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SHR Neuro Krebs Kardio Lipid Stoffw Microb

Bsteh, G; Hegen, H; Riedl, K; Altmann, P; Auer, M; Berek, K; Di Pauli, F; Ehling, R; Kornek, B; Monschein, T; Rinner, W; Schmied, C; Wurth, S; Zebenholzer, K; Zinganell, A; Zrzavy, T; Zulehner, G; Deisenhammer, F; Rommer, P; Leutmezer, F; Berger, T.
Quantifying the risk of disease reactivation after interferon and glatiramer acetate discontinuation in multiple sclerosis: The VIAADISC score.
Eur J Neurol. 2021; 28(5):1609-1616 Doi: 10.1111/ene.14705 [OPEN ACCESS]
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Wurth Sebastian

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There is a lack of evidence guiding discontinuation of disease-modifying therapy (DMT) in relapsing multiple sclerosis (RMS). Thus, the objective of this study was to generate and validate a risk score for disease reactivation after DMT discontinuation in RMS. We drew a generation and validation dataset from two separate prospectively collected observational databases including RMS patients who received interferon-β or glatiramer acetate for ≥12 months, then discontinued DMT for ≥6 months and had ≥2 years of follow-up available. In the generation sample (n = 168), regression analysis was performed to identify clinical or magnetic resonance imaging (MRI) variables independently predicting disease reactivation after DMT discontinuation. A predictive score was calculated using the variables included in the multivariable model and applied to the validation sample (n = 98). The variables included in the final model as independent predictors of disease reactivation were age at discontinuation, MRI activity at discontinuation, and duration of clinical stability (all p < 0.001). The resulting score was able to robustly identify patients at high (83%-85%), moderate (36%-38%), and low risk (7%) of disease reactivation within 5 years after DMT discontinuation in both cohorts. The composite VIAADISC score is a valuable tool to inform and support patients and neurologists in the process of decision making to discontinue injectable DMTs. © 2020 The Authors. European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology.

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disease-modifying therapy
multiple sclerosis
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