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Jouvenot G, Courbon G, Lefort M, Rollot F, Casey R, Le Page E, Michel L, Edan G, de Seze J, Kremer L, Bigaut K, Vukusic S, Mathey G, Ciron J, Ruet A, Maillart E, Labauge P, Zephir H, Papeix C, Defer G, Lebrun-Frenay C, Moreau T, Laplaud DA, Berger E, Stankoff B, Clavelou P, Thouvenot E, Heinzlef O, Pelletier J, Al-Khedr A, Casez O, Bourre B, Cabre P, Wahab A, Magy L, Camdessanché JP, Doghri I, Moulin S, Ben-Nasr H, Labeyrie C, Hankiewicz K, Neau JP, Pottier C, Nifle C, Collongues N, Kerbrat A. High-Efficacy Therapy Discontinuation vs Continuation in Patients 50 Years and Older With Nonactive MS. JAMA Neurol 2024:2816799. [PMID: 38526462 DOI: 10.1001/jamaneurol.2024.0395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/26/2024]
Abstract
Importance A recent randomized clinical trial concluded that discontinuing medium-efficacy therapy might be a reasonable option for older patients with nonactive multiple sclerosis (MS), but there is a lack of data on discontinuing high-efficacy therapy (HET). In younger patients, the discontinuation of natalizumab and fingolimod is associated with a risk of rebound of disease activity. Objective To determine whether discontinuing HET in patients 50 years and older with nonactive MS is associated with an increased risk of relapse compared with continuing HET. Design, Setting, and Participants This observational cohort study used data from 38 referral centers from the French MS registry (Observatoire Français de la Sclérose en Plaques [OFSEP] database). Among 84704 patients in the database, data were extracted for 1857 patients 50 years and older with relapsing-remitting MS treated by HET and with no relapse or magnetic resonance imaging activity for at least 2 years. After verification of the medical records, 1620 patients were classified as having discontinued HET or having remained taking treatment and were matched 1:1 using a dynamic propensity score (including age, sex, disease phenotype, disability, treatment of interest, and time since last inflammatory activity). Patients were included from February 2008 to November 2021, with a mean (SD) follow-up of 5.1 (2.9) years. Data were extracted in June 2022. Exposures Natalizumab, fingolimod, rituximab, and ocrelizumab. Main Outcomes and Measures Time to first relapse. Results Of 1620 included patients, 1175 (72.5%) were female, and the mean (SD) age was 54.7 (4.8) years. Among the 1452 in the HET continuation group and 168 in the HET discontinuation group, 154 patients in each group were matched using propensity scores (mean [SD] age, 57.7 [5.5] years; mean [SD] delay since the last inflammatory activity, 5.6 [3.8] years; mean [SD] follow-up duration after propensity score matching, 2.5 [2.1] years). Time to first relapse was significantly reduced in the HET discontinuation group compared with the HET continuation group (hazard ratio, 4.1; 95% CI, 2.0-8.5; P < .001) but differed between HETs, with a hazard ratio of 7.2 (95% CI, 2.1-24.5; P = .001) for natalizumab, 4.5 (95% CI, 1.3-15.5; P = .02) for fingolimod, and 1.1 (95% CI, 0.3-4.8; P = .85) for anti-CD20 therapy. Conclusion and Relevance As in younger patients, in patients 50 years and older with nonactive MS, the risk of relapse increased significantly after stopping HETs that impact immune cell trafficking (natalizumab and fingolimod). There was no significant increase in risk after stopping HETs that deplete B-cells (anti-CD20 therapy). This result may inform decisions about stopping HETs in clinical practice.
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Affiliation(s)
- Guillaume Jouvenot
- Center for Clinical Investigation, INSERM U1434, Strasbourg, France
- Biopathology of Myelin, Neuroprotection and Therapeutic Strategy, INSERM U1119, Strasbourg, France
| | - Guilhem Courbon
- Department of Neurology, University Hospital of Rennes, Rennes, France
| | - Mathilde Lefort
- University of Rennes, EHESP, CNRS, INSERM, Arènes-UMR 6051, RSMS (Recherche sur les Services et Management en Santé)-U 1309, Rennes, France
| | - Fabien Rollot
- Université de Lyon, Université Claude Bernard, Lyon, France
- Department of Neurology, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Sclérose en Plaques, Pathologies de la Myéline et Neuro-Inflammation, Bron, France
- Centre de Recherche en Neurosciences de Lyon, Observatoire Français de La Sclérose en Plaques, INSERM 1028 and CNRS UMR 5292, Lyon, France
- Eugène Devic EDMUS Foundation Against Multiple Sclerosis, State-Approved Foundation, Bron, France
| | - Romain Casey
- Université de Lyon, Université Claude Bernard, Lyon, France
- Department of Neurology, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Sclérose en Plaques, Pathologies de la Myéline et Neuro-Inflammation, Bron, France
- Centre de Recherche en Neurosciences de Lyon, Observatoire Français de La Sclérose en Plaques, INSERM 1028 and CNRS UMR 5292, Lyon, France
- Eugène Devic EDMUS Foundation Against Multiple Sclerosis, State-Approved Foundation, Bron, France
| | - Emmanuelle Le Page
- Department of Neurology, University Hospital of Rennes, Rennes, France
- CIC-P 1414 INSERM, University Hospital of Rennes, Rennes, France
| | - Laure Michel
- Department of Neurology, University Hospital of Rennes, Rennes, France
- CIC-P 1414 INSERM, University Hospital of Rennes, Rennes, France
| | - Gilles Edan
- Department of Neurology, University Hospital of Rennes, Rennes, France
- CIC-P 1414 INSERM, University Hospital of Rennes, Rennes, France
| | - Jérome de Seze
- Center for Clinical Investigation, INSERM U1434, Strasbourg, France
- Biopathology of Myelin, Neuroprotection and Therapeutic Strategy, INSERM U1119, Strasbourg, France
- Department of Neurology, University Hospital of Strasbourg, Strasbourg, France
| | - Laurent Kremer
- Biopathology of Myelin, Neuroprotection and Therapeutic Strategy, INSERM U1119, Strasbourg, France
- Department of Neurology, University Hospital of Strasbourg, Strasbourg, France
| | - Kevin Bigaut
- Biopathology of Myelin, Neuroprotection and Therapeutic Strategy, INSERM U1119, Strasbourg, France
- Department of Neurology, University Hospital of Strasbourg, Strasbourg, France
| | - Sandra Vukusic
- Université de Lyon, Université Claude Bernard, Lyon, France
- Department of Neurology, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Sclérose en Plaques, Pathologies de la Myéline et Neuro-Inflammation, Bron, France
- Centre de Recherche en Neurosciences de Lyon, Observatoire Français de La Sclérose en Plaques, INSERM 1028 and CNRS UMR 5292, Lyon, France
- Eugène Devic EDMUS Foundation Against Multiple Sclerosis, State-Approved Foundation, Bron, France
| | - Guillaume Mathey
- Department of Neurology, Nancy University Hospital, Nancy, France
- Université de Lorraine, APEMAC, Nancy, France
| | - Jonathan Ciron
- CRC-SEP, Department of Neurology, CHU de Toulouse, Toulouse, France
| | - Aurélie Ruet
- Department of Neurology, CHU de Bordeaux, CIC Bordeaux CIC1401, Bordeaux, France
| | - Elisabeth Maillart
- Département de Neurologie, Hôpital Pitié-Salpêtrière, APHP, Centre de Ressources et de Compétences SEP, Paris, France
| | | | | | - Caroline Papeix
- Department of Neurology, Fondation Rothschild, Paris, France
| | - Gilles Defer
- Department of Neurology, MS Expert Centre, CHU de Caen, Caen, France
| | - Christine Lebrun-Frenay
- Neurology, UR2CA-URRIS, Centre Hospitalier Universitaire Pasteur2, Université Nice Côte d'Azur, Nice, France
| | | | - David Axel Laplaud
- Department of Neurology, CHU de Nantes, Nantes, France
- Nantes Université, CHU Nantes, INSERM, CIC 14131413, Center for Research in Translational Immunology, UMR 1064, Nantes, France
| | - Eric Berger
- Service de Neurologie, CHU de Besançon, Besançon, France
| | - Bruno Stankoff
- Department of Neurology, AP-HP, Saint-Antoine Hospital, Paris, France
| | - Pierre Clavelou
- Department of Neurology, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Eric Thouvenot
- Department of Neurology, Nimes University Hospital, Nimes, France
| | | | - Jean Pelletier
- Service de Neurologie, APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Marseille, France
| | | | - Olivier Casez
- CHU Grenoble Alpes, Department of Neurology, Neurology MS Clinic Grenoble, Grenoble Alpes University Hospital, Grenoble, France
| | | | - Philippe Cabre
- Department of Neurology, CHU de la Martinique, Fort-de-France, France
| | - Abir Wahab
- Department of Neurology, APHP, Hôpital Henri Mondor, Créteil, France
| | - Laurent Magy
- Department of Neurology, CHU de Limoges, Hôpital Dupuytren, Limoges, France
| | | | - Ines Doghri
- Department of Neurology, CHU de Tours, Hôpital Bretonneau, Tours, France
| | - Solène Moulin
- Department of Neurology, CHU de Reims, CRC-SEP, Reims, France
| | - Haifa Ben-Nasr
- Hôpital Sud Francilien, Department of Neurology, Corbeil-Essonnes, France
| | - Céline Labeyrie
- Department of Neurology, CHU Bicêtre, Le Kremlin-Bicêtre, France
| | - Karolina Hankiewicz
- Department of Neurology, Hôpital Pierre Delafontaine, Centre Hospitalier de Saint-Denis, Saint-Denis, France
| | - Jean-Philippe Neau
- Department of Neurology, CHU La Milétrie, Hôpital Jean Bernard, Poitiers, France
| | - Corinne Pottier
- Department of Neurology, CH de Pontoise, Hôpital René Dubos, Pontoise, France
| | - Chantal Nifle
- Departement of Neurology, Centre Hospitalier de Versailles, Le Chesnay, France
| | - Nicolas Collongues
- Center for Clinical Investigation, INSERM U1434, Strasbourg, France
- Biopathology of Myelin, Neuroprotection and Therapeutic Strategy, INSERM U1119, Strasbourg, France
- Department of Neurology, University Hospital of Strasbourg, Strasbourg, France
- Department of Pharmacology, Addictology, Toxicology and Therapeutics, Strasbourg University, Strasbourg, France
| | - Anne Kerbrat
- Department of Neurology, University Hospital of Rennes, Rennes, France
- CIC-P 1414 INSERM, University Hospital of Rennes, Rennes, France
- Empenn U1228, University of Rennes, Inria, CNRS, INSERM, IRISA UMR 6074, Rennes, France
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Benallegue N, Rollot F, Wiertlewski S, Casey R, Debouverie M, Kerbrat A, De Seze J, Ciron J, Ruet A, Labauge P, Maillart E, Zephir H, Papeix C, Defer G, Lebrun-Frenay C, Moreau T, Berger E, Stankoff B, Clavelou P, Heinzlef O, Pelletier J, Thouvenot E, Al Khedr A, Bourre B, Casez O, Cabre P, Wahab A, Magy L, Vukusic S, Laplaud DA. Highly Effective Therapies as First-Line Treatment for Pediatric-Onset Multiple Sclerosis. JAMA Neurol 2024; 81:273-282. [PMID: 38345791 PMCID: PMC10862269 DOI: 10.1001/jamaneurol.2023.5566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 12/07/2023] [Indexed: 02/15/2024]
Abstract
Importance Moderately effective therapies (METs) have been the main treatment in pediatric-onset multiple sclerosis (POMS) for years. Despite the expanding use of highly effective therapies (HETs), treatment strategies for POMS still lack consensus. Objective To assess the real-world association of HET as an index treatment compared with MET with disease activity. Design, Setting, and Participants This was a retrospective cohort study conducted from January 1, 2010, to December 8, 2022, until the last recorded visit. The median follow-up was 5.8 years. A total of 36 French MS centers participated in the Observatoire Français de la Sclérose en Plaques (OFSEP) cohort. Of the total participants in OFSEP, only treatment-naive children with relapsing-remitting POMS who received a first HET or MET before adulthood and at least 1 follow-up clinical visit were included in the study. All eligible participants were included in the study, and none declined to participate. Exposure HET or MET at treatment initiation. Main Outcomes and Measures The primary outcome was the time to first relapse after treatment. Secondary outcomes were annualized relapse rate (ARR), magnetic resonance imaging (MRI) activity, time to Expanded Disability Status Scale (EDSS) progression, tertiary education attainment, and treatment safety/tolerability. An adapted statistical method was used to model the logarithm of event rate by penalized splines of time, allowing adjustment for effects of covariates that is sensitive to nonlinearity and interactions. Results Of the 3841 children (5.2% of 74 367 total participants in OFSEP), 530 patients (mean [SD] age, 16.0 [1.8] years; 364 female [68.7%]) were included in the study. In study patients, both treatment strategies were associated with a reduced risk of first relapse within the first 2 years. HET dampened disease activity with a 54% reduction in first relapse risk (adjusted hazard ratio [HR], 0.46; 95% CI, 0.31-0.67; P < .001) sustained over 5 years, confirmed on MRI activity (adjusted odds ratio [OR], 0.34; 95% CI, 0.18-0.66; P = .001), and with a better tolerability pattern than MET. The risk of discontinuation at 2 years was 6 times higher with MET (HR, 5.97; 95% CI, 2.92-12.20). The primary reasons for treatment discontinuation were lack of efficacy and intolerance. Index treatment was not associated with EDSS progression or tertiary education attainment (adjusted OR, 0.51; 95% CI, 0.24-1.10; P = .09). Conclusions and Relevance Results of this cohort study suggest that compared with MET, initial HET in POMS was associated with a reduction in the risk of first relapse with an optimal outcome within the first 2 years and was associated with a lower rate of treatment switching and a better midterm tolerance in children. These findings suggest prioritizing initial HET in POMS, although long-term safety studies are needed.
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Affiliation(s)
- Nail Benallegue
- Department of Paediatric Neurology, Universitaire Angers, CHU Angers, Angers, France
- Nantes Université, CHU Nantes, Inserm, CIC 14131413, Center for Research in Transplantation and Translational Immunology, UMR 1064, Nantes, France
| | - Fabien Rollot
- Université de Lyon, Université Claude Bernard, Lyon 1, Lyon, France
- Department of Neurology, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Sclérose en Plaques, Pathologies de la Myéline et Neuro-Infammation, Bron, France
- Centre de Recherche en Neurosciences de Lyon, Observatoire Français de La Sclérose en Plaques, Inserm 1028 et CNRS UMR 5292, Lyon, France
- EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis, State-Approved Foundation, Bron, France
| | - Sandrine Wiertlewski
- Nantes Université, CHU Nantes, Inserm, CIC 14131413, Center for Research in Transplantation and Translational Immunology, UMR 1064, Nantes, France
- Department of Neurology, CHU Nantes, Nantes, France
| | - Romain Casey
- Université de Lyon, Université Claude Bernard, Lyon 1, Lyon, France
- Department of Neurology, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Sclérose en Plaques, Pathologies de la Myéline et Neuro-Infammation, Bron, France
- Centre de Recherche en Neurosciences de Lyon, Observatoire Français de La Sclérose en Plaques, Inserm 1028 et CNRS UMR 5292, Lyon, France
- EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis, State-Approved Foundation, Bron, France
| | - Marc Debouverie
- Department of Neurology, Centre Hospitalier Régional Et Universitaire de Nancy, Université de Lorraine, 4360 APEMAC Vandoeuvre-Lès-Nancy, EA, France
| | - Anne Kerbrat
- Rennes University, CHU Rennes, CRC-SEP Neurology Department, and EMPENN U 1228, Inserm, INRIA, CNRS, Rennes, France
| | - Jérôme De Seze
- Department of Neurology Et Centre d’Investigation Clinique, CHU de Strasbourg, INSERM 1434, Strasbourg, France
| | - Jonathan Ciron
- Department of Neurology, CRC-SEP, CHU de Toulouse, Hôpital Pierre-Paul Riquet, Toulouse, France
- Institut Toulousain Des Maladies Infectieuses Et Inflammatoires (Infinity), Inserm UMR 1291, CNRS UMR 5051, Université Toulouse III, Toulouse, France
| | - Aurelie Ruet
- Department of Neurology, CHU de Bordeaux, Bordeaux, France
- Université de Bordeaux, Inserm, Neurocentre Magendie, U1215 Bordeaux, France
| | - Pierre Labauge
- CRC SEP, Department of Neurology, Montpellier Universitary Hospital, Montpellier, France
| | | | - Helene Zephir
- Pôle Des Neurosciences Et de L’appareil Locomoteur, CRC-SEP, Hôpital Roger Salengro, Université de Lille, Inserm U1172, Lille, France
| | - Caroline Papeix
- Département of Neurology, Hôpital Fondation A.de Rothschild, Paris, France
| | - Gilles Defer
- Department of Neurology, Centre Expert SEP, CHU de Caen, Université Normandie, Caen, France
| | - Christine Lebrun-Frenay
- CRC-SEP Neurologie Pasteur 2, CHU de Nice, Université Cote d’Azur, UMR2CA (URRIS), Nice, France
| | | | - Eric Berger
- Department of Neurology, CHU de Besançon, Besançon, France
| | - Bruno Stankoff
- Department of Neurology, CHU Saint-Antoine, Paris, France
| | - Pierre Clavelou
- Department of Neurology, CHU de Clermont-Ferrand, Clermont-Ferrand, France
| | - Olivier Heinzlef
- Département de Neurologie, Centre Hospitalier de Poissy, St Germain, France
| | - Jean Pelletier
- Aix Marseille Univ, APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie – MICeME, CRMBM CEMEREM UMR7339, Marseille, France
| | - Eric Thouvenot
- Department of Neurology, CHU de Nîmes, Nîmes, France
- IGF, University Montpellier, CNRS, Inserm, Montpellier, France
| | | | | | - Olivier Casez
- Department of Neurology, CHU de Grenoble, Grenoble, France
| | - Philippe Cabre
- Department of Neurology, CHU de Fort de France, Fort de France, France
| | - Abir Wahab
- Department of Neurology, Assistance Publique des Hôpitaux de Paris, Hôpital Henri Mondor, Université Paris Est, Créteil, France
| | - Laurent Magy
- Department of Neurology, CHU de Limoges, Limoges, France
| | - Sandra Vukusic
- Université de Lyon, Université Claude Bernard, Lyon 1, Lyon, France
- Department of Neurology, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Sclérose en Plaques, Pathologies de la Myéline et Neuro-Infammation, Bron, France
- Centre de Recherche en Neurosciences de Lyon, Observatoire Français de La Sclérose en Plaques, Inserm 1028 et CNRS UMR 5292, Lyon, France
- EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis, State-Approved Foundation, Bron, France
| | - David-Axel Laplaud
- Nantes Université, CHU Nantes, Inserm, CIC 14131413, Center for Research in Transplantation and Translational Immunology, UMR 1064, Nantes, France
- Department of Neurology, CHU Nantes, Nantes, France
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Collongues N, Durand-Dubief F, Lebrun-Frenay C, Audoin B, Ayrignac X, Bensa C, Bigaut K, Bourre B, Carra-Dallière C, Ciron J, Defer G, Kwiatkowski A, Leray E, Maillart E, Marignier R, Mathey G, Morel N, Thouvenot E, Zéphir H, Boucher J, Boutière C, Branger P, Da Silva A, Demortière S, Guillaume M, Hebant B, Januel E, Kerbrat A, Manchon E, Moisset X, Montcuquet A, Pierret C, Pique J, Poupart J, Prunis C, Roux T, Schmitt P, Androdias G, Cohen M. Cancer and multiple sclerosis: 2023 recommendations from the French Multiple Sclerosis Society. Mult Scler 2024:13524585231223880. [PMID: 38357870 DOI: 10.1177/13524585231223880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2024]
Abstract
BACKGROUND Epidemiological data reveal that 45% of persons with multiple sclerosis (PwMS) in France are more than 50 years. This population more than 50 is more susceptible to cancer, and this risk may be increased by frequent use of immunosuppressive drugs. Consequently, concerns have arisen about the potential increased risk of cancer in PwMS and how patients should be screened and managed in terms of cancer risk. OBJECTIVE To develop evidence-based recommendations to manage the coexistence of cancer and multiple sclerosis (MS). METHODS The French Group for Recommendations in MS collected articles from PubMed and university databases covering the period January 1975 through June 2022. The RAND/UCLA method was employed to achieve formal consensus. MS experts comprehensively reviewed the full-text articles and developed the initial recommendations. A group of multidisciplinary health care specialists then validated the final proposal. RESULTS Five key questions were addressed, encompassing various topics such as cancer screening before or after initiating a disease-modifying therapy (DMT), appropriate management of MS in the context of cancer, recommended follow-up for cancer in patients receiving a DMT, and the potential reintroduction of a DMT after initial cancer treatment. A strong consensus was reached for all 31 recommendations. CONCLUSION These recommendations propose a strategic approach to managing cancer risk in PwMS.
