Medicatie niet effectief voor de gemiddelde MS patient boven de 53
DISEASE-MODIFYING DRUGS ARE [URL="
https://overcomingms.org/disease-modify ... -findings/"][U]NOT EFFECTIVE[/U][/URL] FOR THE AVERAGE PERSON WITH MS AGED 53 OR MORE: MAJOR STUDY FINDINGS
Overcoming Multiple Sclerosis:
[QUOTE]They did a meta-analysis of clinical trials that assessed how effective particular DMDs were, involving in total over 28,000 people with MS. Meta-analysis is a technique where researchers pool the results of all relevant, well-conducted studies, and it provides much greater statistical strength to reach conclusions about efficacy.
They found that the usual MS drugs were less and less effective the older the average person with MS in the clinical trials was, to the point where, at age 53, they stopped being effective at all!
They also showed that the newer generation, more potent MS drugs were more effective than that standard first generation drugs like Copaxone and interferons only for people with MS who were under 40 years old.
These surprising results give serious pause for thought. The researchers themselves say: “…in view of this meta-analysis, it should serve as a reminder that aggressive immunomodulatory DMTs may be harmful in older MS patients…”. By this they meant that not only were older people likely to experience side effects without the prospect of any benefit, but that aggressive MS drugs might also hinder the usual repair processes after nervous system damage.
While the researchers were quick to point out that these conclusions apply to the “average patient”, and that some may still get some benefit after the age of 53, older people newly diagnosed with MS would be well advised to discuss the pros and cons of starting a DMD with their doctor in significant detail. Likewise, those people on a DMD who are passing this age should consider a similar conversation with their doctor. [/QUOTE]
[URL="
https://www.frontiersin.org/articles/10 ... 00577/full"][U]
Het onderzoek[/U][/URL]: Meta-analysis of the Age-Dependent Efficacy of Multiple Sclerosis Treatments
[QUOTE][B]Objective[/B]: To perform a meta-analysis of randomized, blinded, multiple sclerosis (MS) clinical trials, to test the hypothesis that efficacy of immunomodulatory disease-modifying therapies (DMTs) on MS disability progression is strongly dependent on age.
[B]Methods[/B]: We performed a literature search with pre-defined criteria and extracted relevant features from 38 clinical trials that assessed efficacy of DMTs on disability progression. We fit a linear regression, weighted for trial sample size, and duration, to examine the hypothesis that age has a defining effect on the therapeutic efficacy of immunomodulatory DMTs.
[B]Results[/B]: More than 28,000 MS subjects participating in trials of 13 categories of immunomodulatory drugs are included in the meta-analysis. The efficacy of immunomodulatory DMTs on MS disability strongly decreased with advancing age (R2 = 0.6757, p = 6.39e−09). Inclusion of baseline EDSS did not significantly improve the model. The regression predicts zero efficacy beyond approximately age 53 years. The comparative efficacy rank derived from the regression residuals differentiates high- and low-efficacy drugs. High-efficacy drugs outperform low-efficacy drugs in inhibiting MS disability only for patients younger than 40.5 years.
[B]Conclusion[/B]: The meta-analysis supports the notion that progressive MS is simply a later stage of the MS disease process and that age is an essential modifier of a drug efficacy. Higher efficacy treatments exert their benefit over lower efficacy treatments only during early stages of MS, and, after age 53, the model suggests that there is no predicted benefit to receiving immunomodulatory DMTs for the average MS patient.[/QUOTE]