Optimization of treatment with interferon beta in multiple sclerosis. Usefulness of automatic system application criteria
A software based tool has been developed (Optem) to allow automatize the recommendations of the Canadian Multiple Sclerosis Working Group for optimizing MS treatment in order to avoid subjective interpretation.
Methods: Treatment Optimization Recommendations (TOR) were applied to our database of patients treated with IFN B1a IM.
Patient data were assessed during year 1 for disease activity and patients assigned to 2 groups according to TOR: " change treatment " (C) and " no change treatment " (N). These assessments were then compared to observed clinical outcomes for disease activity over the following years.
Results: We have data on 55 patients.
The " change treatment " status was assigned to 22 patients, and " no change treatment " to 33 patients. The estimated sensitivity and specificity according to last visit status were 73.9 and 84.4%.
During the following years, the Relapse Rate was always higher in the " change treatment " group (C) than in the " no change treatment " group (N) (5y; C: 0.7, N: 0.07; p<0.001, 12 m - last visit; C:0.536, N: 0.34). We obtained the same results with the EDSS (4y; C: 3.53, N: 2.55, annual progression rate in 12 m - last visit; C: 0.29, N: 0.13).
Conclusions: Applying TOR to the first year of therapy allowed for accurate edition of continued disease activity in relapses and in disability progression.
Author: Juan Luis Ruiz Pena, Pablo Duque and Guillermo Izquierdo
Credits/Source: BMC Neurology 2008, 8:3
Published on: 2008-03-06
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