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Affiliation(s)
- Nicolas Collongues
- Department of Neurology, University Hospital of Strasbourg, Strasbourg, France
- Center for Clinical Investigation, INSERM U1434, Strasbourg, France
- Biopathology of Myelin, Neuroprotection and Therapeutic Strategy, INSERM U1119, Strasbourg, France
- Department of Pharmacology, Addictology, Toxicology, and Therapeutics, Strasbourg University, Strasbourg, France
| | - Françoise Durand-Dubief
- Service de Sclérose en Plaques, Pathologies de la Myéline et Neuro-Inflammation, Hôpital Neurologique Pierre Wertheimer, Bron, France
| | - Christine Lebrun-Frenay
- Department of Neurology, CHU Nice, Nice, France
- Université Côte d'Azur, UMR2CA-URRIS, Nice, France
| | - Bertrand Audoin
- Department of Neurology, CRMBM, APHM, Aix-Marseille University, Marseille, France
| | - Xavier Ayrignac
- Department of Neurology, Montpellier University Hospital, Montpellier, France
- University of Montpellier, Montpellier, France
- INM, INSERM, Montpellier, France
| | - Caroline Bensa
- Department of Neurology, Hôpital Fondation Adolphe de Rothschild, Paris, France
| | - Kévin Bigaut
- Department of Neurology, University Hospital of Strasbourg, Strasbourg, France
- Biopathology of Myelin, Neuroprotection and Therapeutic Strategy, INSERM U1119, Strasbourg, France
| | | | | | - Jonathan Ciron
- CHU de Toulouse, CRC-SEP, Department of Neurology, Toulouse, France
- Université Toulouse III, Infinity, INSERM UMR1291-CNRS UMR5051, Toulouse, France
| | - Gilles Defer
- Department of Neurology, Caen University Hospital, Caen, France
| | - Arnaud Kwiatkowski
- Department of Neurology, Lille Catholic University, Lille Catholic Hospitals, Lille, France
| | - Emmanuelle Leray
- Université de Rennes, EHESP, CNRS, INSERM, ARENES-UMR 6051, RSMS-U1309, Rennes, France
| | | | - Romain Marignier
- Service de Sclérose en Plaques, Pathologies de la Myéline et Neuro-Inflammation, Hôpital Neurologique Pierre Wertheimer, Bron, France
| | - Guillaume Mathey
- Department of Neurology, Nancy University Hospital, Nancy, France
| | - Nathalie Morel
- Service de Neurologie, Centre Hospitalier Annecy Genevois, Epagny-Metz-Tessy, France
| | - Eric Thouvenot
- Service de Neurologie, CHU de Nîmes, Nîmes, France
- Institut de Génomique Fonctionnelle, Université de Montpellier, CNRS, INSERM, Montpellier, France
| | - Hélène Zéphir
- University of Lille, INSERM U1172, CHU de Lille, Lille, France
| | - Julie Boucher
- Department of Neurology, CHU de Lille, Lille, France
| | - Clémence Boutière
- Department of Neurology, University Hospital of Marseille, Marseille, France
| | - Pierre Branger
- Service de Neurologie, CHU de Caen Normandie, Caen, France
| | - Angélique Da Silva
- Breast Cancer Unit, Centre François Baclesse, Institut Normand du Sein, Caen, France
| | - Sarah Demortière
- Department of Neurology, CRMBM, APHM, Aix-Marseille University, Marseille, France
| | | | | | - Edouard Januel
- Sorbonne Université, Paris, France/Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpital Pitié Salpêtrière, Département de Santé Publique, Paris, France
- Département de Neurologie, Hôpital Pitié Salpêtrière, AP-HP, Paris, France
| | - Anne Kerbrat
- Service de Neurologie, CHU de Rennes, France
- EMPENN U1228, INSERM-INRIA, Rennes, France
| | - Eric Manchon
- Service de Neurologie, Centre Hospitalier de Gonesse, Gonesse, France
| | - Xavier Moisset
- Université Clermont Auvergne, CHU Clermont-Ferrand, INSERM, Neuro-Dol, Clermont-Ferrand, France
| | | | - Chloé Pierret
- Université de Rennes, EHESP, CNRS, INSERM, ARENES-UMR 6051, RSMS U-1309, Rennes, France
| | - Julie Pique
- Service de Sclérose en Plaques, Pathologies de la Myéline et Neuro-Inflammation, Hôpital Neurologique Pierre Wertheimer, Bron, France
| | - Julien Poupart
- Department of Neurology and U995-LIRIC-Lille Inflammation Research International Center, INSERM, University of Lille, CHU Lille, Lille, France
| | - Chloé Prunis
- Department of Neurology, Nancy University Hospital, Nancy, France
| | - Thomas Roux
- Hôpital La Pitié-Salpêtrière, Service de Neurologie, Paris, France
- CRC-SEP Paris. Centre des maladies inflammatoires rares du cerveau et de la moelle de l'enfant et de l'adulte (Mircem)
| | | | - Géraldine Androdias
- Service de Sclérose en Plaques, Pathologies de la Myéline et Neuro-Inflammation, Service de Neurologie, Hôpital Neurologique Pierre Wertheimer, Bron, France
- Clinique de la Sauvegarde-Ramsay Santé, Lyon, France
| | - Mikael Cohen
- Department of Neurology, CHU Nice, Nice, France/Université Côte d'Azur, UMR2CA-URRIS, Nice, France
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Clavelou P, Castelnovo G, Pourcher V, De Sèze J, Vermersch P, Ben-Amor AF, Savarin C, Defer G. Correction: Expert Narrative Review of the Safety of Cladribine Tablets for the Management of Relapsing Multiple Sclerosis. Neurol Ther 2024; 13:255-256. [PMID: 37982989 PMCID: PMC10787701 DOI: 10.1007/s40120-023-00564-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2023] Open
Affiliation(s)
- Pierre Clavelou
- Department of Neurology, Clermont-Ferrand University Hospital, 58 Rue Montalembert, 63003, Clermont-Ferrand Cedex 1, France.
| | - Giovanni Castelnovo
- Department of Neurology, Nîmes University Hospital, Hopital Caremeau, Nîmes, France
| | - Valérie Pourcher
- Department of Infectious and Tropical Diseases, Pitié-Salpêtrière Hospital, APHP, Sorbonne Université, INSERM 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique Paris, Paris, France
| | - Jerome De Sèze
- Department of Neurology, Strasbourg University Hospital, Strasbourg, France
| | - Patrick Vermersch
- Univ. Lille, Inserm U1172 LilNCog, CHU Lille, FHU Precise, Lille, France
| | - Ali-Frederic Ben-Amor
- Global Medical Affairs Neurology and Immunology, Ares Trading SA (An affiliate of Merck KGaA, Darmstadt, Germany), Eysins, Switzerland
| | - Carine Savarin
- Neurology Department, Medical Affairs (An affiliate of Merck KGaA, Darmstadt, Germany), Merck Santé, Lyon, France
| | - Gilles Defer
- Department of Neurology, Caen University Hospital, Caen, France
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Rollot F, Uhry Z, Dantony E, Vukusic S, Debouverie M, Le Page E, Ciron J, Ruet A, De Sèze J, Zéphir H, Labauge P, Defer G, Lebrun-Frenay C, Moreau T, Laplaud DA, Berger E, Clavelou P, Pelletier J, Thouvenot E, Heinzlef O, Camdessanche JP, Fauvernier M, Remontet L, Leray E. Comparison of 2 Methods for Estimating Multiple Sclerosis-Related Mortality. Neurology 2023; 101:e2483-e2496. [PMID: 37827849 PMCID: PMC10791051 DOI: 10.1212/wnl.0000000000207925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 09/11/2023] [Indexed: 10/14/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Determining whether multiple sclerosis (MS) causes death is challenging. Our objective was to contrast 2 frameworks to estimate probabilities of death attributed to MS (PMS) and other causes (Pother): the cause-specific framework (CSF), which requires the causes of death, and the excess mortality framework (EMF), which does not. METHODS We used data from the Observatoire Français de la Sclérose en Plaques (OFSEP, n = 37,524) and from a comparative subset where causes of death were available (4,004 women with relapsing-onset MS [R-MS]). In CSF, the probabilities were estimated using the Aalen-Johansen method. In EMF, they were estimated from the excess mortality hazard, which is the additional mortality among patients with MS as compared with the expected mortality in the matched general population. PMS values were estimated at 30 years of follow-up, (1) with both frameworks in the comparative subset, by age group at onset, and (2) with EMF only in the OFSEP population, by initial phenotype, sex, and age at onset. RESULTS In the comparative subset, the estimated 30-year PMS values were greater using EMF than CSF: 10.9% (95% CI 8.3-13.6) vs 8.7% (6.4-11.8) among the youngest and 20.4% (11.3-29.5) vs 16.2% (8.7-30.2) for the oldest groups, respectively. In the CSF, probabilities of death from unknown causes ranged from 1.5% (0.7-3.0) to 6.4% (2.5-16.4), and even after their reallocation, PMS values remained lower with CSF than with EMF. The estimated probabilities of being alive were close using the 2 frameworks, and the estimated POther (EMF vs CSF) was 2.6% (2.5-2.6) vs 2.1% (1.2-3.9) and 18.1% (16.9-19.3) vs 26.4% (16.5-42.2), respectively, for the youngest and oldest groups. In the OFSEP population, the estimated 30-year PMS values ranged from 7.5% (6.4-8.7) to 24.0% (19.1-28.9) in patients with R-MS and from 25.4% (21.1-29.7) to 36.8% (28.3-45.3) in primary progressive patients, depending on sex and age. DISCUSSION EMF has the great advantage of not requiring death certificates, their quality being less than optimal. Conceptually, it also seems more relevant because it avoids having to state, for each individual, whether death was directly or indirectly caused by MS or whether it would have occurred anyway, which is especially difficult in such chronic diseases.
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Affiliation(s)
- Fabien Rollot
- From the Université de Lyon (F.R., S.V.), Université Claude Bernard Lyon 1; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuroinflammation (F.R., S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron; Observatoire Français de la Sclérose en Plaques (F.R., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR 5292; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., S.V.), State-Approved Foundation, Bron; Direction des Maladies non Transmissible et des Traumatismes (Z.U.), Santé Publique France, Saint-Maurice; Service de Biostatistique-Bioinformatique (Z.U., E.D., M.F., L.R.), Pôle Santé Publique, Hospices Civils de Lyon; Laboratoire de Biométrie et Biologie Evolutive UMR 5558 (E.D., M.F., L.R.), Université Lyon 1 and CNRS, Villeurbanne; Service de Neurologie (M.D.), Centre Hospitalier Régional et Universitaire de Nancy, Université de Lorraine, EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Neurology Department (E.L.P.), CRCSEP Rennes, Clinical Investigation Centre CIC-P 1414, Rennes University Hospital; Service de Neurologie (J.C.), CHU de Toulouse, Hôpital Pierre-Paul Riquet, CRC-SEP; Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity) (J.C.), INSERM UMR 1291, CNRS UMR 5051, Université Toulouse III; Service de Neurologie (A.R.), CRC SEP, CHU de Bordeaux; U1215 INSERM (A.R.), Neurocentre Magendie, Université de Bordeaux; Service de Neurologie et Centre d'Investigation Clinique (J.D.S.), CHU de Strasbourg, INSERM 1434; Pôle des Neurosciences et de l'Appareil Locomoteur (H.Z.), CRC-SEP, Hôpital Roger Salengro, Université de Lille, Inserm U1172; CRC SEP (P.L.), Service de Neurologie, CHU de Montpellier; Service de Neurologie (G.D.), CRC-SEP Normandie, CHU de Caen, Université Normandie; Service de Neurologie (C.L.-F.), Neurologie Pasteur 2, CHU de Nice, Université Nice Cote d'Azur UR2CA-URRIS; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (D.A.L.), CHU Nantes; INSERM (D.A.L.), CIC 0004, CRTI-INSERM UMR U1064, Nantes; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (P.C.), CHU de Clermont-Ferrand, INSERM 1107 NeuroDol, Clermont-Ferrand; Aix Marseille University (J.P.), APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, CEMEREM; Service de Neurologie (E.T.), CHU de Nîmes; Institut de Génomique Fonctionnelle (E.T.), Université de Montpellier, CNRS, INSERM; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; and Univ Rennes (E.L.), EHESP, CNRS, Inserm, ARENES UMR 6051, RSMS U 1309, France
| | - Zoé Uhry
- From the Université de Lyon (F.R., S.V.), Université Claude Bernard Lyon 1; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuroinflammation (F.R., S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron; Observatoire Français de la Sclérose en Plaques (F.R., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR 5292; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., S.V.), State-Approved Foundation, Bron; Direction des Maladies non Transmissible et des Traumatismes (Z.U.), Santé Publique France, Saint-Maurice; Service de Biostatistique-Bioinformatique (Z.U., E.D., M.F., L.R.), Pôle Santé Publique, Hospices Civils de Lyon; Laboratoire de Biométrie et Biologie Evolutive UMR 5558 (E.D., M.F., L.R.), Université Lyon 1 and CNRS, Villeurbanne; Service de Neurologie (M.D.), Centre Hospitalier Régional et Universitaire de Nancy, Université de Lorraine, EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Neurology Department (E.L.P.), CRCSEP Rennes, Clinical Investigation Centre CIC-P 1414, Rennes University Hospital; Service de Neurologie (J.C.), CHU de Toulouse, Hôpital Pierre-Paul Riquet, CRC-SEP; Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity) (J.C.), INSERM UMR 1291, CNRS UMR 5051, Université Toulouse III; Service de Neurologie (A.R.), CRC SEP, CHU de Bordeaux; U1215 INSERM (A.R.), Neurocentre Magendie, Université de Bordeaux; Service de Neurologie et Centre d'Investigation Clinique (J.D.S.), CHU de Strasbourg, INSERM 1434; Pôle des Neurosciences et de l'Appareil Locomoteur (H.Z.), CRC-SEP, Hôpital Roger Salengro, Université de Lille, Inserm U1172; CRC SEP (P.L.), Service de Neurologie, CHU de Montpellier; Service de Neurologie (G.D.), CRC-SEP Normandie, CHU de Caen, Université Normandie; Service de Neurologie (C.L.-F.), Neurologie Pasteur 2, CHU de Nice, Université Nice Cote d'Azur UR2CA-URRIS; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (D.A.L.), CHU Nantes; INSERM (D.A.L.), CIC 0004, CRTI-INSERM UMR U1064, Nantes; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (P.C.), CHU de Clermont-Ferrand, INSERM 1107 NeuroDol, Clermont-Ferrand; Aix Marseille University (J.P.), APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, CEMEREM; Service de Neurologie (E.T.), CHU de Nîmes; Institut de Génomique Fonctionnelle (E.T.), Université de Montpellier, CNRS, INSERM; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; and Univ Rennes (E.L.), EHESP, CNRS, Inserm, ARENES UMR 6051, RSMS U 1309, France
| | - Emmanuelle Dantony
- From the Université de Lyon (F.R., S.V.), Université Claude Bernard Lyon 1; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuroinflammation (F.R., S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron; Observatoire Français de la Sclérose en Plaques (F.R., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR 5292; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., S.V.), State-Approved Foundation, Bron; Direction des Maladies non Transmissible et des Traumatismes (Z.U.), Santé Publique France, Saint-Maurice; Service de Biostatistique-Bioinformatique (Z.U., E.D., M.F., L.R.), Pôle Santé Publique, Hospices Civils de Lyon; Laboratoire de Biométrie et Biologie Evolutive UMR 5558 (E.D., M.F., L.R.), Université Lyon 1 and CNRS, Villeurbanne; Service de Neurologie (M.D.), Centre Hospitalier Régional et Universitaire de Nancy, Université de Lorraine, EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Neurology Department (E.L.P.), CRCSEP Rennes, Clinical Investigation Centre CIC-P 1414, Rennes University Hospital; Service de Neurologie (J.C.), CHU de Toulouse, Hôpital Pierre-Paul Riquet, CRC-SEP; Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity) (J.C.), INSERM UMR 1291, CNRS UMR 5051, Université Toulouse III; Service de Neurologie (A.R.), CRC SEP, CHU de Bordeaux; U1215 INSERM (A.R.), Neurocentre Magendie, Université de Bordeaux; Service de Neurologie et Centre d'Investigation Clinique (J.D.S.), CHU de Strasbourg, INSERM 1434; Pôle des Neurosciences et de l'Appareil Locomoteur (H.Z.), CRC-SEP, Hôpital Roger Salengro, Université de Lille, Inserm U1172; CRC SEP (P.L.), Service de Neurologie, CHU de Montpellier; Service de Neurologie (G.D.), CRC-SEP Normandie, CHU de Caen, Université Normandie; Service de Neurologie (C.L.-F.), Neurologie Pasteur 2, CHU de Nice, Université Nice Cote d'Azur UR2CA-URRIS; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (D.A.L.), CHU Nantes; INSERM (D.A.L.), CIC 0004, CRTI-INSERM UMR U1064, Nantes; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (P.C.), CHU de Clermont-Ferrand, INSERM 1107 NeuroDol, Clermont-Ferrand; Aix Marseille University (J.P.), APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, CEMEREM; Service de Neurologie (E.T.), CHU de Nîmes; Institut de Génomique Fonctionnelle (E.T.), Université de Montpellier, CNRS, INSERM; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; and Univ Rennes (E.L.), EHESP, CNRS, Inserm, ARENES UMR 6051, RSMS U 1309, France
| | - Sandra Vukusic
- From the Université de Lyon (F.R., S.V.), Université Claude Bernard Lyon 1; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuroinflammation (F.R., S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron; Observatoire Français de la Sclérose en Plaques (F.R., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR 5292; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., S.V.), State-Approved Foundation, Bron; Direction des Maladies non Transmissible et des Traumatismes (Z.U.), Santé Publique France, Saint-Maurice; Service de Biostatistique-Bioinformatique (Z.U., E.D., M.F., L.R.), Pôle Santé Publique, Hospices Civils de Lyon; Laboratoire de Biométrie et Biologie Evolutive UMR 5558 (E.D., M.F., L.R.), Université Lyon 1 and CNRS, Villeurbanne; Service de Neurologie (M.D.), Centre Hospitalier Régional et Universitaire de Nancy, Université de Lorraine, EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Neurology Department (E.L.P.), CRCSEP Rennes, Clinical Investigation Centre CIC-P 1414, Rennes University Hospital; Service de Neurologie (J.C.), CHU de Toulouse, Hôpital Pierre-Paul Riquet, CRC-SEP; Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity) (J.C.), INSERM UMR 1291, CNRS UMR 5051, Université Toulouse III; Service de Neurologie (A.R.), CRC SEP, CHU de Bordeaux; U1215 INSERM (A.R.), Neurocentre Magendie, Université de Bordeaux; Service de Neurologie et Centre d'Investigation Clinique (J.D.S.), CHU de Strasbourg, INSERM 1434; Pôle des Neurosciences et de l'Appareil Locomoteur (H.Z.), CRC-SEP, Hôpital Roger Salengro, Université de Lille, Inserm U1172; CRC SEP (P.L.), Service de Neurologie, CHU de Montpellier; Service de Neurologie (G.D.), CRC-SEP Normandie, CHU de Caen, Université Normandie; Service de Neurologie (C.L.-F.), Neurologie Pasteur 2, CHU de Nice, Université Nice Cote d'Azur UR2CA-URRIS; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (D.A.L.), CHU Nantes; INSERM (D.A.L.), CIC 0004, CRTI-INSERM UMR U1064, Nantes; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (P.C.), CHU de Clermont-Ferrand, INSERM 1107 NeuroDol, Clermont-Ferrand; Aix Marseille University (J.P.), APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, CEMEREM; Service de Neurologie (E.T.), CHU de Nîmes; Institut de Génomique Fonctionnelle (E.T.), Université de Montpellier, CNRS, INSERM; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; and Univ Rennes (E.L.), EHESP, CNRS, Inserm, ARENES UMR 6051, RSMS U 1309, France
| | - Marc Debouverie
