Accepted for Publication: June 18, 2021.
Published Online: August 16, 2021. doi:10.1001/jamaneurol.2021.2738
Corresponding Author: Tim Spelman, PhD, MD, Department of Clinical Neuroscience, Karolinska Institute, Tomtebodavägen 18A, SE-171 77 Stockholm, Sweden (tim.spelman@ki.se).
Author Contributions: Dr Spelman had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
Concept and design: Spelman, Magyari, Hillert, Lycke.
Acquisition, analysis, or interpretation of data: All authors.
Drafting of the manuscript: Spelman, Magyari, Lycke.
Critical revision of the manuscript for important intellectual content: All authors.
Statistical analysis: Spelman.
Obtained funding: Piehl, Hillert, Lycke.
Administrative, technical, or material support: Magyari, Piehl, Sellebjerg, Lycke.
Supervision: Lycke.
Conflict of Interest Disclosures: Dr Spelman reported receiving compensation for serving on scientific advisory boards, honoraria for consultancy, and funding for travel from Biogen Inc; and speaker honoraria from Novartis. Dr Magyari reported receiving personal fees and grants from Biogen, Novartis, Merck, Sanofi, and Roche; personal fees from AbbVie, Alexion, and Bristol Myers Squibb; and grants from Teva outside the submitted work. Dr Piehl reported receiving grants from Swedish Medical Research Council and County of Stockholm during the conduct of the study; grants from Genzyme, Merck KGaA, UCB, Biogen, and Novartis; and personal fees from Parexel serving as chair of DMC in clinical trials outside the submitted work. Dr Rasmussen reported receiving personal fees from Novartis, Biogen, Alexion, Roche, Bristol Myers Squibb, Sanofi, and Merck outside the submitted work. Dr Sellebjerg reported receiving grants and personal fees from Biogen, Novartis, Merck, Roche, and Sanofi Genzyme; and personal fees from Bristol Myers Squibb and Alexion outside the submitted work. Ms Joensen reported receiving personal fees from Biogen outside the submitted work. Dr Hillert reported receiving grants and personal fees from Biogen, Celgene, Merck, Novartis, and Sanofi; grants from Roche; personal fees from Janssen, Bayer Schering, and Teva; funding from Swedish Research Council and the Swedish Brain Foundation; and serving as principal investigator for or receiving unrestricted research support from Biogen Idec, Merck Serono, TEVA, Sanofi Genzyme, and Bayer Schering outside the submitted work. Dr Lycke reported receiving grants from the Swedish Federal Government during the conduct of the study; personal fees from Biogen, Novartis, Merck, Alexion, Roche, Sanofi Genzyme, and BMS; and grants from Biogen and Novartis; and serving on the editorial board of the Acta Neurologica Scandinavica outside the submitted work. No other disclosures were reported.
Funding/Support: This study was supported by the Swedish Research Council, the Swedish Brain Foundation, the Karolinska University Hospital, the Patient-Centered Outcomes Research Institute, the Swedish Multiple Sclerosis Research Foundation, the Swedish Federal Government (LUA/ALF Agreement ALFGBG-722081), the Swedish Association of Persons with Neurological Disabilities, the Research Foundation of the Multiple Sclerosis Society of Gothenburg, the Edith Jacobson Foundation, and NEURO Sweden.
Role of the Funder/Sponsor: The funding sources had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.
1.Col
N , Alvarez
E , Springmann
V ,
et al. A novel tool to improve shared decision making and adherence in multiple sclerosis: development and preliminary testing.
MDM Policy Pract. 2019;4(2):2381468319879134. doi:
10.1177/2381468319879134
PubMedGoogle Scholar 9.Mäurer
M , Tiel-Wilck
K , Oehm
E ,
et al. Reasons to switch: a noninterventional study evaluating immunotherapy switches in a large German multicentre cohort of patients with relapsing-remitting multiple sclerosis.
Ther Adv Neurol Disord. 2019;12:1756286419892077. doi:
10.1177/1756286419892077
PubMedGoogle Scholar 12.Chalmer
TA , Baggesen
LM , Nørgaard
M , Koch-Henriksen
N , Magyari
M , Sorensen
PS ; Danish Multiple Sclerosis Group. Early versus later treatment start in multiple sclerosis: a register-based cohort study.
Eur J Neurol. 2018;25(10):1262-e110. doi:
10.1111/ene.13692
PubMedGoogle ScholarCrossref 15.Mikol
DD , Barkhof
F , Chang
P ,
et al; REGARD study group. Comparison of subcutaneous interferon beta-1a with glatiramer acetate in patients with relapsing multiple sclerosis (the REbif vs Glatiramer Acetate in Relapsing MS Disease [REGARD] study): a multicentre, randomised, parallel, open-label trial.
