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An investigation of clinical outcome measures in PPMS to inform the design of investigator initiated clinical trials.
Proposal
5995
Title of Proposed Research
An investigation of clinical outcome measures in PPMS to inform the design of investigator initiated clinical trials.
Lead Researcher
Marcus Koch MD PhD
Affiliation
University of Calgary, Calgary, Alberta, Canada
Funding Source
Potential Conflicts of Interest
Data Sharing Agreement Date
30 September 2019
Lay Summary
Primary progressive multiple sclerosis (PPMS) is an incurable chronic neurological condition. Treatment trials in PPMS are difficult in part because there is no clarity about the most useful outcome measures and inclusion criteria. In the proposed research, we will determine rates of clinical worsening on a variety of outcome measures, which will help to select the most fitting primary outcome measure in investigator initiated trials.We will also investigate the relation of baseline characteristics of the study participants (such as sex, age, MRI characteristics at baseline) which the risk of worsening of disability throughout the duration of the trial. These analyses will help to select the most useful inclusion and exclusion criteria for investigator initiated trials in PPMS.
Study Data Provided
[{ "PostingID": 4594, "Title": "NOVARTIS-CFTY720D2306", "Description": "A Double-blind, Randomized, Multicenter, Placebo-controlled, Parallel-group Study Comparing the Efficacy and Safety of 0.5mg FTY720 Administered Orally Once Daily Versus Placebo in Patients With Primary Progressive Multiple Sclerosis" }]
Statistical Analysis Plan
In this research project, we will determine the proportion of progressed patients by comparing baseline and follow-up disability measures. Patients missing the disability measure at baseline, the time point of interest, or the corresponding confirmation assessment (at either 3 or at 6 months) will be excluded from the analysis. Disability progression is defined as a 20% or more worsening from baseline in the time for the T25FW and the 9HPT, and according to the trial definition for the EDSS.We will determine these proportions of worsened patients for all outcome measures and their combinations, and for all time points these disability measures were used.This part of the analysis will inform the choice of the most useful primary outcome measure for trials in PPMS.In addition to this, we will use binary logistic regression models to investigate the association of baseline characteristics (sex, age, MRI characteristics at baseline, disability measures at baseline) with the risk of worsening throughout the trial. The association of each predictor variable to the risk of worsening will be expressed as an Odds ratio with its corresponding 95% confidence interval.
Publication Citation
Koch MW, Mostert J, Repovic P, Bowen JD, Strijbis E, Uitdehaag B, Cutter G. Smoking, obesity, and disability worsening in PPMS: an analysis of the INFORMS original trial dataset. J Neurol. 2022 Mar;269(3):1663-1669.
DOI: 10.1007/s00415-021-10750-z
Koch MW, Mostert J, Zhang Y, Wolinsky JS, Lublin FD, Strijbis E, Cutter G. Association of Age With Contrast-Enhancing Lesions Across the Multiple Sclerosis Disease Spectrum. Neurology. 2021 Sep 28;97(13):e1334-e1342.
DOI: 10.1212/WNL.0000000000012603
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