- From the Université de Lyon (F.R., S.V.), Université Claude Bernard Lyon 1; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuroinflammation (F.R., S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron; Observatoire Français de la Sclérose en Plaques (F.R., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR 5292; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., S.V.), State-Approved Foundation, Bron; Direction des Maladies non Transmissible et des Traumatismes (Z.U.), Santé Publique France, Saint-Maurice; Service de Biostatistique-Bioinformatique (Z.U., E.D., M.F., L.R.), Pôle Santé Publique, Hospices Civils de Lyon; Laboratoire de Biométrie et Biologie Evolutive UMR 5558 (E.D., M.F., L.R.), Université Lyon 1 and CNRS, Villeurbanne; Service de Neurologie (M.D.), Centre Hospitalier Régional et Universitaire de Nancy, Université de Lorraine, EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Neurology Department (E.L.P.), CRCSEP Rennes, Clinical Investigation Centre CIC-P 1414, Rennes University Hospital; Service de Neurologie (J.C.), CHU de Toulouse, Hôpital Pierre-Paul Riquet, CRC-SEP; Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity) (J.C.), INSERM UMR 1291, CNRS UMR 5051, Université Toulouse III; Service de Neurologie (A.R.), CRC SEP, CHU de Bordeaux; U1215 INSERM (A.R.), Neurocentre Magendie, Université de Bordeaux; Service de Neurologie et Centre d'Investigation Clinique (J.D.S.), CHU de Strasbourg, INSERM 1434; Pôle des Neurosciences et de l'Appareil Locomoteur (H.Z.), CRC-SEP, Hôpital Roger Salengro, Université de Lille, Inserm U1172; CRC SEP (P.L.), Service de Neurologie, CHU de Montpellier; Service de Neurologie (G.D.), CRC-SEP Normandie, CHU de Caen, Université Normandie; Service de Neurologie (C.L.-F.), Neurologie Pasteur 2, CHU de Nice, Université Nice Cote d'Azur UR2CA-URRIS; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (D.A.L.), CHU Nantes; INSERM (D.A.L.), CIC 0004, CRTI-INSERM UMR U1064, Nantes; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (P.C.), CHU de Clermont-Ferrand, INSERM 1107 NeuroDol, Clermont-Ferrand; Aix Marseille University (J.P.), APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, CEMEREM; Service de Neurologie (E.T.), CHU de Nîmes; Institut de Génomique Fonctionnelle (E.T.), Université de Montpellier, CNRS, INSERM; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; and Univ Rennes (E.L.), EHESP, CNRS, Inserm, ARENES UMR 6051, RSMS U 1309, France
| | - Emmanuelle Le Page
- From the Université de Lyon (F.R., S.V.), Université Claude Bernard Lyon 1; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuroinflammation (F.R., S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron; Observatoire Français de la Sclérose en Plaques (F.R., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR 5292; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., S.V.), State-Approved Foundation, Bron; Direction des Maladies non Transmissible et des Traumatismes (Z.U.), Santé Publique France, Saint-Maurice; Service de Biostatistique-Bioinformatique (Z.U., E.D., M.F., L.R.), Pôle Santé Publique, Hospices Civils de Lyon; Laboratoire de Biométrie et Biologie Evolutive UMR 5558 (E.D., M.F., L.R.), Université Lyon 1 and CNRS, Villeurbanne; Service de Neurologie (M.D.), Centre Hospitalier Régional et Universitaire de Nancy, Université de Lorraine, EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Neurology Department (E.L.P.), CRCSEP Rennes, Clinical Investigation Centre CIC-P 1414, Rennes University Hospital; Service de Neurologie (J.C.), CHU de Toulouse, Hôpital Pierre-Paul Riquet, CRC-SEP; Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity) (J.C.), INSERM UMR 1291, CNRS UMR 5051, Université Toulouse III; Service de Neurologie (A.R.), CRC SEP, CHU de Bordeaux; U1215 INSERM (A.R.), Neurocentre Magendie, Université de Bordeaux; Service de Neurologie et Centre d'Investigation Clinique (J.D.S.), CHU de Strasbourg, INSERM 1434; Pôle des Neurosciences et de l'Appareil Locomoteur (H.Z.), CRC-SEP, Hôpital Roger Salengro, Université de Lille, Inserm U1172; CRC SEP (P.L.), Service de Neurologie, CHU de Montpellier; Service de Neurologie (G.D.), CRC-SEP Normandie, CHU de Caen, Université Normandie; Service de Neurologie (C.L.-F.), Neurologie Pasteur 2, CHU de Nice, Université Nice Cote d'Azur UR2CA-URRIS; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (D.A.L.), CHU Nantes; INSERM (D.A.L.), CIC 0004, CRTI-INSERM UMR U1064, Nantes; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (P.C.), CHU de Clermont-Ferrand, INSERM 1107 NeuroDol, Clermont-Ferrand; Aix Marseille University (J.P.), APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, CEMEREM; Service de Neurologie (E.T.), CHU de Nîmes; Institut de Génomique Fonctionnelle (E.T.), Université de Montpellier, CNRS, INSERM; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; and Univ Rennes (E.L.), EHESP, CNRS, Inserm, ARENES UMR 6051, RSMS U 1309, France
| | - Jonathan Ciron
- From the Université de Lyon (F.R., S.V.), Université Claude Bernard Lyon 1; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuroinflammation (F.R., S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron; Observatoire Français de la Sclérose en Plaques (F.R., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR 5292; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., S.V.), State-Approved Foundation, Bron; Direction des Maladies non Transmissible et des Traumatismes (Z.U.), Santé Publique France, Saint-Maurice; Service de Biostatistique-Bioinformatique (Z.U., E.D., M.F., L.R.), Pôle Santé Publique, Hospices Civils de Lyon; Laboratoire de Biométrie et Biologie Evolutive UMR 5558 (E.D., M.F., L.R.), Université Lyon 1 and CNRS, Villeurbanne; Service de Neurologie (M.D.), Centre Hospitalier Régional et Universitaire de Nancy, Université de Lorraine, EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Neurology Department (E.L.P.), CRCSEP Rennes, Clinical Investigation Centre CIC-P 1414, Rennes University Hospital; Service de Neurologie (J.C.), CHU de Toulouse, Hôpital Pierre-Paul Riquet, CRC-SEP; Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity) (J.C.), INSERM UMR 1291, CNRS UMR 5051, Université Toulouse III; Service de Neurologie (A.R.), CRC SEP, CHU de Bordeaux; U1215 INSERM (A.R.), Neurocentre Magendie, Université de Bordeaux; Service de Neurologie et Centre d'Investigation Clinique (J.D.S.), CHU de Strasbourg, INSERM 1434; Pôle des Neurosciences et de l'Appareil Locomoteur (H.Z.), CRC-SEP, Hôpital Roger Salengro, Université de Lille, Inserm U1172; CRC SEP (P.L.), Service de Neurologie, CHU de Montpellier; Service de Neurologie (G.D.), CRC-SEP Normandie, CHU de Caen, Université Normandie; Service de Neurologie (C.L.-F.), Neurologie Pasteur 2, CHU de Nice, Université Nice Cote d'Azur UR2CA-URRIS; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (D.A.L.), CHU Nantes; INSERM (D.A.L.), CIC 0004, CRTI-INSERM UMR U1064, Nantes; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (P.C.), CHU de Clermont-Ferrand, INSERM 1107 NeuroDol, Clermont-Ferrand; Aix Marseille University (J.P.), APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, CEMEREM; Service de Neurologie (E.T.), CHU de Nîmes; Institut de Génomique Fonctionnelle (E.T.), Université de Montpellier, CNRS, INSERM; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; and Univ Rennes (E.L.), EHESP, CNRS, Inserm, ARENES UMR 6051, RSMS U 1309, France
| | - Aurélie Ruet
- From the Université de Lyon (F.R., S.V.), Université Claude Bernard Lyon 1; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuroinflammation (F.R., S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron; Observatoire Français de la Sclérose en Plaques (F.R., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR 5292; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., S.V.), State-Approved Foundation, Bron; Direction des Maladies non Transmissible et des Traumatismes (Z.U.), Santé Publique France, Saint-Maurice; Service de Biostatistique-Bioinformatique (Z.U., E.D., M.F., L.R.), Pôle Santé Publique, Hospices Civils de Lyon; Laboratoire de Biométrie et Biologie Evolutive UMR 5558 (E.D., M.F., L.R.), Université Lyon 1 and CNRS, Villeurbanne; Service de Neurologie (M.D.), Centre Hospitalier Régional et Universitaire de Nancy, Université de Lorraine, EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Neurology Department (E.L.P.), CRCSEP Rennes, Clinical Investigation Centre CIC-P 1414, Rennes University Hospital; Service de Neurologie (J.C.), CHU de Toulouse, Hôpital Pierre-Paul Riquet, CRC-SEP; Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity) (J.C.), INSERM UMR 1291, CNRS UMR 5051, Université Toulouse III; Service de Neurologie (A.R.), CRC SEP, CHU de Bordeaux; U1215 INSERM (A.R.), Neurocentre Magendie, Université de Bordeaux; Service de Neurologie et Centre d'Investigation Clinique (J.D.S.), CHU de Strasbourg, INSERM 1434; Pôle des Neurosciences et de l'Appareil Locomoteur (H.Z.), CRC-SEP, Hôpital Roger Salengro, Université de Lille, Inserm U1172; CRC SEP (P.L.), Service de Neurologie, CHU de Montpellier; Service de Neurologie (G.D.), CRC-SEP Normandie, CHU de Caen, Université Normandie; Service de Neurologie (C.L.-F.), Neurologie Pasteur 2, CHU de Nice, Université Nice Cote d'Azur UR2CA-URRIS; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (D.A.L.), CHU Nantes; INSERM (D.A.L.), CIC 0004, CRTI-INSERM UMR U1064, Nantes; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (P.C.), CHU de Clermont-Ferrand, INSERM 1107 NeuroDol, Clermont-Ferrand; Aix Marseille University (J.P.), APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, CEMEREM; Service de Neurologie (E.T.), CHU de Nîmes; Institut de Génomique Fonctionnelle (E.T.), Université de Montpellier, CNRS, INSERM; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; and Univ Rennes (E.L.), EHESP, CNRS, Inserm, ARENES UMR 6051, RSMS U 1309, France
| | - Jérome De Sèze
- From the Université de Lyon (F.R., S.V.), Université Claude Bernard Lyon 1; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuroinflammation (F.R., S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron; Observatoire Français de la Sclérose en Plaques (F.R., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR 5292; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., S.V.), State-Approved Foundation, Bron; Direction des Maladies non Transmissible et des Traumatismes (Z.U.), Santé Publique France, Saint-Maurice; Service de Biostatistique-Bioinformatique (Z.U., E.D., M.F., L.R.), Pôle Santé Publique, Hospices Civils de Lyon; Laboratoire de Biométrie et Biologie Evolutive UMR 5558 (E.D., M.F., L.R.), Université Lyon 1 and CNRS, Villeurbanne; Service de Neurologie (M.D.), Centre Hospitalier Régional et Universitaire de Nancy, Université de Lorraine, EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Neurology Department (E.L.P.), CRCSEP Rennes, Clinical Investigation Centre CIC-P 1414, Rennes University Hospital; Service de Neurologie (J.C.), CHU de Toulouse, Hôpital Pierre-Paul Riquet, CRC-SEP; Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity) (J.C.), INSERM UMR 1291, CNRS UMR 5051, Université Toulouse III; Service de Neurologie (A.R.), CRC SEP, CHU de Bordeaux; U1215 INSERM (A.R.), Neurocentre Magendie, Université de Bordeaux; Service de Neurologie et Centre d'Investigation Clinique (J.D.S.), CHU de Strasbourg, INSERM 1434; Pôle des Neurosciences et de l'Appareil Locomoteur (H.Z.), CRC-SEP, Hôpital Roger Salengro, Université de Lille, Inserm U1172; CRC SEP (P.L.), Service de Neurologie, CHU de Montpellier; Service de Neurologie (G.D.), CRC-SEP Normandie, CHU de Caen, Université Normandie; Service de Neurologie (C.L.-F.), Neurologie Pasteur 2, CHU de Nice, Université Nice Cote d'Azur UR2CA-URRIS; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (D.A.L.), CHU Nantes; INSERM (D.A.L.), CIC 0004, CRTI-INSERM UMR U1064, Nantes; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (P.C.), CHU de Clermont-Ferrand, INSERM 1107 NeuroDol, Clermont-Ferrand; Aix Marseille University (J.P.), APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, CEMEREM; Service de Neurologie (E.T.), CHU de Nîmes; Institut de Génomique Fonctionnelle (E.T.), Université de Montpellier, CNRS, INSERM; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; and Univ Rennes (E.L.), EHESP, CNRS, Inserm, ARENES UMR 6051, RSMS U 1309, France
| | - Hélène Zéphir
- From the Université de Lyon (F.R., S.V.), Université Claude Bernard Lyon 1; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuroinflammation (F.R., S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron; Observatoire Français de la Sclérose en Plaques (F.R., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR 5292; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., S.V.), State-Approved Foundation, Bron; Direction des Maladies non Transmissible et des Traumatismes (Z.U.), Santé Publique France, Saint-Maurice; Service de Biostatistique-Bioinformatique (Z.U., E.D., M.F., L.R.), Pôle Santé Publique, Hospices Civils de Lyon; Laboratoire de Biométrie et Biologie Evolutive UMR 5558 (E.D., M.F., L.R.), Université Lyon 1 and CNRS, Villeurbanne; Service de Neurologie (M.D.), Centre Hospitalier Régional et Universitaire de Nancy, Université de Lorraine, EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Neurology Department (E.L.P.), CRCSEP Rennes, Clinical Investigation Centre CIC-P 1414, Rennes University Hospital; Service de Neurologie (J.C.), CHU de Toulouse, Hôpital Pierre-Paul Riquet, CRC-SEP; Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity) (J.C.), INSERM UMR 1291, CNRS UMR 5051, Université Toulouse III; Service de Neurologie (A.R.), CRC SEP, CHU de Bordeaux; U1215 INSERM (A.R.), Neurocentre Magendie, Université de Bordeaux; Service de Neurologie et Centre d'Investigation Clinique (J.D.S.), CHU de Strasbourg, INSERM 1434; Pôle des Neurosciences et de l'Appareil Locomoteur (H.Z.), CRC-SEP, Hôpital Roger Salengro, Université de Lille, Inserm U1172; CRC SEP (P.L.), Service de Neurologie, CHU de Montpellier; Service de Neurologie (G.D.), CRC-SEP Normandie, CHU de Caen, Université Normandie; Service de Neurologie (C.L.-F.), Neurologie Pasteur 2, CHU de Nice, Université Nice Cote d'Azur UR2CA-URRIS; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (D.A.L.), CHU Nantes; INSERM (D.A.L.), CIC 0004, CRTI-INSERM UMR U1064, Nantes; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (P.C.), CHU de Clermont-Ferrand, INSERM 1107 NeuroDol, Clermont-Ferrand; Aix Marseille University (J.P.), APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, CEMEREM; Service de Neurologie (E.T.), CHU de Nîmes; Institut de Génomique Fonctionnelle (E.T.), Université de Montpellier, CNRS, INSERM; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; and Univ Rennes (E.L.), EHESP, CNRS, Inserm, ARENES UMR 6051, RSMS U 1309, France
| | - Pierre Labauge
- From the Université de Lyon (F.R., S.V.), Université Claude Bernard Lyon 1; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuroinflammation (F.R., S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron; Observatoire Français de la Sclérose en Plaques (F.R., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR 5292; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., S.V.), State-Approved Foundation, Bron; Direction des Maladies non Transmissible et des Traumatismes (Z.U.), Santé Publique France, Saint-Maurice; Service de Biostatistique-Bioinformatique (Z.U., E.D., M.F., L.R.), Pôle Santé Publique, Hospices Civils de Lyon; Laboratoire de Biométrie et Biologie Evolutive UMR 5558 (E.D., M.F., L.R.), Université Lyon 1 and CNRS, Villeurbanne; Service de Neurologie (M.D.), Centre Hospitalier Régional et Universitaire de Nancy, Université de Lorraine, EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Neurology Department (E.L.P.), CRCSEP Rennes, Clinical Investigation Centre CIC-P 1414, Rennes University Hospital; Service de Neurologie (J.C.), CHU de Toulouse, Hôpital Pierre-Paul Riquet, CRC-SEP; Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity) (J.C.), INSERM UMR 1291, CNRS UMR 5051, Université Toulouse III; Service de Neurologie (A.R.), CRC SEP, CHU de Bordeaux; U1215 INSERM (A.R.), Neurocentre Magendie, Université de Bordeaux; Service de Neurologie et Centre d'Investigation Clinique (J.D.S.), CHU de Strasbourg, INSERM 1434; Pôle des Neurosciences et de l'Appareil Locomoteur (H.Z.), CRC-SEP, Hôpital Roger Salengro, Université de Lille, Inserm U1172; CRC SEP (P.L.), Service de Neurologie, CHU de Montpellier; Service de Neurologie (G.D.), CRC-SEP Normandie, CHU de Caen, Université Normandie; Service de Neurologie (C.L.-F.), Neurologie Pasteur 2, CHU de Nice, Université Nice Cote d'Azur UR2CA-URRIS; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (D.A.L.), CHU Nantes; INSERM (D.A.L.), CIC 0004, CRTI-INSERM UMR U1064, Nantes; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (P.C.), CHU de Clermont-Ferrand, INSERM 1107 NeuroDol, Clermont-Ferrand; Aix Marseille University (J.P.), APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, CEMEREM; Service de Neurologie (E.T.), CHU de Nîmes; Institut de Génomique Fonctionnelle (E.T.), Université de Montpellier, CNRS, INSERM; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; and Univ Rennes (E.L.), EHESP, CNRS, Inserm, ARENES UMR 6051, RSMS U 1309, France
| | - Gilles Defer
- From the Université de Lyon (F.R., S.V.), Université Claude Bernard Lyon 1; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuroinflammation (F.R., S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron; Observatoire Français de la Sclérose en Plaques (F.R., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR 5292; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., S.V.), State-Approved Foundation, Bron; Direction des Maladies non Transmissible et des Traumatismes (Z.U.), Santé Publique France, Saint-Maurice; Service de Biostatistique-Bioinformatique (Z.U., E.D., M.F., L.R.), Pôle Santé Publique, Hospices Civils de Lyon; Laboratoire de Biométrie et Biologie Evolutive UMR 5558 (E.D., M.F., L.R.), Université Lyon 1 and CNRS, Villeurbanne; Service de Neurologie (M.D.), Centre Hospitalier Régional et Universitaire de Nancy, Université de Lorraine, EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Neurology Department (E.L.P.), CRCSEP Rennes, Clinical Investigation Centre CIC-P 1414, Rennes University Hospital; Service de Neurologie (J.C.), CHU de Toulouse, Hôpital Pierre-Paul Riquet, CRC-SEP; Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity) (J.C.), INSERM UMR 1291, CNRS UMR 5051, Université Toulouse III; Service de Neurologie (A.R.), CRC SEP, CHU de Bordeaux; U1215 INSERM (A.R.), Neurocentre Magendie, Université de Bordeaux; Service de Neurologie et Centre d'Investigation Clinique (J.D.S.), CHU de Strasbourg, INSERM 1434; Pôle des Neurosciences et de l'Appareil Locomoteur (H.Z.), CRC-SEP, Hôpital Roger Salengro, Université de Lille, Inserm U1172; CRC SEP (P.L.), Service de Neurologie, CHU de Montpellier; Service de Neurologie (G.D.), CRC-SEP Normandie, CHU de Caen, Université Normandie; Service de Neurologie (C.L.-F.), Neurologie Pasteur 2, CHU de Nice, Université Nice Cote d'Azur UR2CA-URRIS; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (D.A.L.), CHU Nantes; INSERM (D.A.L.), CIC 0004, CRTI-INSERM UMR U1064, Nantes; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (P.C.), CHU de Clermont-Ferrand, INSERM 1107 NeuroDol, Clermont-Ferrand; Aix Marseille University (J.P.), APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, CEMEREM; Service de Neurologie (E.T.), CHU de Nîmes; Institut de Génomique Fonctionnelle (E.T.), Université de Montpellier, CNRS, INSERM; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; and Univ Rennes (E.L.), EHESP, CNRS, Inserm, ARENES UMR 6051, RSMS U 1309, France
