri, Turkey.
Seyed Mohammad BaghbanianNeurology Department, Booalisina Hospital, Mazandaran University of Medical Sciences, Sari, Iran.
Rana KarabudakDepartment of Neurological Sciences, Faculty of Medicine, Yeditepe University, Istanbul, Turkey.
Abdullah Al-AsmiCollege of Medicine & Health Sciences and Sultan Qaboos University Hospital, Sultan Qaboos University, Al-Khodh, Oman.
Gregor Brecl JakobDepartment of Neurology, University Medical Centre Ljubljana, Ljubljana, Slovenia.
Samia J KhouryNehme and Therese Tohme Multiple Sclerosis Center, American University of Beirut Medical Center, Beirut, Lebanon.
Masoud EtemadifarNeurology, Dr. Etemadifar MS Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
Vincent van PeschDepartment of Neurology, Cliniques Universitaires Saint-Luc, Brussels, Belgium.
Katherine BuzzardDepartment of Neurosciences, Box Hill Hospital, Box Hill, Australia.
Bruce TaylorRoyal Hobart Hospital, Hobart, Australia.
Helmut ButzkuevenDepartment of Neuroscience, Central Clinical School, The Alfred, Melbourne, VIC, Australia.
Anneke Van der WaltDepartment of Neuroscience, Central Clinical School, The Alfred, Melbourne, VIC, Australia. anneke.vanderwalt@monash.edu.ORCID http://orcid.org/0000-0002-4278-7003

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe COVID-19 pandemic raised concern amongst clinicians that disease-modifying therapies (DMT), particularly anti-CD20 monoclonal antibodies (mAb) and fingolimod, could worsen COVID-19 in people with multiple sclerosis (pwMS). This study aimed to examine DMT prescribing trends pre- and post-pandemic onset.

methodsA multi-centre longitudinal study with 8,771 participants from MSBase was conducted. Two time periods were defined: pre-pandemic (March 11 2018-March 10 2020) and post-pandemic onset (March 11 2020-11 March 2022). The association between time and prescribing trends was analysed using multivariable mixed-effects logistic regression. DMT initiation refers to first initiation of any DMT, whilst DMT switches indicate changing regimen within 6 months of last use.

resultsPost-pandemic onset, there was a significant increase in DMT initiation/switching to natalizumab and cladribine [(Natalizumab-initiation: OR 1.72, 95% CI 1.39-2.13; switching: OR 1.66, 95% CI 1.40-1.98), (Cladribine-initiation: OR 1.43, 95% CI 1.09-1.87; switching: OR 1.67, 95% CI 1.41-1.98)]. Anti-CD20mAb initiation/switching decreased in the year of the pandemic, but recovered in the second year, such that overall odds increased slightly post-pandemic (initiation: OR 1.26, 95% CI 1.06-1.49; Switching: OR 1.15, 95% CI 1.02-1.29. Initiation/switching of fingolimod, interferon-beta, and alemtuzumab significantly decreased [(Fingolimod-initiation: OR 0.55, 95% CI 0.41-0.73; switching: OR 0.49, 95% CI 0.41-0.58), (Interferon-gamma-initiation: OR 0.48, 95% CI 0.41-0.57; switching: OR 0.78, 95% CI 0.62-0.99), (Alemtuzumab-initiation: OR 0.27, 95% CI 0.15-0.48; switching: OR 0.27, 95% CI 0.17-0.44)].

conclusionsPost-pandemic onset, clinicians preferentially prescribed natalizumab and cladribine over anti-CD20 mAbs and fingolimod, likely to preserve efficacy but reduce perceived immunosuppressive risks. This could have implications for disease progression in pwMS. Our findings highlight the significance of equitable DMT access globally, and the importance of evidence-based decision-making in global health challenges.

Indexed as

COVID-19Fingolimod HydrochlorideImmunosuppressive AgentsMultiple SclerosisNatalizumabAdultAlemtuzumabCladribineFemaleHumansImmunologic FactorsLongitudinal StudiesMaleMiddle AgedPractice Patterns, Physicians'AlemtuzumabCladribineFingolimod HydrochlorideImmunologic FactorsImmunosuppressive AgentsNatalizumabAnti-CD20 monoclonal antibodiesCladribineCOVID-19Disease-modifying therapyMultiple sclerosisNatalizumab

Identifiers

PMID38935148
PMCPMC11377668

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.