Abstract Details

Title Prognostic Factors of Disease Activity in Newly Diagnosed Teriflunomide-treated Patients with Multiple Sclerosis—A Nationwide Danish Study

Topic Multiple Sclerosis

Presentation(s) P6 - Poster Session 6 (8:00 AM-9:00 AM)

Poster/Presentation
Number 6-016

Objective To investigate the prognostic effect of relapse count, T2 MRI lesion load (T2L), Expanded Disability Status Scale (EDSS) scores, age, and sex in patients newly diagnosed with multiple sclerosis (MS) commencing teriflunomide (TFL) treatment.

Background Physicians frequently rely on relapse counts, T2L, and EDSS scores to help guide treatment decisions for newly diagnosed individuals. The expanding number of treatment options highlights the necessity of improved prediction of individual disease trajectories.

Design/Methods We conducted a nationwide cohort study using data from the Danish Multiple Sclerosis Registry. Eligible participants had relapsing-remitting MS or clinically isolated syndrome and initiated TFL as their first treatment between 2013 and 2019. The effect of age, pre-treatment relapses, T2L, and EDSS scores on the risk of disease activity on TFL were analysed stratified by sex using the Aalen-Johansen estimator, a time-fixed binomial regression model, and a proportional odds cumulative incidence model.

Results In total 784 individuals were included (57.4 % females). A high number of pre-treatment relapses (≥2) was associated with an increased risk of disease activity (odds ratio [OR] and 95% CI: 1.76 [1.11 – 2.81]) in females only. Age group 50+ was associated with lower risk of disease activity in both sexes (OR_females 0.28 [0.14 – 0.56]; OR_males 0.22 [0.09 – 0.55]), and in addition, age group 35-49 was also associated with lower risk of disease activity in males (OR 0.42 [0.24 - 0.72]). EDSS scores and T2L did not show any consistent association with disease activity.

Conclusions A high number of pre-treatment relapses was only associated with an increased risk of disease activity in females. In males higher age was associated with lower risk of disease activity, while only age 50+ was associated with lower risk in females. Clinicians may consider age, sex and relapses when deciding on TFL treatment.

Authors/Disclosures
Mie R. Mahler, MD (The Danish Multiple Sclerosis Registry) PRESENTER	The institution of Miss Mahler has received research support from Copenhagen University Hospital - Rigshospitalet's research fund. Miss Mahler has a non-compensated relationship as a participant in a scientific meeting with Merck that is relevant to AAN interests or activities.
Melinda Magyari, MD	Dr. Magyari has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Roche. Dr. Magyari has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Merck. Dr. Magyari has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Magyari has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck. Dr. Magyari has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Magyari has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi. Dr. Magyari has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion. Dr. Magyari has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Bristol Myers Squibb. The institution of Dr. Magyari has received research support from The Danish MS Society. The institution of Dr. Magyari has received research support from Biogen. The institution of Dr. Magyari has received research support from Novartis. The institution of Dr. Magyari has received research support from Roche. The institution of Dr. Magyari has received research support from Merck. The institution of Dr. Magyari has received research support from Sanofi.
Luigi Pontieri (The Danish Multiple Sclerosis Registry)	No disclosure on file
Frederik Elberling (The Danish Multiple Sclerosis Registry)	No disclosure on file
Arkadiusz Weglewski (Sydvestjysk Sygehus)	Dr. Weglewski has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck. Dr. Weglewski has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck. Dr. Weglewski has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Weglewski has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Sanofi Genzyme. Dr. Weglewski has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Merck. Dr. Weglewski has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Sanofi Genzyme. Dr. Weglewski has received publishing royalties from a publication relating to health care. Dr. Weglewski has received publishing royalties from a publication relating to health care.
Mai Bang Poulsen	No disclosure on file
Plamen Bekyarov	No disclosure on file
Zsolt Illes, MD (TENSI KFT. PECS)	No disclosure on file
Matthias Kant (Sygehus Soenderjylland)	Matthias Kant has nothing to disclose.
Tobias Sejbaek, MD, PhD (Esbjerg Hospital)	Prof. Sejbaek has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen, Merck, NeuroXpharm, Novartis, Roche, Sandoz and Sanofi. The institution of Prof. Sejbaek has received research support from Merck, Novartis, Roche and Sanofi.
Morten Leif Munding Stilund (Regional hospital of west jutland)	Morten Leif Munding Stilund has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Medicinske Tidsskrifter.
Peter V. Rasmussen, MD (Aarhus University Hospital, Neurology)	Dr. Rasmussen has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Rasmussen has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion. Dr. Rasmussen has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Rasmussen has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Rasmussen has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi. Dr. Rasmussen has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck.
Maria Pedersen	No disclosure on file
Inga Urbonaviciute (Aalborg University Hospital)	No disclosure on file
Finn Sellebjerg, MD (Copenhagen University Hospital Rigshospitalet)	Dr. Sellebjerg has received personal compensation for serving as an employee of Danish Multiple Sclerosis Society. Dr. Sellebjerg has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Novartis. Dr. Sellebjerg has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Sellebjerg has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Sellebjerg has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Sellebjerg has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi Genzyme. Dr. Sellebjerg has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Biogen. Dr. Sellebjerg has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Roche. Dr. Sellebjerg has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Novartis. Dr. Sellebjerg has received personal compensation in the range of $500-$4,999 for serving as an officer or member of the Board of Directors for Gangsted Foundation. Dr. Sellebjerg has received personal compensation in the range of $500-$4,999 for serving as an officer or member of the Board of Directors for Warwara Larsen Foundation. The institution of Dr. Sellebjerg has received research support from Biogen. The institution of Dr. Sellebjerg has received research support from Merck. The institution of Dr. Sellebjerg has received research support from Novartis. The institution of Dr. Sellebjerg has received research support from Sanofi Genzyme. Dr. Sellebjerg has received publishing royalties from a publication relating to health care.

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