| | - Christine Lebrun-Frenay
- From the Université de Lyon (F.R., S.V.), Université Claude Bernard Lyon 1; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuroinflammation (F.R., S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron; Observatoire Français de la Sclérose en Plaques (F.R., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR 5292; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., S.V.), State-Approved Foundation, Bron; Direction des Maladies non Transmissible et des Traumatismes (Z.U.), Santé Publique France, Saint-Maurice; Service de Biostatistique-Bioinformatique (Z.U., E.D., M.F., L.R.), Pôle Santé Publique, Hospices Civils de Lyon; Laboratoire de Biométrie et Biologie Evolutive UMR 5558 (E.D., M.F., L.R.), Université Lyon 1 and CNRS, Villeurbanne; Service de Neurologie (M.D.), Centre Hospitalier Régional et Universitaire de Nancy, Université de Lorraine, EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Neurology Department (E.L.P.), CRCSEP Rennes, Clinical Investigation Centre CIC-P 1414, Rennes University Hospital; Service de Neurologie (J.C.), CHU de Toulouse, Hôpital Pierre-Paul Riquet, CRC-SEP; Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity) (J.C.), INSERM UMR 1291, CNRS UMR 5051, Université Toulouse III; Service de Neurologie (A.R.), CRC SEP, CHU de Bordeaux; U1215 INSERM (A.R.), Neurocentre Magendie, Université de Bordeaux; Service de Neurologie et Centre d'Investigation Clinique (J.D.S.), CHU de Strasbourg, INSERM 1434; Pôle des Neurosciences et de l'Appareil Locomoteur (H.Z.), CRC-SEP, Hôpital Roger Salengro, Université de Lille, Inserm U1172; CRC SEP (P.L.), Service de Neurologie, CHU de Montpellier; Service de Neurologie (G.D.), CRC-SEP Normandie, CHU de Caen, Université Normandie; Service de Neurologie (C.L.-F.), Neurologie Pasteur 2, CHU de Nice, Université Nice Cote d'Azur UR2CA-URRIS; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (D.A.L.), CHU Nantes; INSERM (D.A.L.), CIC 0004, CRTI-INSERM UMR U1064, Nantes; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (P.C.), CHU de Clermont-Ferrand, INSERM 1107 NeuroDol, Clermont-Ferrand; Aix Marseille University (J.P.), APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, CEMEREM; Service de Neurologie (E.T.), CHU de Nîmes; Institut de Génomique Fonctionnelle (E.T.), Université de Montpellier, CNRS, INSERM; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; and Univ Rennes (E.L.), EHESP, CNRS, Inserm, ARENES UMR 6051, RSMS U 1309, France
| | - Thibault Moreau
- From the Université de Lyon (F.R., S.V.), Université Claude Bernard Lyon 1; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuroinflammation (F.R., S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron; Observatoire Français de la Sclérose en Plaques (F.R., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR 5292; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., S.V.), State-Approved Foundation, Bron; Direction des Maladies non Transmissible et des Traumatismes (Z.U.), Santé Publique France, Saint-Maurice; Service de Biostatistique-Bioinformatique (Z.U., E.D., M.F., L.R.), Pôle Santé Publique, Hospices Civils de Lyon; Laboratoire de Biométrie et Biologie Evolutive UMR 5558 (E.D., M.F., L.R.), Université Lyon 1 and CNRS, Villeurbanne; Service de Neurologie (M.D.), Centre Hospitalier Régional et Universitaire de Nancy, Université de Lorraine, EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Neurology Department (E.L.P.), CRCSEP Rennes, Clinical Investigation Centre CIC-P 1414, Rennes University Hospital; Service de Neurologie (J.C.), CHU de Toulouse, Hôpital Pierre-Paul Riquet, CRC-SEP; Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity) (J.C.), INSERM UMR 1291, CNRS UMR 5051, Université Toulouse III; Service de Neurologie (A.R.), CRC SEP, CHU de Bordeaux; U1215 INSERM (A.R.), Neurocentre Magendie, Université de Bordeaux; Service de Neurologie et Centre d'Investigation Clinique (J.D.S.), CHU de Strasbourg, INSERM 1434; Pôle des Neurosciences et de l'Appareil Locomoteur (H.Z.), CRC-SEP, Hôpital Roger Salengro, Université de Lille, Inserm U1172; CRC SEP (P.L.), Service de Neurologie, CHU de Montpellier; Service de Neurologie (G.D.), CRC-SEP Normandie, CHU de Caen, Université Normandie; Service de Neurologie (C.L.-F.), Neurologie Pasteur 2, CHU de Nice, Université Nice Cote d'Azur UR2CA-URRIS; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (D.A.L.), CHU Nantes; INSERM (D.A.L.), CIC 0004, CRTI-INSERM UMR U1064, Nantes; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (P.C.), CHU de Clermont-Ferrand, INSERM 1107 NeuroDol, Clermont-Ferrand; Aix Marseille University (J.P.), APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, CEMEREM; Service de Neurologie (E.T.), CHU de Nîmes; Institut de Génomique Fonctionnelle (E.T.), Université de Montpellier, CNRS, INSERM; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; and Univ Rennes (E.L.), EHESP, CNRS, Inserm, ARENES UMR 6051, RSMS U 1309, France
| | - David A Laplaud
- From the Université de Lyon (F.R., S.V.), Université Claude Bernard Lyon 1; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuroinflammation (F.R., S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron; Observatoire Français de la Sclérose en Plaques (F.R., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR 5292; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., S.V.), State-Approved Foundation, Bron; Direction des Maladies non Transmissible et des Traumatismes (Z.U.), Santé Publique France, Saint-Maurice; Service de Biostatistique-Bioinformatique (Z.U., E.D., M.F., L.R.), Pôle Santé Publique, Hospices Civils de Lyon; Laboratoire de Biométrie et Biologie Evolutive UMR 5558 (E.D., M.F., L.R.), Université Lyon 1 and CNRS, Villeurbanne; Service de Neurologie (M.D.), Centre Hospitalier Régional et Universitaire de Nancy, Université de Lorraine, EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Neurology Department (E.L.P.), CRCSEP Rennes, Clinical Investigation Centre CIC-P 1414, Rennes University Hospital; Service de Neurologie (J.C.), CHU de Toulouse, Hôpital Pierre-Paul Riquet, CRC-SEP; Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity) (J.C.), INSERM UMR 1291, CNRS UMR 5051, Université Toulouse III; Service de Neurologie (A.R.), CRC SEP, CHU de Bordeaux; U1215 INSERM (A.R.), Neurocentre Magendie, Université de Bordeaux; Service de Neurologie et Centre d'Investigation Clinique (J.D.S.), CHU de Strasbourg, INSERM 1434; Pôle des Neurosciences et de l'Appareil Locomoteur (H.Z.), CRC-SEP, Hôpital Roger Salengro, Université de Lille, Inserm U1172; CRC SEP (P.L.), Service de Neurologie, CHU de Montpellier; Service de Neurologie (G.D.), CRC-SEP Normandie, CHU de Caen, Université Normandie; Service de Neurologie (C.L.-F.), Neurologie Pasteur 2, CHU de Nice, Université Nice Cote d'Azur UR2CA-URRIS; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (D.A.L.), CHU Nantes; INSERM (D.A.L.), CIC 0004, CRTI-INSERM UMR U1064, Nantes; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (P.C.), CHU de Clermont-Ferrand, INSERM 1107 NeuroDol, Clermont-Ferrand; Aix Marseille University (J.P.), APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, CEMEREM; Service de Neurologie (E.T.), CHU de Nîmes; Institut de Génomique Fonctionnelle (E.T.), Université de Montpellier, CNRS, INSERM; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; and Univ Rennes (E.L.), EHESP, CNRS, Inserm, ARENES UMR 6051, RSMS U 1309, France
| | - Eric Berger
- From the Université de Lyon (F.R., S.V.), Université Claude Bernard Lyon 1; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuroinflammation (F.R., S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron; Observatoire Français de la Sclérose en Plaques (F.R., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR 5292; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., S.V.), State-Approved Foundation, Bron; Direction des Maladies non Transmissible et des Traumatismes (Z.U.), Santé Publique France, Saint-Maurice; Service de Biostatistique-Bioinformatique (Z.U., E.D., M.F., L.R.), Pôle Santé Publique, Hospices Civils de Lyon; Laboratoire de Biométrie et Biologie Evolutive UMR 5558 (E.D., M.F., L.R.), Université Lyon 1 and CNRS, Villeurbanne; Service de Neurologie (M.D.), Centre Hospitalier Régional et Universitaire de Nancy, Université de Lorraine, EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Neurology Department (E.L.P.), CRCSEP Rennes, Clinical Investigation Centre CIC-P 1414, Rennes University Hospital; Service de Neurologie (J.C.), CHU de Toulouse, Hôpital Pierre-Paul Riquet, CRC-SEP; Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity) (J.C.), INSERM UMR 1291, CNRS UMR 5051, Université Toulouse III; Service de Neurologie (A.R.), CRC SEP, CHU de Bordeaux; U1215 INSERM (A.R.), Neurocentre Magendie, Université de Bordeaux; Service de Neurologie et Centre d'Investigation Clinique (J.D.S.), CHU de Strasbourg, INSERM 1434; Pôle des Neurosciences et de l'Appareil Locomoteur (H.Z.), CRC-SEP, Hôpital Roger Salengro, Université de Lille, Inserm U1172; CRC SEP (P.L.), Service de Neurologie, CHU de Montpellier; Service de Neurologie (G.D.), CRC-SEP Normandie, CHU de Caen, Université Normandie; Service de Neurologie (C.L.-F.), Neurologie Pasteur 2, CHU de Nice, Université Nice Cote d'Azur UR2CA-URRIS; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (D.A.L.), CHU Nantes; INSERM (D.A.L.), CIC 0004, CRTI-INSERM UMR U1064, Nantes; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (P.C.), CHU de Clermont-Ferrand, INSERM 1107 NeuroDol, Clermont-Ferrand; Aix Marseille University (J.P.), APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, CEMEREM; Service de Neurologie (E.T.), CHU de Nîmes; Institut de Génomique Fonctionnelle (E.T.), Université de Montpellier, CNRS, INSERM; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; and Univ Rennes (E.L.), EHESP, CNRS, Inserm, ARENES UMR 6051, RSMS U 1309, France
| | - Pierre Clavelou
- From the Université de Lyon (F.R., S.V.), Université Claude Bernard Lyon 1; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuroinflammation (F.R., S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron; Observatoire Français de la Sclérose en Plaques (F.R., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR 5292; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., S.V.), State-Approved Foundation, Bron; Direction des Maladies non Transmissible et des Traumatismes (Z.U.), Santé Publique France, Saint-Maurice; Service de Biostatistique-Bioinformatique (Z.U., E.D., M.F., L.R.), Pôle Santé Publique, Hospices Civils de Lyon; Laboratoire de Biométrie et Biologie Evolutive UMR 5558 (E.D., M.F., L.R.), Université Lyon 1 and CNRS, Villeurbanne; Service de Neurologie (M.D.), Centre Hospitalier Régional et Universitaire de Nancy, Université de Lorraine, EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Neurology Department (E.L.P.), CRCSEP Rennes, Clinical Investigation Centre CIC-P 1414, Rennes University Hospital; Service de Neurologie (J.C.), CHU de Toulouse, Hôpital Pierre-Paul Riquet, CRC-SEP; Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity) (J.C.), INSERM UMR 1291, CNRS UMR 5051, Université Toulouse III; Service de Neurologie (A.R.), CRC SEP, CHU de Bordeaux; U1215 INSERM (A.R.), Neurocentre Magendie, Université de Bordeaux; Service de Neurologie et Centre d'Investigation Clinique (J.D.S.), CHU de Strasbourg, INSERM 1434; Pôle des Neurosciences et de l'Appareil Locomoteur (H.Z.), CRC-SEP, Hôpital Roger Salengro, Université de Lille, Inserm U1172; CRC SEP (P.L.), Service de Neurologie, CHU de Montpellier; Service de Neurologie (G.D.), CRC-SEP Normandie, CHU de Caen, Université Normandie; Service de Neurologie (C.L.-F.), Neurologie Pasteur 2, CHU de Nice, Université Nice Cote d'Azur UR2CA-URRIS; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (D.A.L.), CHU Nantes; INSERM (D.A.L.), CIC 0004, CRTI-INSERM UMR U1064, Nantes; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (P.C.), CHU de Clermont-Ferrand, INSERM 1107 NeuroDol, Clermont-Ferrand; Aix Marseille University (J.P.), APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, CEMEREM; Service de Neurologie (E.T.), CHU de Nîmes; Institut de Génomique Fonctionnelle (E.T.), Université de Montpellier, CNRS, INSERM; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; and Univ Rennes (E.L.), EHESP, CNRS, Inserm, ARENES UMR 6051, RSMS U 1309, France
| | - Jean Pelletier
- From the Université de Lyon (F.R., S.V.), Université Claude Bernard Lyon 1; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuroinflammation (F.R., S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron; Observatoire Français de la Sclérose en Plaques (F.R., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR 5292; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., S.V.), State-Approved Foundation, Bron; Direction des Maladies non Transmissible et des Traumatismes (Z.U.), Santé Publique France, Saint-Maurice; Service de Biostatistique-Bioinformatique (Z.U., E.D., M.F., L.R.), Pôle Santé Publique, Hospices Civils de Lyon; Laboratoire de Biométrie et Biologie Evolutive UMR 5558 (E.D., M.F., L.R.), Université Lyon 1 and CNRS, Villeurbanne; Service de Neurologie (M.D.), Centre Hospitalier Régional et Universitaire de Nancy, Université de Lorraine, EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Neurology Department (E.L.P.), CRCSEP Rennes, Clinical Investigation Centre CIC-P 1414, Rennes University Hospital; Service de Neurologie (J.C.), CHU de Toulouse, Hôpital Pierre-Paul Riquet, CRC-SEP; Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity) (J.C.), INSERM UMR 1291, CNRS UMR 5051, Université Toulouse III; Service de Neurologie (A.R.), CRC SEP, CHU de Bordeaux; U1215 INSERM (A.R.), Neurocentre Magendie, Université de Bordeaux; Service de Neurologie et Centre d'Investigation Clinique (J.D.S.), CHU de Strasbourg, INSERM 1434; Pôle des Neurosciences et de l'Appareil Locomoteur (H.Z.), CRC-SEP, Hôpital Roger Salengro, Université de Lille, Inserm U1172; CRC SEP (P.L.), Service de Neurologie, CHU de Montpellier; Service de Neurologie (G.D.), CRC-SEP Normandie, CHU de Caen, Université Normandie; Service de Neurologie (C.L.-F.), Neurologie Pasteur 2, CHU de Nice, Université Nice Cote d'Azur UR2CA-URRIS; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (D.A.L.), CHU Nantes; INSERM (D.A.L.), CIC 0004, CRTI-INSERM UMR U1064, Nantes; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (P.C.), CHU de Clermont-Ferrand, INSERM 1107 NeuroDol, Clermont-Ferrand; Aix Marseille University (J.P.), APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, CEMEREM; Service de Neurologie (E.T.), CHU de Nîmes; Institut de Génomique Fonctionnelle (E.T.), Université de Montpellier, CNRS, INSERM; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; and Univ Rennes (E.L.), EHESP, CNRS, Inserm, ARENES UMR 6051, RSMS U 1309, France
| | - Eric Thouvenot
- From the Université de Lyon (F.R., S.V.), Université Claude Bernard Lyon 1; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuroinflammation (F.R., S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron; Observatoire Français de la Sclérose en Plaques (F.R., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR 5292; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., S.V.), State-Approved Foundation, Bron; Direction des Maladies non Transmissible et des Traumatismes (Z.U.), Santé Publique France, Saint-Maurice; Service de Biostatistique-Bioinformatique (Z.U., E.D., M.F., L.R.), Pôle Santé Publique, Hospices Civils de Lyon; Laboratoire de Biométrie et Biologie Evolutive UMR 5558 (E.D., M.F., L.R.), Université Lyon 1 and CNRS, Villeurbanne; Service de Neurologie (M.D.), Centre Hospitalier Régional et Universitaire de Nancy, Université de Lorraine, EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Neurology Department (E.L.P.), CRCSEP Rennes, Clinical Investigation Centre CIC-P 1414, Rennes University Hospital; Service de Neurologie (J.C.), CHU de Toulouse, Hôpital Pierre-Paul Riquet, CRC-SEP; Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity) (J.C.), INSERM UMR 1291, CNRS UMR 5051, Université Toulouse III; Service de Neurologie (A.R.), CRC SEP, CHU de Bordeaux; U1215 INSERM (A.R.), Neurocentre Magendie, Université de Bordeaux; Service de Neurologie et Centre d'Investigation Clinique (J.D.S.), CHU de Strasbourg, INSERM 1434; Pôle des Neurosciences et de l'Appareil Locomoteur (H.Z.), CRC-SEP, Hôpital Roger Salengro, Université de Lille, Inserm U1172; CRC SEP (P.L.), Service de Neurologie, CHU de Montpellier; Service de Neurologie (G.D.), CRC-SEP Normandie, CHU de Caen, Université Normandie; Service de Neurologie (C.L.-F.), Neurologie Pasteur 2, CHU de Nice, Université Nice Cote d'Azur UR2CA-URRIS; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (D.A.L.), CHU Nantes; INSERM (D.A.L.), CIC 0004, CRTI-INSERM UMR U1064, Nantes; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (P.C.), CHU de Clermont-Ferrand, INSERM 1107 NeuroDol, Clermont-Ferrand; Aix Marseille University (J.P.), APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, CEMEREM; Service de Neurologie (E.T.), CHU de Nîmes; Institut de Génomique Fonctionnelle (E.T.), Université de Montpellier, CNRS, INSERM; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; and Univ Rennes (E.L.), EHESP, CNRS, Inserm, ARENES UMR 6051, RSMS U 1309, France
| | - Olivier Heinzlef
- From the Université de Lyon (F.R., S.V.), Université Claude Bernard Lyon 1; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuroinflammation (F.R., S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron; Observatoire Français de la Sclérose en Plaques (F.R., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR 5292; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., S.V.), State-Approved Foundation, Bron; Direction des Maladies non Transmissible et des Traumatismes (Z.U.), Santé Publique France, Saint-Maurice; Service de Biostatistique-Bioinformatique (Z.U., E.D., M.F., L.R.), Pôle Santé Publique, Hospices Civils de Lyon; Laboratoire de Biométrie et Biologie Evolutive UMR 5558 (E.D., M.F., L.R.), Université Lyon 1 and CNRS, Villeurbanne; Service de Neurologie (M.D.), Centre Hospitalier Régional et Universitaire de Nancy, Université de Lorraine, EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Neurology Department (E.L.P.), CRCSEP Rennes, Clinical Investigation Centre CIC-P 1414, Rennes University Hospital; Service de Neurologie (J.C.), CHU de Toulouse, Hôpital Pierre-Paul Riquet, CRC-SEP; Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity) (J.C.), INSERM UMR 1291, CNRS UMR 5051, Université Toulouse III; Service de Neurologie (A.R.), CRC SEP, CHU de Bordeaux; U1215 INSERM (A.R.), Neurocentre Magendie, Université de Bordeaux; Service de Neurologie et Centre d'Investigation Clinique (J.D.S.), CHU de Strasbourg, INSERM 1434; Pôle des Neurosciences et de l'Appareil Locomoteur (H.Z.), CRC-SEP, Hôpital Roger Salengro, Université de Lille, Inserm U1172; CRC SEP (P.L.), Service de Neurologie, CHU de Montpellier; Service de Neurologie (G.D.), CRC-SEP Normandie, CHU de Caen, Université Normandie; Service de Neurologie (C.L.-F.), Neurologie Pasteur 2, CHU de Nice, Université Nice Cote d'Azur UR2CA-URRIS; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (D.A.L.), CHU Nantes; INSERM (D.A.L.), CIC 0004, CRTI-INSERM UMR U1064, Nantes; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (P.C.), CHU de Clermont-Ferrand, INSERM 1107 NeuroDol, Clermont-Ferrand; Aix Marseille University (J.P.), APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, CEMEREM; Service de Neurologie (E.T.), CHU de Nîmes; Institut de Génomique Fonctionnelle (E.T.), Université de Montpellier, CNRS, INSERM; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; and Univ Rennes (E.L.), EHESP, CNRS, Inserm, ARENES UMR 6051, RSMS U 1309, France