Lancet Neurol. 2008;7(10):903-914. doi:
10.1016/S1474-4422(08)70200-X
PubMedGoogle ScholarCrossref 16.O’Connor
P , Filippi
M , Arnason
B ,
et al; BEYOND Study Group. 250 μg or 500 μg Interferon beta-1b versus 20 mg glatiramer acetate in relapsing-remitting multiple sclerosis: a prospective, randomised, multicentre study.
Lancet Neurol. 2009;8(10):889-897. doi:
10.1016/S1474-4422(09)70226-1
PubMedGoogle ScholarCrossref 22.Devonshire
V , Havrdova
E , Radue
EW ,
et al; FREEDOMS study group. Relapse and disability outcomes in patients with multiple sclerosis treated with fingolimod: subgroup analyses of the double-blind, randomised, placebo-controlled FREEDOMS study.
Lancet Neurol. 2012;11(5):420-428. doi:
10.1016/S1474-4422(12)70056-X
PubMedGoogle ScholarCrossref 23.Shirani
A , Zhao
Y , Petkau
J ,
et al. Multiple sclerosis in older adults: the clinical profile and impact of interferon beta treatment.
Biomed Res Int. 2015;2015:451912. doi:
10.1155/2015/451912
PubMedGoogle Scholar 25.The National Board of Health and Welfare. National Guideline for Healthcare of Multiple Sclerosis (MS) and Parkinson Disease (PD). National Board of Health and Welfare; 2016.
29.Confavreux
C , O’Connor
P , Comi
G ,
et al; TOWER Trial Group. Oral teriflunomide for patients with relapsing multiple sclerosis (TOWER): a randomised, double-blind, placebo-controlled, phase 3 trial.
Lancet Neurol. 2014;13(3):247-256. doi:
10.1016/S1474-4422(13)70308-9
PubMedGoogle ScholarCrossref 32.Boster
A , Nicholas
J , Wu
N ,
et al. Comparative effectiveness research of disease-modifying therapies for the management of multiple sclerosis: analysis of a large health insurance claims database.
Neurol Ther. 2017;6(1):91-102. doi:
10.1007/s40120-017-0064-x
PubMedGoogle ScholarCrossref 33.Hutchinson
M , Fox
RJ , Havrdova
E ,
et al. Efficacy and safety of BG-12 (dimethyl fumarate) and other disease-modifying therapies for the treatment of relapsing-remitting multiple sclerosis: a systematic review and mixed treatment comparison.
Curr Med Res Opin. 2014;30(4):613-627. doi:
10.1185/03007995.2013.863755
PubMedGoogle ScholarCrossref 35.Iacobaeus
E , Arrambide
G , Amato
MP ,
et al; 2018 ECTRIMS Focused Workshop Group. Aggressive multiple sclerosis (1): towards a definition of the phenotype.
Mult Scler. 2020;1352458520925369. doi:
10.1177/1352458520925369PubMedGoogle Scholar 36.Arrambide
G , Iacobaeus
E , Amato
MP ,
et al; 2018 ECTRIMS Focused Workshop Group. Aggressive multiple sclerosis (2): treatment.
Mult Scler. 2020;1352458520924595.
PubMedGoogle Scholar 40.Meyer-Moock
S , Feng
YS , Maeurer
M , Dippel
FW , Kohlmann
T . Systematic literature review and validity evaluation of the Expanded Disability Status Scale (EDSS) and the Multiple Sclerosis Functional Composite (MSFC) in patients with multiple sclerosis.
BMC Neurol. 2014;14:58. doi:
10.1186/1471-2377-14-58
PubMedGoogle ScholarCrossref 41.Alping
P , Piehl
F , Langer-Gould
A , Frisell
T ; COMBAT-MS Study Group. Validation of the Swedish Multiple Sclerosis Register: further improving a resource for pharmacoepidemiologic evaluations.
Epidemiology. 2019;30(2):230-233. doi:
10.1097/EDE.0000000000000948
PubMedGoogle ScholarCrossref 44.Östergren
O , Martikainen
P , Tarkiainen
L , Elstad
JI , Brønnum-Hansen
H . Contribution of smoking and alcohol consumption to income differences in life expectancy: evidence using Danish, Finnish, Norwegian and Swedish register data.
J Epidemiol Community Health. 2019;73(4):334-339. doi:
10.1136/jech-2018-211640
PubMedGoogle ScholarCrossref