| | - Jean-Philippe Camdessanche
- From the Université de Lyon (F.R., S.V.), Université Claude Bernard Lyon 1; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuroinflammation (F.R., S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron; Observatoire Français de la Sclérose en Plaques (F.R., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR 5292; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., S.V.), State-Approved Foundation, Bron; Direction des Maladies non Transmissible et des Traumatismes (Z.U.), Santé Publique France, Saint-Maurice; Service de Biostatistique-Bioinformatique (Z.U., E.D., M.F., L.R.), Pôle Santé Publique, Hospices Civils de Lyon; Laboratoire de Biométrie et Biologie Evolutive UMR 5558 (E.D., M.F., L.R.), Université Lyon 1 and CNRS, Villeurbanne; Service de Neurologie (M.D.), Centre Hospitalier Régional et Universitaire de Nancy, Université de Lorraine, EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Neurology Department (E.L.P.), CRCSEP Rennes, Clinical Investigation Centre CIC-P 1414, Rennes University Hospital; Service de Neurologie (J.C.), CHU de Toulouse, Hôpital Pierre-Paul Riquet, CRC-SEP; Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity) (J.C.), INSERM UMR 1291, CNRS UMR 5051, Université Toulouse III; Service de Neurologie (A.R.), CRC SEP, CHU de Bordeaux; U1215 INSERM (A.R.), Neurocentre Magendie, Université de Bordeaux; Service de Neurologie et Centre d'Investigation Clinique (J.D.S.), CHU de Strasbourg, INSERM 1434; Pôle des Neurosciences et de l'Appareil Locomoteur (H.Z.), CRC-SEP, Hôpital Roger Salengro, Université de Lille, Inserm U1172; CRC SEP (P.L.), Service de Neurologie, CHU de Montpellier; Service de Neurologie (G.D.), CRC-SEP Normandie, CHU de Caen, Université Normandie; Service de Neurologie (C.L.-F.), Neurologie Pasteur 2, CHU de Nice, Université Nice Cote d'Azur UR2CA-URRIS; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (D.A.L.), CHU Nantes; INSERM (D.A.L.), CIC 0004, CRTI-INSERM UMR U1064, Nantes; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (P.C.), CHU de Clermont-Ferrand, INSERM 1107 NeuroDol, Clermont-Ferrand; Aix Marseille University (J.P.), APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, CEMEREM; Service de Neurologie (E.T.), CHU de Nîmes; Institut de Génomique Fonctionnelle (E.T.), Université de Montpellier, CNRS, INSERM; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; and Univ Rennes (E.L.), EHESP, CNRS, Inserm, ARENES UMR 6051, RSMS U 1309, France
| | - Mathieu Fauvernier
- From the Université de Lyon (F.R., S.V.), Université Claude Bernard Lyon 1; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuroinflammation (F.R., S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron; Observatoire Français de la Sclérose en Plaques (F.R., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR 5292; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., S.V.), State-Approved Foundation, Bron; Direction des Maladies non Transmissible et des Traumatismes (Z.U.), Santé Publique France, Saint-Maurice; Service de Biostatistique-Bioinformatique (Z.U., E.D., M.F., L.R.), Pôle Santé Publique, Hospices Civils de Lyon; Laboratoire de Biométrie et Biologie Evolutive UMR 5558 (E.D., M.F., L.R.), Université Lyon 1 and CNRS, Villeurbanne; Service de Neurologie (M.D.), Centre Hospitalier Régional et Universitaire de Nancy, Université de Lorraine, EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Neurology Department (E.L.P.), CRCSEP Rennes, Clinical Investigation Centre CIC-P 1414, Rennes University Hospital; Service de Neurologie (J.C.), CHU de Toulouse, Hôpital Pierre-Paul Riquet, CRC-SEP; Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity) (J.C.), INSERM UMR 1291, CNRS UMR 5051, Université Toulouse III; Service de Neurologie (A.R.), CRC SEP, CHU de Bordeaux; U1215 INSERM (A.R.), Neurocentre Magendie, Université de Bordeaux; Service de Neurologie et Centre d'Investigation Clinique (J.D.S.), CHU de Strasbourg, INSERM 1434; Pôle des Neurosciences et de l'Appareil Locomoteur (H.Z.), CRC-SEP, Hôpital Roger Salengro, Université de Lille, Inserm U1172; CRC SEP (P.L.), Service de Neurologie, CHU de Montpellier; Service de Neurologie (G.D.), CRC-SEP Normandie, CHU de Caen, Université Normandie; Service de Neurologie (C.L.-F.), Neurologie Pasteur 2, CHU de Nice, Université Nice Cote d'Azur UR2CA-URRIS; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (D.A.L.), CHU Nantes; INSERM (D.A.L.), CIC 0004, CRTI-INSERM UMR U1064, Nantes; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (P.C.), CHU de Clermont-Ferrand, INSERM 1107 NeuroDol, Clermont-Ferrand; Aix Marseille University (J.P.), APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, CEMEREM; Service de Neurologie (E.T.), CHU de Nîmes; Institut de Génomique Fonctionnelle (E.T.), Université de Montpellier, CNRS, INSERM; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; and Univ Rennes (E.L.), EHESP, CNRS, Inserm, ARENES UMR 6051, RSMS U 1309, France
| | - Laurent Remontet
- From the Université de Lyon (F.R., S.V.), Université Claude Bernard Lyon 1; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuroinflammation (F.R., S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron; Observatoire Français de la Sclérose en Plaques (F.R., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR 5292; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., S.V.), State-Approved Foundation, Bron; Direction des Maladies non Transmissible et des Traumatismes (Z.U.), Santé Publique France, Saint-Maurice; Service de Biostatistique-Bioinformatique (Z.U., E.D., M.F., L.R.), Pôle Santé Publique, Hospices Civils de Lyon; Laboratoire de Biométrie et Biologie Evolutive UMR 5558 (E.D., M.F., L.R.), Université Lyon 1 and CNRS, Villeurbanne; Service de Neurologie (M.D.), Centre Hospitalier Régional et Universitaire de Nancy, Université de Lorraine, EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Neurology Department (E.L.P.), CRCSEP Rennes, Clinical Investigation Centre CIC-P 1414, Rennes University Hospital; Service de Neurologie (J.C.), CHU de Toulouse, Hôpital Pierre-Paul Riquet, CRC-SEP; Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity) (J.C.), INSERM UMR 1291, CNRS UMR 5051, Université Toulouse III; Service de Neurologie (A.R.), CRC SEP, CHU de Bordeaux; U1215 INSERM (A.R.), Neurocentre Magendie, Université de Bordeaux; Service de Neurologie et Centre d'Investigation Clinique (J.D.S.), CHU de Strasbourg, INSERM 1434; Pôle des Neurosciences et de l'Appareil Locomoteur (H.Z.), CRC-SEP, Hôpital Roger Salengro, Université de Lille, Inserm U1172; CRC SEP (P.L.), Service de Neurologie, CHU de Montpellier; Service de Neurologie (G.D.), CRC-SEP Normandie, CHU de Caen, Université Normandie; Service de Neurologie (C.L.-F.), Neurologie Pasteur 2, CHU de Nice, Université Nice Cote d'Azur UR2CA-URRIS; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (D.A.L.), CHU Nantes; INSERM (D.A.L.), CIC 0004, CRTI-INSERM UMR U1064, Nantes; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (P.C.), CHU de Clermont-Ferrand, INSERM 1107 NeuroDol, Clermont-Ferrand; Aix Marseille University (J.P.), APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, CEMEREM; Service de Neurologie (E.T.), CHU de Nîmes; Institut de Génomique Fonctionnelle (E.T.), Université de Montpellier, CNRS, INSERM; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; and Univ Rennes (E.L.), EHESP, CNRS, Inserm, ARENES UMR 6051, RSMS U 1309, France
| | - Emmanuelle Leray
- From the Université de Lyon (F.R., S.V.), Université Claude Bernard Lyon 1; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuroinflammation (F.R., S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron; Observatoire Français de la Sclérose en Plaques (F.R., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR 5292; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., S.V.), State-Approved Foundation, Bron; Direction des Maladies non Transmissible et des Traumatismes (Z.U.), Santé Publique France, Saint-Maurice; Service de Biostatistique-Bioinformatique (Z.U., E.D., M.F., L.R.), Pôle Santé Publique, Hospices Civils de Lyon; Laboratoire de Biométrie et Biologie Evolutive UMR 5558 (E.D., M.F., L.R.), Université Lyon 1 and CNRS, Villeurbanne; Service de Neurologie (M.D.), Centre Hospitalier Régional et Universitaire de Nancy, Université de Lorraine, EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Neurology Department (E.L.P.), CRCSEP Rennes, Clinical Investigation Centre CIC-P 1414, Rennes University Hospital; Service de Neurologie (J.C.), CHU de Toulouse, Hôpital Pierre-Paul Riquet, CRC-SEP; Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity) (J.C.), INSERM UMR 1291, CNRS UMR 5051, Université Toulouse III; Service de Neurologie (A.R.), CRC SEP, CHU de Bordeaux; U1215 INSERM (A.R.), Neurocentre Magendie, Université de Bordeaux; Service de Neurologie et Centre d'Investigation Clinique (J.D.S.), CHU de Strasbourg, INSERM 1434; Pôle des Neurosciences et de l'Appareil Locomoteur (H.Z.), CRC-SEP, Hôpital Roger Salengro, Université de Lille, Inserm U1172; CRC SEP (P.L.), Service de Neurologie, CHU de Montpellier; Service de Neurologie (G.D.), CRC-SEP Normandie, CHU de Caen, Université Normandie; Service de Neurologie (C.L.-F.), Neurologie Pasteur 2, CHU de Nice, Université Nice Cote d'Azur UR2CA-URRIS; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (D.A.L.), CHU Nantes; INSERM (D.A.L.), CIC 0004, CRTI-INSERM UMR U1064, Nantes; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (P.C.), CHU de Clermont-Ferrand, INSERM 1107 NeuroDol, Clermont-Ferrand; Aix Marseille University (J.P.), APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, CEMEREM; Service de Neurologie (E.T.), CHU de Nîmes; Institut de Génomique Fonctionnelle (E.T.), Université de Montpellier, CNRS, INSERM; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; and Univ Rennes (E.L.), EHESP, CNRS, Inserm, ARENES UMR 6051, RSMS U 1309, France
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Delsanti R, Arnaud C, Defer G. Neurological disorders related to recreational nitrous oxide abuse: Two sides of the same coin. Rev Neurol (Paris) 2023:S0035-3787(23)01118-9. [PMID: 38052664 DOI: 10.1016/j.neurol.2023.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 02/07/2023] [Accepted: 10/10/2023] [Indexed: 12/07/2023]
Affiliation(s)
- R Delsanti
- Department of Neurology, CHU of Caen Normandie, avenue de la Côte-de-Nacre, 14000 Caen, France; Normandie University, UNICAEN, UFR de médecine, 14000 Caen, France.
| | - C Arnaud
- Department of Neurology, CHU of Caen Normandie, avenue de la Côte-de-Nacre, 14000 Caen, France; Normandie University, UNICAEN, UFR de médecine, 14000 Caen, France
| | - G Defer
- Department of Neurology, CHU of Caen Normandie, avenue de la Côte-de-Nacre, 14000 Caen, France; Normandie University, UNICAEN, UFR de médecine, 14000 Caen, France; UMR-S1237, Physiopathology and Imaging of Neurological Disorders, Inserm, Caen, France
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Clavelou P, Castelnovo G, Pourcher V, De Sèze J, Vermersch P, Ben-Amor AF, Savarin C, Defer G. Expert Narrative Review of the Safety of Cladribine Tablets for the Management of Relapsing Multiple Sclerosis. Neurol Ther 2023; 12:1457-1476. [PMID: 37382841 PMCID: PMC10444734 DOI: 10.1007/s40120-023-00496-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 05/11/2023] [Indexed: 06/30/2023] Open
Abstract
Cladribine tablets (CladT) is a highly active oral disease-modifying therapy (DMT) for the management of relapsing multiple sclerosis (RMS). CladT acts as an immune reconstitution therapy, in that two short courses of treatment 1 year apart have been shown to suppress disease activity for a prolonged period in most patients, without need for continued DMT. Each course of CladT induces a profound reduction in B lymphocytes that recovers over months, and serious lymphopenia (Grade 3-4) is uncommon. Smaller reductions in levels of T lymphocytes occur slightly later: on average, these remain within the normal range and repopulate progressively. A larger effect occurs on CD8 vs. CD4 cells. Reactivation of latent or opportunistic infections (e.g. varicella zoster, tuberculosis) is mostly associated with very low lymphocyte counts (< 200/mm3). Screening and managing pre-existing infections, vaccinating non-exposed patients and delaying the 2nd year of treatment with CladT to allow lymphocytes to recover to > 800/mm3 (if necessary) are important for avoiding infections and higher-grade lymphopenia. There was no demonstrable or apparent effect of CladT on the efficacy of vaccinations, including against Covid-19. Adverse events consistent with drug-induced liver injury (DILI) represent a rare but potentially serious complication of CladT therapy in spontaneous adverse event reporting; patients should be screened for liver dysfunction before starting treatment. Ongoing hepatic monitoring is not required, but CladT must be withdrawn if signs and symptoms of DILI develop. There was a numerical imbalance for malignancies when comparing cladribine to placebo in the clinical programme, particularly in short-term data, but recent evidence shows that the risk of malignancy with CladT is similar to the background rate in the general population and to that with other DMTs. Overall, CladT is well tolerated with a favorable safety profile appropriate for the management of RMS.
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Affiliation(s)
- Pierre Clavelou
- Department of Neurology, Clermont-Ferrand University Hospital, 58 Rue Montalembert, 63003, Clermont-Ferrand Cedex 1, France.
| | - Giovanni Castelnovo
- Department of Neurology, Nîmes University Hospital, Hopital Caremeau, Nîmes, France
| | - Valérie Pourcher
- Department of Infectious and Tropical Diseases, Pitié-Salpêtrière Hospital, APHP, Sorbonne Université, INSERM 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique Paris, Paris, France
| | - Jerome De Sèze
- Department of Neurology, Strasbourg University Hospital, Strasbourg, France
| | - Patrick Vermersch
- Univ. Lille, Inserm U1172 LilNCog, CHU Lille, FHU Precise, Lille, France
| | - Ali-Frederic Ben-Amor
- Global Medical Affairs Neurology and Immunology, Ares Trading SA (An affiliate of Merck KGaA, Darmstadt, Germany), Eysins, Switzerland
| | - Carine Savarin
- Neurology Department, Medical Affairs (An affiliate of Merck KGaA, Darmstadt, Germany), Merck Santé, Lyon, France
| | - Gilles Defer
- Department of Neurology, Caen University Hospital, Caen, France
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Defer G, Castelnovo G, Pourcher V, Savarin C, De Sèze J, Vermersch P, Clavelou P. Revue d’expertise d’analyse des données de sécurité concernant le traitement de reconstitution immunitaire (IRT) par Cladribine comprimés (cp). Rev Neurol (Paris) 2023. [DOI: 10.1016/j.neurol.2023.01.700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
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Arnold D, Foley J, Defer G, Zhovtis RL, Cohen JA, Butzkueven H, Cutter G, Giovannoni G, Killestein J, Wiendl H, Sinks S, Kuhelj R, Lasky T, Bodhinathan K. Critères d’évaluation exploratoires à l’IRM de l’étude NOVA : étude randomisée et contrôlée de l’efficacité de l’administration de natalizumab toutes les 6 semaines (Q6W) vs la poursuite d’une administration toutes les 4 semaines (Q4W) dans la SEP. Rev Neurol (Paris) 2023. [DOI: 10.1016/j.neurol.2023.01.657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
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Gavoille A, Rollot F, Casey R, Debouverie M, Le Page E, Ciron J, De Seze J, Ruet A, Maillart E, Labauge P, Zephir H, Papeix C, Defer G, Lebrun-Frenay C, Moreau T, Laplaud DA, Berger E, Stankoff B, Clavelou P, Thouvenot E, Heinzlef O, Pelletier J, Al Khedr A, Casez O, Bourre B, Cabre P, Wahab A, Magy L, Camdessanche JP, Maurousset A, Moulin S, Ben NH, Boulos DD, Hankiewicz K, Neau JP, Pottier C, Nifle C, Rabilloud M, Subtil F, Vukusic S. Investigating the Long-term Effect of Pregnancy on the Course of Multiple Sclerosis Using Causal Inference. Neurology 2023; 100:e1296-e1308. [PMID: 36564207 PMCID: PMC10033171 DOI: 10.1212/wnl.0000000000206774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 11/17/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The question of the long-term safety of pregnancy is a major concern in patients with multiple sclerosis (MS), but its study is biased by reverse causation (women with higher disability are less likely to experience pregnancy). Using a causal inference approach, we aimed to estimate the unbiased long-term effects of pregnancy on disability and relapse risk in patients with MS and secondarily the short-term effects (during the perpartum and postpartum years) and delayed effects (occurring beyond 1 year after delivery). METHODS We conducted an observational cohort study with data from patients with MS followed in the Observatoire Français de la Sclérose en Plaques registry between 1990 and 2020. We included female patients with MS aged 18-45 years at MS onset, clinically followed up for more than 2 years, and with ≥3 Expanded Disease Status Scale (EDSS) measurements. Outcomes were the mean EDSS score at the end of follow-up and the annual probability of relapse during follow-up. Counterfactual outcomes were predicted using the longitudinal targeted maximum likelihood estimator in the entire study population. The patients exposed to at least 1 pregnancy during their follow-up were compared with the counterfactual situation in which, contrary to what was observed, they would not have been exposed to any pregnancy. Short-term and delayed effects were analyzed from the first pregnancy of early-exposed patients (who experienced it during their first 3 years of follow-up). RESULTS We included 9,100 patients, with a median follow-up duration of 7.8 years, of whom 2,125 (23.4%) patients were exposed to at least 1 pregnancy. Pregnancy had no significant long-term causal effect on the mean EDSS score at 9 years (causal mean difference [95% CI] = 0.00 [-0.16 to 0.15]) or on the annual probability of relapse (causal risk ratio [95% CI] = 0.95 [0.93-1.38]). For the 1,253 early-exposed patients, pregnancy significantly decreased the probability of relapse during the perpartum year and significantly increased it during the postpartum year, but no significant delayed effect was found on the EDSS and relapse rate. DISCUSSION Using a causal inference approach, we found no evidence of significantly deleterious or beneficial long-term effects of pregnancy on disability. The beneficial effects found in other studies were probably related to a reverse causation bias.
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Affiliation(s)
- Antoine Gavoille
- From the Service de Neurologie (A.G., F.R., R.C., S.V.), Sclérose en Plaques, Pathologies de La Myéline et Neuro-inflammation, Hôpital Neurologique Pierre-Wertheimer, Hospices Civils de Lyon, Bron; Université de Lyon (A.G., M.R., F.S.), Université Claude Bernard Lyon 1, CNRS, Laboratoire de Biométrie et Biologie Évolutive UMR 5558, Villeurbanne; Service de Biostatistique-Bioinformatique (A.G., M.R., F.S.), Hospices Civils de Lyon; Université de Lyon (F.R., R.C., S.V.), Université Claude Bernard Lyon 1; Observatoire Français de La Sclérose en Plaques (F.R., R.C., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., R.C., S.V.), State-approved Foundation, Bron; Nancy University Hospital (M.D.), Department of Neurology, Université de Lorraine, APEMAC; CHU Pontchaillou (E.L.P.), CIC1414 INSERM, Rennes; CHU de Toulouse (J.C.), Hôpital Pierre-Paul Riquet, Department of Neurology, CRC-SEP, Toulouse; Infinity (J.C.), INSERM UMR1291-CNRS UMR5051, Université Toulouse III; CHU de Strasbourg (J.D.S.), Department of Neurology and Clinical Investigation Center, CIC 1434, INSERM 1434; Univ. Bordeaux (A.R.), F-33000 Bordeaux INSERM U1215, Neurocentre Magendie, F-33000 Bordeaux CHU de Bordeaux, Department of Neurology, CIC Bordeaux CIC1401; Département de Neurologie (E.M.), Hôpital Pitié-Salpêtrière, APHP, Paris; Centre de Ressources et de Compétences SEP Paris (E.M.); CHU de Montpellier (P.L.), MS Unit; University of Montpellier (MUSE) (P.L.); CHU Lille (H.Z.), CRCSEP Lille, Univ Lille, U1172; Fondation Rotschild (C. Papeix), Department of Neurology, Paris; CHU de Caen (G.D.), MS Expert Centre, Department of Neurology, Avenue de La Côte-de-Nacre, Normandy University, Caen; Neurology (C.L.-F.), UR2CA, Centre Hospitalier Universitaire Pasteur2, Université Nice Côte d'Azur, Nice; CHU de Dijon (T.M.), Department of Neurology, EA4184; CHU de Nantes (D.A.L.), Service de Neurologie & CIC015 INSERM; CRTI-Inserm U1064 (D.A.L.), Nantes; CHU de Besançon (E.B.), Service de Neurologie; Sorbonne Universités (B.S.), UPMC Paris 06, Brain and Spine Institute, ICM, Hôpital de La Pitié Salpêtrière, Inserm UMR S 1127, CNRS UMR 7225, and Department of Neurology, AP-HP, Saint-Antoine Hospital; CHU Clermont-Ferrand (Pierre Clavelou), Department of Neurology, F-63000 Clermont-Ferrand Université Clermont Auvergne, Inserm, Neuro-Dol, F-63000 Clermont-Ferrand; Department of Neurology (E.T.), Nimes University Hospital; Institut de Génomique Fonctionnelle (E.T.), UMR5203, INSERM 1191, Univ. Montpellier; Hôpital de Poissy (O.H.), Department of Neurology; Aix Marseille Univ (J.P.), APHM, Hôpital de La Timone, Pôle de Neurosciences Cliniques, Service de Neurologie; CHU d'Amiens (A.A.K.), Department of Neurology; CHU Grenoble Alpes (O.C.), Department of Neurology, La Tronche/Grenoble; CHU de Rouen (B.B.), Department of Neurology; CHU de La Martinique (Philippe Cabre), Department of Neurology, Fort-de-France; APHP (A.W.), Hôpital Henri Mondor, Department of Neurology, Créteil; CHU de Limoges (L.M.), Hôpital Dupuytren, Department of Neurology; CHU de Saint-Étienne (J.-P.C.), Hôpital Nord, Department of Neurology; CHU de Tours (A.M.), Hôpital Bretonneau, CRC SEP and Department of Neurology; CHU de Reims (S.M.), CRC-SEP, Department of Neurology; Hôpital Sud Francilien (N.H.B.), Department of Neurology, Corbeil Essonnes; CHU Bicêtre (D.D.B.), Department of Neurology, Le Kremlin Bicêtre; Department of Neurology (K.H.), Hôpital Pierre Delafontaine, Centre Hospitalier de Saint-Denis; CHU La Milétrie (J.-P.N.), Hôpital Jean Bernard, Department of Neurology, Poitiers; CH de Pontoise (C. Pottier), Hôpital René Dubos, Department of Neurology; and Centre Hospitalier de Versailles (C.N.), Department of Neurology, F-78150 Le Chesnay, France.
| | - Fabien Rollot
- From the Service de Neurologie (A.G., F.R., R.C., S.V.), Sclérose en Plaques, Pathologies de La Myéline et Neuro-inflammation, Hôpital Neurologique Pierre-Wertheimer, Hospices Civils de Lyon, Bron; Université de Lyon (A.G., M.R., F.S.), Université Claude Bernard Lyon 1, CNRS, Laboratoire de Biométrie et Biologie Évolutive UMR 5558, Villeurbanne; Service de Biostatistique-Bioinformatique (A.G., M.R., F.S.), Hospices Civils de Lyon; Université de Lyon (F.R., R.C., S.V.), Université Claude Bernard Lyon 1; Observatoire Français de La Sclérose en Plaques (F.R., R.C., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., R.C., S.V.), State-approved Foundation, Bron; Nancy University Hospital (M.D.), Department of Neurology, Université de Lorraine, APEMAC; CHU Pontchaillou (E.L.P.), CIC1414 INSERM, Rennes; CHU de Toulouse (J.C.), Hôpital Pierre-Paul Riquet, Department of Neurology, CRC-SEP, Toulouse; Infinity (J.C.), INSERM UMR1291-CNRS UMR5051, Université Toulouse III; CHU de Strasbourg (J.D.S.), Department of Neurology and Clinical Investigation Center, CIC 1434, INSERM 1434; Univ. Bordeaux (A.R.), F-33000 Bordeaux INSERM U1215, Neurocentre Magendie, F-33000 Bordeaux CHU de Bordeaux, Department of Neurology, CIC Bordeaux CIC1401; Département de Neurologie (E.M.), Hôpital Pitié-Salpêtrière, APHP, Paris; Centre de Ressources et de Compétences SEP Paris (E.M.); CHU de Montpellier (P.L.), MS Unit; University of Montpellier (MUSE) (P.L.); CHU Lille (H.Z.), CRCSEP Lille, Univ Lille, U1172; Fondation Rotschild (C. Papeix), Department of Neurology, Paris; CHU de Caen (G.D.), MS Expert Centre, Department of Neurology, Avenue de La Côte-de-Nacre, Normandy University, Caen; Neurology (C.L.-F.), UR2CA, Centre Hospitalier Universitaire Pasteur2, Université Nice Côte d'Azur, Nice; CHU de Dijon (T.M.), Department of Neurology, EA4184; CHU de Nantes (D.A.L.), Service de Neurologie & CIC015 INSERM; CRTI-Inserm U1064 (D.A.L.), Nantes; CHU de Besançon (E.B.), Service de Neurologie; Sorbonne Universités (B.S.), UPMC Paris 06, Brain and Spine Institute, ICM, Hôpital de La Pitié Salpêtrière, Inserm UMR S 1127, CNRS UMR 7225, and Department of Neurology, AP-HP, Saint-Antoine Hospital; CHU Clermont-Ferrand (Pierre Clavelou), Department of Neurology, F-63000 Clermont-Ferrand Université Clermont Auvergne, Inserm, Neuro-Dol, F-63000 Clermont-Ferrand; Department of Neurology (E.T.), Nimes University Hospital; Institut de Génomique Fonctionnelle (E.T.), UMR5203, INSERM 1191, Univ. Montpellier; Hôpital de Poissy (O.H.), Department of Neurology; Aix Marseille Univ (J.P.), APHM, Hôpital de La Timone, Pôle de Neurosciences Cliniques, Service de Neurologie; CHU d'Amiens (A.A.K.), Department of Neurology; CHU Grenoble Alpes (O.C.), Department of Neurology, La Tronche/Grenoble; CHU de Rouen (B.B.), Department of Neurology; CHU de La Martinique (Philippe Cabre), Department of Neurology, Fort-de-France; APHP (A.W.), Hôpital Henri Mondor, Department of Neurology, Créteil; CHU de Limoges (L.M.), Hôpital Dupuytren, Department of Neurology; CHU de Saint-Étienne (J.-P.C.), Hôpital Nord, Department of Neurology; CHU de Tours (A.M.), Hôpital Bretonneau, CRC SEP and Department of Neurology; CHU de Reims (S.M.), CRC-SEP, Department of Neurology; Hôpital Sud Francilien (N.H.B.), Department of Neurology, Corbeil Essonnes; CHU Bicêtre (D.D.B.), Department of Neurology, Le Kremlin Bicêtre; Department of Neurology (K.H.), Hôpital Pierre Delafontaine, Centre Hospitalier de Saint-Denis; CHU La Milétrie (J.-P.N.), Hôpital Jean Bernard, Department of Neurology, Poitiers; CH de Pontoise (C. Pottier), Hôpital René Dubos, Department of Neurology; and Centre Hospitalier de Versailles (C.N.), Department of Neurology, F-78150 Le Chesnay, France
| | - Romain Casey
- From the Service de Neurologie (A.G., F.R., R.C., S.V.), Sclérose en Plaques, Pathologies de La Myéline et Neuro-inflammation, Hôpital Neurologique Pierre-Wertheimer, Hospices Civils de Lyon, Bron; Université de Lyon (A.G., M.R., F.S.), Université Claude Bernard Lyon 1, CNRS, Laboratoire de Biométrie et Biologie Évolutive UMR 5558, Villeurbanne; Service de Biostatistique-Bioinformatique (A.G., M.R., F.S.), Hospices Civils de Lyon; Université de Lyon (F.R., R.C., S.V.), Université Claude Bernard Lyon 1; Observatoire Français de La Sclérose en Plaques (F.R., R.C., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., R.C., S.V.), State-approved Foundation, Bron; Nancy University Hospital (M.D.), Department of Neurology, Université de Lorraine, APEMAC; CHU Pontchaillou (E.L.P.), CIC1414 INSERM, Rennes; CHU de Toulouse (J.C.), Hôpital Pierre-Paul Riquet, Department of Neurology, CRC-SEP, Toulouse; Infinity (J.C.), INSERM UMR1291-CNRS UMR5051, Université Toulouse III; CHU de Strasbourg (J.D.S.), Department of Neurology and Clinical Investigation Center, CIC 1434, INSERM 1434; Univ. Bordeaux (A.R.), F-33000 Bordeaux INSERM U1215, Neurocentre Magendie, F-33000 Bordeaux CHU de Bordeaux, Department of Neurology, CIC Bordeaux CIC1401; Département de Neurologie (E.M.), Hôpital Pitié-Salpêtrière, APHP, Paris; Centre de Ressources et de Compétences SEP Paris (E.M.); CHU de Montpellier (P.L.), MS Unit; University of Montpellier (MUSE) (P.L.); CHU Lille (H.Z.), CRCSEP Lille, Univ Lille, U1172; Fondation Rotschild (C. Papeix), Department of Neurology, Paris; CHU de Caen (G.D.), MS Expert Centre, Department of Neurology, Avenue de La Côte-de-Nacre, Normandy University, Caen; Neurology (C.L.-F.), UR2CA, Centre Hospitalier Universitaire Pasteur2, Université Nice Côte d'Azur, Nice; CHU de Dijon (T.M.), Department of Neurology, EA4184; CHU de Nantes (D.A.L.), Service de Neurologie & CIC015 INSERM; CRTI-Inserm U1064 (D.A.L.), Nantes; CHU de Besançon (E.B.), Service de Neurologie; Sorbonne Universités (B.S.), UPMC Paris 06, Brain and Spine Institute, ICM, Hôpital de La Pitié Salpêtrière, Inserm UMR S 1127, CNRS UMR 7225, and Department of Neurology, AP-HP, Saint-Antoine Hospital; CHU Clermont-Ferrand (Pierre Clavelou), Department of Neurology, F-63000 Clermont-Ferrand Université Clermont Auvergne, Inserm, Neuro-Dol, F-63000 Clermont-Ferrand; Department of Neurology (E.T.), Nimes University Hospital; Institut de Génomique Fonctionnelle (E.T.), UMR5203, INSERM 1191, Univ. Montpellier; Hôpital de Poissy (O.H.), Department of Neurology; Aix Marseille Univ (J.P.), APHM, Hôpital de La Timone, Pôle de Neurosciences Cliniques, Service de Neurologie; CHU d'Amiens (A.A.K.), Department of Neurology; CHU Grenoble Alpes (O.C.), Department of Neurology, La Tronche/Grenoble; CHU de Rouen (B.B.), Department of Neurology; CHU de La Martinique (Philippe Cabre), Department of Neurology, Fort-de-France; APHP (A.W.), Hôpital Henri Mondor, Department of Neurology, Créteil; CHU de Limoges (L.M.), Hôpital Dupuytren, Department of Neurology; CHU de Saint-Étienne (J.-P.C.), Hôpital Nord, Department of Neurology; CHU de Tours (A.M.), Hôpital Bretonneau, CRC SEP and Department of Neurology; CHU de Reims (S.M.), CRC-SEP, Department of Neurology; Hôpital Sud Francilien (N.H.B.), Department of Neurology, Corbeil Essonnes; CHU Bicêtre (D.D.B.), Department of Neurology, Le Kremlin Bicêtre; Department of Neurology (K.H.), Hôpital Pierre Delafontaine, Centre Hospitalier de Saint-Denis; CHU La Milétrie (J.-P.N.), Hôpital Jean Bernard, Department of Neurology, Poitiers; CH de Pontoise (C. Pottier), Hôpital René Dubos, Department of Neurology; and Centre Hospitalier de Versailles (C.N.), Department of Neurology, F-78150 Le Chesnay, France
| | - Marc Debouverie
- From the Service de Neurologie (A.G., F.R., R.C., S.V.), Sclérose en Plaques, Pathologies de La Myéline et Neuro-inflammation, Hôpital Neurologique Pierre-Wertheimer, Hospices Civils de Lyon, Bron; Université de Lyon (A.G., M.R., F.S.), Université Claude Bernard Lyon 1, CNRS, Laboratoire de Biométrie et Biologie Évolutive UMR 5558, Villeurbanne; Service de Biostatistique-Bioinformatique (A.G., M.R., F.S.), Hospices Civils de Lyon; Université de Lyon (F.R., R.C., S.V.), Université Claude Bernard Lyon 1; Observatoire Français de La Sclérose en Plaques (F.R., R.C., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., R.C., S.V.), State-approved Foundation, Bron; Nancy University Hospital (M.D.), Department of Neurology, Université de Lorraine, APEMAC; CHU Pontchaillou (E.L.P.), CIC1414 INSERM, Rennes; CHU de Toulouse (J.C.), Hôpital Pierre-Paul Riquet, Department of Neurology, CRC-SEP, Toulouse; Infinity (J.C.), INSERM UMR1291-CNRS UMR5051, Université Toulouse III; CHU de Strasbourg (J.D.S.), Department of Neurology and Clinical Investigation Center, CIC 1434, INSERM 1434; Univ. Bordeaux (A.R.), F-33000 Bordeaux INSERM U1215, Neurocentre Magendie, F-33000 Bordeaux CHU de Bordeaux, Department of Neurology, CIC Bordeaux CIC1401; Département de Neurologie (E.M.), Hôpital Pitié-Salpêtrière, APHP, Paris; Centre de Ressources et de Compétences SEP Paris (E.M.); CHU de Montpellier (P.L.), MS Unit; University of Montpellier (MUSE) (P.L.); CHU Lille (H.Z.), CRCSEP Lille, Univ Lille, U1172; Fondation Rotschild (C. Papeix), Department of Neurology, Paris; CHU de Caen (G.D.), MS Expert Centre, Department of Neurology, Avenue de La Côte-de-Nacre, Normandy University, Caen; Neurology (C.L.-F.), UR2CA, Centre Hospitalier Universitaire Pasteur2, Université Nice Côte d'Azur, Nice; CHU de Dijon (T.M.), Department of Neurology, EA4184; CHU de Nantes (D.A.L.), Service de Neurologie & CIC015 INSERM; CRTI-Inserm U1064 (D.A.L.), Nantes; CHU de Besançon (E.B.), Service de Neurologie; Sorbonne Universités (B.S.), UPMC Paris 06, Brain and Spine Institute, ICM, Hôpital de La Pitié Salpêtrière, Inserm UMR S 1127, CNRS UMR 7225, and Department of Neurology, AP-HP, Saint-Antoine Hospital; CHU Clermont-Ferrand (Pierre Clavelou), Department of Neurology, F-63000 Clermont-Ferrand Université Clermont Auvergne, Inserm, Neuro-Dol, F-63000 Clermont-Ferrand; Department of Neurology (E.T.), Nimes University Hospital; Institut de Génomique Fonctionnelle (E.T.), UMR5203, INSERM 1191, Univ. Montpellier; Hôpital de Poissy (O.H.), Department of Neurology; Aix Marseille Univ (J.P.), APHM, Hôpital de La Timone, Pôle de Neurosciences Cliniques, Service de Neurologie; CHU d'Amiens (A.A.K.), Department of Neurology; CHU Grenoble Alpes (O.C.), Department of Neurology, La Tronche/Grenoble; CHU de Rouen (B.B.), Department of Neurology; CHU de La Martinique (Philippe Cabre), Department of Neurology, Fort-de-France; APHP (A.W.), Hôpital Henri Mondor, Department of Neurology, Créteil; CHU de Limoges (L.M.), Hôpital Dupuytren, Department of Neurology; CHU de Saint-Étienne (J.-P.C.), Hôpital Nord, Department of Neurology; CHU de Tours (A.M.), Hôpital Bretonneau, CRC SEP and Department of Neurology; CHU de Reims (S.M.), CRC-SEP, Department of Neurology; Hôpital Sud Francilien (N.H.B.), Department of Neurology, Corbeil Essonnes; CHU Bicêtre (D.D.B.), Department of Neurology, Le Kremlin Bicêtre; Department of Neurology (K.H.), Hôpital Pierre Delafontaine, Centre Hospitalier de Saint-Denis; CHU La Milétrie (J.-P.N.), Hôpital Jean Bernard, Department of Neurology, Poitiers; CH de Pontoise (C. Pottier), Hôpital René Dubos, Department of Neurology; and Centre Hospitalier de Versailles (C.N.), Department of Neurology, F-78150 Le Chesnay, France
| | - Emmanuelle Le Page
- From the Service de Neurologie (A.G., F.R., R.C., S.V.), Sclérose en Plaques, Pathologies de La Myéline et Neuro-inflammation, Hôpital Neurologique Pierre-Wertheimer, Hospices Civils de Lyon, Bron; Université de Lyon (A.G., M.R., F.S.), Université Claude Bernard Lyon 1, CNRS, Laboratoire de Biométrie et Biologie Évolutive UMR 5558, Villeurbanne; Service de Biostatistique-Bioinformatique (A.G., M.R., F.S.), Hospices Civils de Lyon; Université de Lyon (F.R., R.C., S.V.), Université Claude Bernard Lyon 1; Observatoire Français de La Sclérose en Plaques (F.R., R.C., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., R.C., S.V.), State-approved Foundation, Bron; Nancy University Hospital (M.D.), Department of Neurology, Université de Lorraine, APEMAC; CHU Pontchaillou (E.L.P.), CIC1414 INSERM, Rennes; CHU de Toulouse (J.C.), Hôpital Pierre-Paul Riquet, Department of Neurology, CRC-SEP, Toulouse; Infinity (J.C.), INSERM UMR1291-CNRS UMR5051, Université Toulouse III; CHU de Strasbourg (J.D.S.), Department of Neurology and Clinical Investigation Center, CIC 1434, INSERM 1434; Univ. Bordeaux (A.R.), F-33000 Bordeaux INSERM U1215, Neurocentre Magendie, F-33000 Bordeaux CHU de Bordeaux, Department of Neurology, CIC Bordeaux CIC1401; Département de Neurologie (E.M.), Hôpital Pitié-Salpêtrière, APHP, Paris; Centre de Ressources et de Compétences SEP Paris (E.M.); CHU de Montpellier (P.L.), MS Unit; University of Montpellier (MUSE) (P.L.); CHU Lille (H.Z.), CRCSEP Lille, Univ Lille, U1172; Fondation Rotschild (C. Papeix), Department of Neurology, Paris; CHU de Caen (G.D.), MS Expert Centre, Department of Neurology, Avenue de La Côte-de-Nacre, Normandy University, Caen; Neurology (C.L.-F.), UR2CA, Centre Hospitalier Universitaire Pasteur2, Université Nice Côte d'Azur, Nice; CHU de Dijon (T.M.), Department of Neurology, EA4184; CHU de Nantes (D.A.L.), Service de Neurologie & CIC015 INSERM; CRTI-Inserm U1064 (D.A.L.), Nantes; CHU de Besançon (E.B.), Service de Neurologie; Sorbonne Universités (B.S.), UPMC Paris 06, Brain and Spine Institute, ICM, Hôpital de La Pitié Salpêtrière, Inserm UMR S 1127, CNRS UMR 7225, and Department of Neurology, AP-HP, Saint-Antoine Hospital; CHU Clermont-Ferrand (Pierre Clavelou), Department of Neurology, F-63000 Clermont-Ferrand Université Clermont Auvergne, Inserm, Neuro-Dol, F-63000 Clermont-Ferrand; Department of Neurology (E.T.), Nimes University Hospital; Institut de Génomique Fonctionnelle (E.T.), UMR5203, INSERM 1191, Univ. Montpellier; Hôpital de Poissy (O.H.), Department of Neurology; Aix Marseille Univ (J.P.), APHM, Hôpital de La Timone, Pôle de Neurosciences Cliniques, Service de Neurologie; CHU d'Amiens (A.A.K.), Department of Neurology; CHU Grenoble Alpes (O.C.), Department of Neurology, La Tronche/Grenoble; CHU de Rouen (B.B.), Department of Neurology; CHU de La Martinique (Philippe Cabre), Department of Neurology, Fort-de-France; APHP (A.W.), Hôpital Henri Mondor, Department of Neurology, Créteil; CHU de Limoges (L.M.), Hôpital Dupuytren, Department of Neurology; CHU de Saint-Étienne (J.-P.C.), Hôpital Nord, Department of Neurology; CHU de Tours (A.M.), Hôpital Bretonneau, CRC SEP and Department of Neurology; CHU de Reims (S.M.), CRC-SEP, Department of Neurology; Hôpital Sud Francilien (N.H.B.), Department of Neurology, Corbeil Essonnes; CHU Bicêtre (D.D.B.), Department of Neurology, Le Kremlin Bicêtre; Department of Neurology (K.H.), Hôpital Pierre Delafontaine, Centre Hospitalier de Saint-Denis; CHU La Milétrie (J.-P.N.), Hôpital Jean Bernard, Department of Neurology, Poitiers; CH de Pontoise (C. Pottier), Hôpital René Dubos, Department of Neurology; and Centre Hospitalier de Versailles (C.N.), Department of Neurology, F-78150 Le Chesnay, France
| | - Jonathan Ciron
- From the Service de Neurologie (A.G., F.R., R.C., S.V.), Sclérose en Plaques, Pathologies de La Myéline et Neuro-inflammation, Hôpital Neurologique Pierre-Wertheimer, Hospices Civils de Lyon, Bron; Université de Lyon (A.G., M.R., F.S.), Université Claude Bernard Lyon 1, CNRS, Laboratoire de Biométrie et Biologie Évolutive UMR 5558, Villeurbanne; Service de Biostatistique-Bioinformatique (A.G., M.R., F.S.), Hospices Civils de Lyon; Université de Lyon (F.R., R.C., S.V.), Université Claude Bernard Lyon 1; Observatoire Français de La Sclérose en Plaques (F.R., R.C., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., R.C., S.V.), State-approved Foundation, Bron; Nancy University Hospital (M.D.), Department of Neurology, Université de Lorraine, APEMAC; CHU Pontchaillou (E.L.P.), CIC1414 INSERM, Rennes; CHU de Toulouse (J.C.), Hôpital Pierre-Paul Riquet, Department of Neurology, CRC-SEP, Toulouse; Infinity (J.C.), INSERM UMR1291-CNRS UMR5051, Université Toulouse III; CHU de Strasbourg (J.D.S.), Department of Neurology and Clinical Investigation Center, CIC 1434, INSERM 1434; Univ. Bordeaux (A.R.), F-33000 Bordeaux INSERM U1215, Neurocentre Magendie, F-33000 Bordeaux CHU de Bordeaux, Department of Neurology, CIC Bordeaux CIC1401; Département de Neurologie (E.M.), Hôpital Pitié-Salpêtrière, APHP, Paris; Centre de Ressources et de Compétences SEP Paris (E.M.); CHU de Montpellier (P.L.), MS Unit; University of Montpellier (MUSE) (P.L.); CHU Lille (H.Z.), CRCSEP Lille, Univ Lille, U1172; Fondation Rotschild (C. Papeix), Department of Neurology, Paris; CHU de Caen (G.D.), MS Expert Centre, Department of Neurology, Avenue de La Côte-de-Nacre, Normandy University, Caen; Neurology (C.L.-F.), UR2CA, Centre Hospitalier Universitaire Pasteur2, Université Nice Côte d'Azur, Nice; CHU de Dijon (T.M.), Department of Neurology, EA4184; CHU de Nantes (D.A.L.), Service de Neurologie & CIC015 INSERM; CRTI-Inserm U1064 (D.A.L.), Nantes; CHU de Besançon (E.B.), Service de Neurologie; Sorbonne Universités (B.S.), UPMC Paris 06, Brain and Spine Institute, ICM, Hôpital de La Pitié Salpêtrière, Inserm UMR S 1127, CNRS UMR 7225, and Department of Neurology, AP-HP, Saint-Antoine Hospital; CHU Clermont-Ferrand (Pierre Clavelou), Department of Neurology, F-63000 Clermont-Ferrand Université Clermont Auvergne, Inserm, Neuro-Dol, F-63000 Clermont-Ferrand; Department of Neurology (E.T.), Nimes University Hospital; Institut de Génomique Fonctionnelle (E.T.), UMR5203, INSERM 1191, Univ. Montpellier; Hôpital de Poissy (O.H.), Department of Neurology; Aix Marseille Univ (J.P.), APHM, Hôpital de La Timone, Pôle de Neurosciences Cliniques, Service de Neurologie; CHU d'Amiens (A.A.K.), Department of Neurology; CHU Grenoble Alpes (O.C.), Department of Neurology, La Tronche/Grenoble; CHU de Rouen (B.B.), Department of Neurology; CHU de La Martinique (Philippe Cabre), Department of Neurology, Fort-de-France; APHP (A.W.), Hôpital Henri Mondor, Department of Neurology, Créteil; CHU de Limoges (L.M.), Hôpital Dupuytren, Department of Neurology; CHU de Saint-Étienne (J.-P.C.), Hôpital Nord, Department of Neurology; CHU de Tours (A.M.), Hôpital Bretonneau, CRC SEP and Department of Neurology; CHU de Reims (S.M.), CRC-SEP, Department of Neurology; Hôpital Sud Francilien (N.H.B.), Department of Neurology, Corbeil Essonnes; CHU Bicêtre (D.D.B.), Department of Neurology, Le Kremlin Bicêtre; Department of Neurology (K.H.), Hôpital Pierre Delafontaine, Centre Hospitalier de Saint-Denis; CHU La Milétrie (J.-P.N.), Hôpital Jean Bernard, Department of Neurology, Poitiers; CH de Pontoise (C. Pottier), Hôpital René Dubos, Department of Neurology; and Centre Hospitalier de Versailles (C.N.), Department of Neurology, F-78150 Le Chesnay, France
| | - Jerome De Seze
- From the Service de Neurologie (A.G., F.R., R.C., S.V.), Sclérose en Plaques, Pathologies de La Myéline et Neuro-inflammation, Hôpital Neurologique Pierre-Wertheimer, Hospices Civils de Lyon, Bron; Université de Lyon (A.G., M.R., F.S.), Université Claude Bernard Lyon 1, CNRS, Laboratoire de Biométrie et Biologie Évolutive UMR 5558, Villeurbanne; Service de Biostatistique-Bioinformatique (A.G., M.R., F.S.), Hospices Civils de Lyon; Université de Lyon (F.R., R.C., S.V.), Université Claude Bernard Lyon 1; Observatoire Français de La Sclérose en Plaques (F.R., R.C., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., R.C., S.V.), State-approved Foundation, Bron; Nancy University Hospital (M.D.), Department of Neurology, Université de Lorraine, APEMAC; CHU Pontchaillou (E.L.P.), CIC1414 INSERM, Rennes; CHU de Toulouse (J.C.), Hôpital Pierre-Paul Riquet, Department of Neurology, CRC-SEP, Toulouse; Infinity (J.C.), INSERM UMR1291-CNRS UMR5051, Université Toulouse III; CHU de Strasbourg (J.D.S.), Department of Neurology and Clinical Investigation Center, CIC 1434, INSERM 1434; Univ. Bordeaux (A.R.), F-33000 Bordeaux INSERM U1215, Neurocentre Magendie, F-33000 Bordeaux CHU de Bordeaux, Department of Neurology, CIC Bordeaux CIC1401; Département de Neurologie (E.M.), Hôpital Pitié-Salpêtrière, APHP, Paris; Centre de Ressources et de Compétences SEP Paris (E.M.); CHU de Montpellier (P.L.), MS Unit; University of Montpellier (MUSE) (P.L.); CHU Lille (H.Z.), CRCSEP Lille, Univ Lille, U1172; Fondation Rotschild (C. Papeix), Department of Neurology, Paris; CHU de Caen (G.D.), MS Expert Centre, Department of Neurology, Avenue de La Côte-de-Nacre, Normandy University, Caen; Neurology (C.L.-F.), UR2CA, Centre Hospitalier Universitaire Pasteur2, Université Nice Côte d'Azur, Nice; CHU de Dijon (T.M.), Department of Neurology, EA4184; CHU de Nantes (D.A.L.), Service de Neurologie & CIC015 INSERM; CRTI-Inserm U1064 (D.A.L.), Nantes; CHU de Besançon (E.B.), Service de Neurologie; Sorbonne Universités (B.S.), UPMC Paris 06, Brain and Spine Institute, ICM, Hôpital de La Pitié Salpêtrière, Inserm UMR S 1127, CNRS UMR 7225, and Department of Neurology, AP-HP, Saint-Antoine Hospital; CHU Clermont-Ferrand (Pierre Clavelou), Department of Neurology, F-63000 Clermont-Ferrand Université Clermont Auvergne, Inserm, Neuro-Dol, F-63000 Clermont-Ferrand; Department of Neurology (E.T.), Nimes University Hospital; Institut de Génomique Fonctionnelle (E.T.), UMR5203, INSERM 1191, Univ. Montpellier; Hôpital de Poissy (O.H.), Department of Neurology; Aix Marseille Univ (J.P.), APHM, Hôpital de La Timone, Pôle de Neurosciences Cliniques, Service de Neurologie; CHU d'Amiens (A.A.K.), Department of Neurology; CHU Grenoble Alpes (O.C.), Department of Neurology, La Tronche/Grenoble; CHU de Rouen (B.B.), Department of Neurology; CHU de La Martinique (Philippe Cabre), Department of Neurology, Fort-de-France; APHP (A.W.), Hôpital Henri Mondor, Department of Neurology, Créteil; CHU de Limoges (L.M.), Hôpital Dupuytren, Department of Neurology; CHU de Saint-Étienne (J.-P.C.), Hôpital Nord, Department of Neurology; CHU de Tours (A.M.), Hôpital Bretonneau, CRC SEP and Department of Neurology; CHU de Reims (S.M.), CRC-SEP, Department of Neurology; Hôpital Sud Francilien (N.H.B.), Department of Neurology, Corbeil Essonnes; CHU Bicêtre (D.D.B.), Department of Neurology, Le Kremlin Bicêtre; Department of Neurology (K.H.), Hôpital Pierre Delafontaine, Centre Hospitalier de Saint-Denis; CHU La Milétrie (J.-P.N.), Hôpital Jean Bernard, Department of Neurology, Poitiers; CH de Pontoise (C. Pottier), Hôpital René Dubos, Department of Neurology; and Centre Hospitalier de Versailles (C.N.), Department of Neurology, F-78150 Le Chesnay, France
| | - Aurélie Ruet
- From the Service de Neurologie (A.G., F.R., R.C., S.V.), Sclérose en Plaques, Pathologies de La Myéline et Neuro-inflammation, Hôpital Neurologique Pierre-Wertheimer, Hospices Civils de Lyon, Bron; Université de Lyon (A.G., M.R., F.S.), Université Claude Bernard Lyon 1, CNRS, Laboratoire de Biométrie et Biologie Évolutive UMR 5558, Villeurbanne; Service de Biostatistique-Bioinformatique (A.G., M.R., F.S.), Hospices Civils de Lyon; Université de Lyon (F.R., R.C., S.V.), Université Claude Bernard Lyon 1; Observatoire Français de La Sclérose en Plaques (F.R., R.C., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., R.C., S.V.), State-approved Foundation, Bron; Nancy University Hospital (M.D.), Department of Neurology, Université de Lorraine, APEMAC; CHU Pontchaillou (E.L.P.), CIC1414 INSERM, Rennes; CHU de Toulouse (J.C.), Hôpital Pierre-Paul Riquet, Department of Neurology, CRC-SEP, Toulouse; Infinity (J.C.), INSERM UMR1291-CNRS UMR5051, Université Toulouse III; CHU de Strasbourg (J.D.S.), Department of Neurology and Clinical Investigation Center, CIC 1434, INSERM 1434; Univ. Bordeaux (A.R.), F-33000 Bordeaux INSERM U1215, Neurocentre Magendie, F-33000 Bordeaux CHU de Bordeaux, Department of Neurology, CIC Bordeaux CIC1401; Département de Neurologie (E.M.), Hôpital Pitié-Salpêtrière, APHP, Paris; Centre de Ressources et de Compétences SEP Paris (E.M.); CHU de Montpellier (P.L.), MS Unit; University of Montpellier (MUSE) (P.L.); CHU Lille (H.Z.), CRCSEP Lille, Univ Lille, U1172; Fondation Rotschild (C. Papeix), Department of Neurology, Paris; CHU de Caen (G.D.), MS Expert Centre, Department of Neurology, Avenue de La Côte-de-Nacre, Normandy University, Caen; Neurology (C.L.-F.), UR2CA, Centre Hospitalier Universitaire Pasteur2, Université Nice Côte d'Azur, Nice; CHU de Dijon (T.M.), Department of Neurology, EA4184; CHU de Nantes (D.A.L.), Service de Neurologie & CIC015 INSERM; CRTI-Inserm U1064 (D.A.L.), Nantes; CHU de Besançon (E.B.), Service de Neurologie; Sorbonne Universités (B.S.), UPMC Paris 06, Brain and Spine Institute, ICM, Hôpital de La Pitié Salpêtrière, Inserm UMR S 1127, CNRS UMR 7225, and Department of Neurology, AP-HP, Saint-Antoine Hospital; CHU Clermont-Ferrand (Pierre Clavelou), Department of Neurology, F-63000 Clermont-Ferrand Université Clermont Auvergne, Inserm, Neuro-Dol, F-63000 Clermont-Ferrand; Department of Neurology (E.T.), Nimes University Hospital; Institut de Génomique Fonctionnelle (E.T.), UMR5203, INSERM 1191, Univ. Montpellier; Hôpital de Poissy (O.H.), Department of Neurology; Aix Marseille Univ (J.P.), APHM, Hôpital de La Timone, Pôle de Neurosciences Cliniques, Service de Neurologie; CHU d'Amiens (A.A.K.), Department of Neurology; CHU Grenoble Alpes (O.C.), Department of Neurology, La Tronche/Grenoble; CHU de Rouen (B.B.), Department of Neurology; CHU de La Martinique (Philippe Cabre), Department of Neurology, Fort-de-France; APHP (A.W.), Hôpital Henri Mondor, Department of Neurology, Créteil; CHU de Limoges (L.M.), Hôpital Dupuytren, Department of Neurology; CHU de Saint-Étienne (J.-P.C.), Hôpital Nord, Department of Neurology; CHU de Tours (A.M.), Hôpital Bretonneau, CRC SEP and Department of Neurology; CHU de Reims (S.M.), CRC-SEP, Department of Neurology; Hôpital Sud Francilien (N.H.B.), Department of Neurology, Corbeil Essonnes; CHU Bicêtre (D.D.B.), Department of Neurology, Le Kremlin Bicêtre; Department of Neurology (K.H.), Hôpital Pierre Delafontaine, Centre Hospitalier de Saint-Denis; CHU La Milétrie (J.-P.N.), Hôpital Jean Bernard, Department of Neurology, Poitiers; CH de Pontoise (C. Pottier), Hôpital René Dubos, Department of Neurology; and Centre Hospitalier de Versailles (C.N.), Department of Neurology, F-78150 Le Chesnay, France
| | - Elisabeth Maillart
- From the Service de Neurologie (A.G., F.R., R.C., S.V.), Sclérose en Plaques, Pathologies de La Myéline et Neuro-inflammation, Hôpital Neurologique Pierre-Wertheimer, Hospices Civils de Lyon, Bron; Université de Lyon (A.G., M.R., F.S.), Université Claude Bernard Lyon 1, CNRS, Laboratoire de Biométrie et Biologie Évolutive UMR 5558, Villeurbanne; Service de Biostatistique-Bioinformatique (A.G., M.R., F.S.), Hospices Civils de Lyon; Université de Lyon (F.R., R.C., S.V.), Université Claude Bernard Lyon 1; Observatoire Français de La Sclérose en Plaques (F.R., R.C., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., R.C., S.V.), State-approved Foundation, Bron; Nancy University Hospital (M.D.), Department of Neurology, Université de Lorraine, APEMAC; CHU Pontchaillou (E.L.P.), CIC1414 INSERM, Rennes; CHU de Toulouse (J.C.), Hôpital Pierre-Paul Riquet, Department of Neurology, CRC-SEP, Toulouse; Infinity (J.C.), INSERM UMR1291-CNRS UMR5051, Université Toulouse III; CHU de Strasbourg (J.D.S.), Department of Neurology and Clinical Investigation Center, CIC 1434, INSERM 1434; Univ. Bordeaux (A.R.), F-33000 Bordeaux INSERM U1215, Neurocentre Magendie, F-33000 Bordeaux CHU de Bordeaux, Department of Neurology, CIC Bordeaux CIC1401; Département de Neurologie (E.M.), Hôpital Pitié-Salpêtrière, APHP, Paris; Centre de Ressources et de Compétences SEP Paris (E.M.); CHU de Montpellier (P.L.), MS Unit; University of Montpellier (MUSE) (P.L.); CHU Lille (H.Z.), CRCSEP Lille, Univ Lille, U1172; Fondation Rotschild (C. Papeix), Department of Neurology, Paris; CHU de Caen (G.D.), MS Expert Centre, Department of Neurology, Avenue de La Côte-de-Nacre, Normandy University, Caen; Neurology (C.L.-F.), UR2CA, Centre Hospitalier Universitaire Pasteur2, Université Nice Côte d'Azur, Nice; CHU de Dijon (T.M.), Department of Neurology, EA4184; CHU de Nantes (D.A.L.), Service de Neurologie & CIC015 INSERM; CRTI-Inserm U1064 (D.A.L.), Nantes; CHU de Besançon (E.B.), Service de Neurologie; Sorbonne Universités (B.S.), UPMC Paris 06, Brain and Spine Institute, ICM, Hôpital de La Pitié Salpêtrière, Inserm UMR S 1127, CNRS UMR 7225, and Department of Neurology, AP-HP, Saint-Antoine Hospital; CHU Clermont-Ferrand (Pierre Clavelou), Department of Neurology, F-63000 Clermont-Ferrand Université Clermont Auvergne, Inserm, Neuro-Dol, F-63000 Clermont-Ferrand; Department of Neurology (E.T.), Nimes University Hospital; Institut de Génomique Fonctionnelle (E.T.), UMR5203, INSERM 1191, Univ. Montpellier; Hôpital de Poissy (O.H.), Department of Neurology; Aix Marseille Univ (J.P.), APHM, Hôpital de La Timone, Pôle de Neurosciences Cliniques, Service de Neurologie; CHU d'Amiens (A.A.K.), Department of Neurology; CHU Grenoble Alpes (O.C.), Department of Neurology, La Tronche/Grenoble; CHU de Rouen (B.B.), Department of Neurology; CHU de La Martinique (Philippe Cabre), Department of Neurology, Fort-de-France; APHP (A.W.), Hôpital Henri Mondor, Department of Neurology, Créteil; CHU de Limoges (L.M.), Hôpital Dupuytren, Department of Neurology; CHU de Saint-Étienne (J.-P.C.), Hôpital Nord, Department of Neurology; CHU de Tours (A.M.), Hôpital Bretonneau, CRC SEP and Department of Neurology; CHU de Reims (S.M.), CRC-SEP, Department of Neurology; Hôpital Sud Francilien (N.H.B.), Department of Neurology, Corbeil Essonnes; CHU Bicêtre (D.D.B.), Department of Neurology, Le Kremlin Bicêtre; Department of Neurology (K.H.), Hôpital Pierre Delafontaine, Centre Hospitalier de Saint-Denis; CHU La Milétrie (J.-P.N.), Hôpital Jean Bernard, Department of Neurology, Poitiers; CH de Pontoise (C. Pottier), Hôpital René Dubos, Department of Neurology; and Centre Hospitalier de Versailles (C.N.), Department of Neurology, F-78150 Le Chesnay, France
| | - Pierre Labauge
- From the Service de Neurologie (A.G., F.R., R.C., S.V.), Sclérose en Plaques, Pathologies de La Myéline et Neuro-inflammation, Hôpital Neurologique Pierre-Wertheimer, Hospices Civils de Lyon, Bron; Université de Lyon (A.G., M.R., F.S.), Université Claude Bernard Lyon 1, CNRS, Laboratoire de Biométrie et Biologie Évolutive UMR 5558, Villeurbanne; Service de Biostatistique-Bioinformatique (A.G., M.R., F.S.), Hospices Civils de Lyon; Université de Lyon (F.R., R.C., S.V.), Université Claude Bernard Lyon 1; Observatoire Français de La Sclérose en Plaques (F.R., R.C., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., R.C., S.V.), State-approved Foundation, Bron; Nancy University Hospital (M.D.), Department of Neurology, Université de Lorraine, APEMAC; CHU Pontchaillou (E.L.P.), CIC1414 INSERM, Rennes; CHU de Toulouse (J.C.), Hôpital Pierre-Paul Riquet, Department of Neurology, CRC-SEP, Toulouse; Infinity (J.C.), INSERM UMR1291-CNRS UMR5051, Université Toulouse III; CHU de Strasbourg (J.D.S.), Department of Neurology and Clinical Investigation Center, CIC 1434, INSERM 1434; Univ. Bordeaux (A.R.), F-33000 Bordeaux INSERM U1215, Neurocentre Magendie, F-33000 Bordeaux CHU de Bordeaux, Department of Neurology, CIC Bordeaux CIC1401; Département de Neurologie (E.M.), Hôpital Pitié-Salpêtrière, APHP, Paris; Centre de Ressources et de Compétences SEP Paris (E.M.); CHU de Montpellier (P.L.), MS Unit; University of Montpellier (MUSE) (P.L.); CHU Lille (H.Z.), CRCSEP Lille, Univ Lille, U1172; Fondation Rotschild (C. Papeix), Department of Neurology, Paris; CHU de Caen (G.D.), MS Expert Centre, Department of Neurology, Avenue de La Côte-de-Nacre, Normandy University, Caen; Neurology (C.L.-F.), UR2CA, Centre Hospitalier Universitaire Pasteur2, Université Nice Côte d'Azur, Nice; CHU de Dijon (T.M.), Department of Neurology, EA4184; CHU de Nantes (D.A.L.), Service de Neurologie & CIC015 INSERM; CRTI-Inserm U1064 (D.A.L.), Nantes; CHU de Besançon (E.B.), Service de Neurologie; Sorbonne Universités (B.S.), UPMC Paris 06, Brain and Spine Institute, ICM, Hôpital de La Pitié Salpêtrière, Inserm UMR S 1127, CNRS UMR 7225, and Department of Neurology, AP-HP, Saint-Antoine Hospital; CHU Clermont-Ferrand (Pierre Clavelou), Department of Neurology, F-63000 Clermont-Ferrand Université Clermont Auvergne, Inserm, Neuro-Dol, F-63000 Clermont-Ferrand; Department of Neurology (E.T.), Nimes University Hospital; Institut de Génomique Fonctionnelle (E.T.), UMR5203, INSERM 1191, Univ. Montpellier; Hôpital de Poissy (O.H.), Department of Neurology; Aix Marseille Univ (J.P.), APHM, Hôpital de La Timone, Pôle de Neurosciences Cliniques, Service de Neurologie; CHU d'Amiens (A.A.K.), Department of Neurology; CHU Grenoble Alpes (O.C.), Department of Neurology, La Tronche/Grenoble; CHU de Rouen (B.B.), Department of Neurology; CHU de La Martinique (Philippe Cabre), Department of Neurology, Fort-de-France; APHP (A.W.), Hôpital Henri Mondor, Department of Neurology, Créteil; CHU de Limoges (L.M.), Hôpital Dupuytren, Department of Neurology; CHU de Saint-Étienne (J.-P.C.), Hôpital Nord, Department of Neurology; CHU de Tours (A.M.), Hôpital Bretonneau, CRC SEP and Department of Neurology; CHU de Reims (S.M.), CRC-SEP, Department of Neurology; Hôpital Sud Francilien (N.H.B.), Department of Neurology, Corbeil Essonnes; CHU Bicêtre (D.D.B.), Department of Neurology, Le Kremlin Bicêtre; Department of Neurology (K.H.), Hôpital Pierre Delafontaine, Centre Hospitalier de Saint-Denis; CHU La Milétrie (J.-P.N.), Hôpital Jean Bernard, Department of Neurology, Poitiers; CH de Pontoise (C. Pottier), Hôpital René Dubos, Department of Neurology; and Centre Hospitalier de Versailles (C.N.), Department of Neurology, F-78150 Le Chesnay, France
| | - Helene Zephir
- From the Service de Neurologie (A.G., F.R., R.C., S.V.), Sclérose en Plaques, Pathologies de La Myéline et Neuro-inflammation, Hôpital Neurologique Pierre-Wertheimer, Hospices Civils de Lyon, Bron; Université de Lyon (A.G., M.R., F.S.), Université Claude Bernard Lyon 1, CNRS, Laboratoire de Biométrie et Biologie Évolutive UMR 5558, Villeurbanne; Service de Biostatistique-Bioinformatique (A.G., M.R., F.S.), Hospices Civils de Lyon; Université de Lyon (F.R., R.C., S.V.), Université Claude Bernard Lyon 1; Observatoire Français de La Sclérose en Plaques (F.R., R.C., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., R.C., S.V.), State-approved Foundation, Bron; Nancy University Hospital (M.D.), Department of Neurology, Université de Lorraine, APEMAC; CHU Pontchaillou (E.L.P.), CIC1414 INSERM, Rennes; CHU de Toulouse (J.C.), Hôpital Pierre-Paul Riquet, Department of Neurology, CRC-SEP, Toulouse; Infinity (J.C.), INSERM UMR1291-CNRS UMR5051, Université Toulouse III; CHU de Strasbourg (J.D.S.), Department of Neurology and Clinical Investigation Center, CIC 1434, INSERM 1434; Univ. Bordeaux (A.R.), F-33000 Bordeaux INSERM U1215, Neurocentre Magendie, F-33000 Bordeaux CHU de Bordeaux, Department of Neurology, CIC Bordeaux CIC1401; Département de Neurologie (E.M.), Hôpital Pitié-Salpêtrière, APHP, Paris; Centre de Ressources et de Compétences SEP Paris (E.M.); CHU de Montpellier (P.L.), MS Unit; University of Montpellier (MUSE) (P.L.); CHU Lille (H.Z.), CRCSEP Lille, Univ Lille, U1172; Fondation Rotschild (C. Papeix), Department of Neurology, Paris; CHU de Caen (G.D.), MS Expert Centre, Department of Neurology, Avenue de La Côte-de-Nacre, Normandy University, Caen; Neurology (C.L.-F.), UR2CA, Centre Hospitalier Universitaire Pasteur2, Université Nice Côte d'Azur, Nice; CHU de Dijon (T.M.), Department of Neurology, EA4184; CHU de Nantes (D.A.L.), Service de Neurologie & CIC015 INSERM; CRTI-Inserm U1064 (D.A.L.), Nantes; CHU de Besançon (E.B.), Service de Neurologie; Sorbonne Universités (B.S.), UPMC Paris 06, Brain and Spine Institute, ICM, Hôpital de La Pitié Salpêtrière, Inserm UMR S 1127, CNRS UMR 7225, and Department of Neurology, AP-HP, Saint-Antoine Hospital; CHU Clermont-Ferrand (Pierre Clavelou), Department of Neurology, F-63000 Clermont-Ferrand Université Clermont Auvergne, Inserm, Neuro-Dol, F-63000 Clermont-Ferrand; Department of Neurology (E.T.), Nimes University Hospital; Institut de Génomique Fonctionnelle (E.T.), UMR5203, INSERM 1191, Univ. Montpellier; Hôpital de Poissy (O.H.), Department of Neurology; Aix Marseille Univ (J.P.), APHM, Hôpital de La Timone, Pôle de Neurosciences Cliniques, Service de Neurologie; CHU d'Amiens (A.A.K.), Department of Neurology; CHU Grenoble Alpes (O.C.), Department of Neurology, La Tronche/Grenoble; CHU de Rouen (B.B.), Department of Neurology; CHU de La Martinique (Philippe Cabre), Department of Neurology, Fort-de-France; APHP (A.W.), Hôpital Henri Mondor, Department of Neurology, Créteil; CHU de Limoges (L.M.), Hôpital Dupuytren, Department of Neurology; CHU de Saint-Étienne (J.-P.C.), Hôpital Nord, Department of Neurology; CHU de Tours (A.M.), Hôpital Bretonneau, CRC SEP and Department of Neurology; CHU de Reims (S.M.), CRC-SEP, Department of Neurology; Hôpital Sud Francilien (N.H.B.), Department of Neurology, Corbeil Essonnes; CHU Bicêtre (D.D.B.), Department of Neurology, Le Kremlin Bicêtre; Department of Neurology (K.H.), Hôpital Pierre Delafontaine, Centre Hospitalier de Saint-Denis; CHU La Milétrie (J.-P.N.), Hôpital Jean Bernard, Department of Neurology, Poitiers; CH de Pontoise (C. Pottier), Hôpital René Dubos, Department of Neurology; and Centre Hospitalier de Versailles (C.N.), Department of Neurology, F-78150 Le Chesnay, France
| | - Caroline Papeix
- From the Service de Neurologie (A.G., F.R., R.C., S.V.), Sclérose en Plaques, Pathologies de La Myéline et Neuro-inflammation, Hôpital Neurologique Pierre-Wertheimer, Hospices Civils de Lyon, Bron; Université de Lyon (A.G., M.R., F.S.), Université Claude Bernard Lyon 1, CNRS, Laboratoire de Biométrie et Biologie Évolutive UMR 5558, Villeurbanne; Service de Biostatistique-Bioinformatique (A.G., M.R., F.S.), Hospices Civils de Lyon; Université de Lyon (F.R., R.C., S.V.), Université Claude Bernard Lyon 1; Observatoire Français de La Sclérose en Plaques (F.R., R.C., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., R.C., S.V.), State-approved Foundation, Bron; Nancy University Hospital (M.D.), Department of Neurology, Université de Lorraine, APEMAC; CHU Pontchaillou (E.L.P.), CIC1414 INSERM, Rennes; CHU de Toulouse (J.C.), Hôpital Pierre-Paul Riquet, Department of Neurology, CRC-SEP, Toulouse; Infinity (J.C.), INSERM UMR1291-CNRS UMR5051, Université Toulouse III; CHU de Strasbourg (J.D.S.), Department of Neurology and Clinical Investigation Center, CIC 1434, INSERM 1434; Univ. Bordeaux (A.R.), F-33000 Bordeaux INSERM U1215, Neurocentre Magendie, F-33000 Bordeaux CHU de Bordeaux, Department of Neurology, CIC Bordeaux CIC1401; Département de Neurologie (E.M.), Hôpital Pitié-Salpêtrière, APHP, Paris; Centre de Ressources et de Compétences SEP Paris (E.M.); CHU de Montpellier (P.L.), MS Unit; University of Montpellier (MUSE) (P.L.); CHU Lille (H.Z.), CRCSEP Lille, Univ Lille, U1172; Fondation Rotschild (C. Papeix), Department of Neurology, Paris; CHU de Caen (G.D.), MS Expert Centre, Department of Neurology, Avenue de La Côte-de-Nacre, Normandy University, Caen; Neurology (C.L.-F.), UR2CA, Centre Hospitalier Universitaire Pasteur2, Université Nice Côte d'Azur, Nice; CHU de Dijon (T.M.), Department of Neurology, EA4184; CHU de Nantes (D.A.L.), Service de Neurologie & CIC015 INSERM; CRTI-Inserm U1064 (D.A.L.), Nantes; CHU de Besançon (E.B.), Service de Neurologie; Sorbonne Universités (B.S.), UPMC Paris 06, Brain and Spine Institute, ICM, Hôpital de La Pitié Salpêtrière, Inserm UMR S 1127, CNRS UMR 7225, and Department of Neurology, AP-HP, Saint-Antoine Hospital; CHU Clermont-Ferrand (Pierre Clavelou), Department of Neurology, F-63000 Clermont-Ferrand Université Clermont Auvergne, Inserm, Neuro-Dol, F-63000 Clermont-Ferrand; Department of Neurology (E.T.), Nimes University Hospital; Institut de Génomique Fonctionnelle (E.T.), UMR5203, INSERM 1191, Univ. Montpellier; Hôpital de Poissy (O.H.), Department of Neurology; Aix Marseille Univ (J.P.), APHM, Hôpital de La Timone, Pôle de Neurosciences Cliniques, Service de Neurologie; CHU d'Amiens (A.A.K.), Department of Neurology; CHU Grenoble Alpes (O.C.), Department of Neurology, La Tronche/Grenoble; CHU de Rouen (B.B.), Department of Neurology; CHU de La Martinique (Philippe Cabre), Department of Neurology, Fort-de-France; APHP (A.W.), Hôpital Henri Mondor, Department of Neurology, Créteil; CHU de Limoges (L.M.), Hôpital Dupuytren, Department of Neurology; CHU de Saint-Étienne (J.-P.C.), Hôpital Nord, Department of Neurology; CHU de Tours (A.M.), Hôpital Bretonneau, CRC SEP and Department of Neurology; CHU de Reims (S.M.), CRC-SEP, Department of Neurology; Hôpital Sud Francilien (N.H.B.), Department of Neurology, Corbeil Essonnes; CHU Bicêtre (D.D.B.), Department of Neurology, Le Kremlin Bicêtre; Department of Neurology (K.H.), Hôpital Pierre Delafontaine, Centre Hospitalier de Saint-Denis; CHU La Milétrie (J.-P.N.), Hôpital Jean Bernard, Department of Neurology, Poitiers; CH de Pontoise (C. Pottier), Hôpital René Dubos, Department of Neurology; and Centre Hospitalier de Versailles (C.N.), Department of Neurology, F-78150 Le Chesnay, France
| | - Gilles Defer
- From the Service de Neurologie (A.G., F.R., R.C., S.V.), Sclérose en Plaques, Pathologies de La Myéline et Neuro-inflammation, Hôpital Neurologique Pierre-Wertheimer, Hospices Civils de Lyon, Bron; Université de Lyon (A.G., M.R., F.S.), Université Claude Bernard Lyon 1, CNRS, Laboratoire de Biométrie et Biologie Évolutive UMR 5558, Villeurbanne; Service de Biostatistique-Bioinformatique (A.G., M.R., F.S.), Hospices Civils de Lyon; Université de Lyon (F.R., R.C., S.V.), Université Claude Bernard Lyon 1; Observatoire Français de La Sclérose en Plaques (F.R., R.C., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., R.C., S.V.), State-approved Foundation, Bron; Nancy University Hospital (M.D.), Department of Neurology, Université de Lorraine, APEMAC; CHU Pontchaillou (E.L.P.), CIC1414 INSERM, Rennes; CHU de Toulouse (J.C.), Hôpital Pierre-Paul Riquet, Department of Neurology, CRC-SEP, Toulouse; Infinity (J.C.), INSERM UMR1291-CNRS UMR5051, Université Toulouse III; CHU de Strasbourg (J.D.S.), Department of Neurology and Clinical Investigation Center, CIC 1434, INSERM 1434; Univ. Bordeaux (A.R.), F-33000 Bordeaux INSERM U1215, Neurocentre Magendie, F-33000 Bordeaux CHU de Bordeaux, Department of Neurology, CIC Bordeaux CIC1401; Département de Neurologie (E.M.), Hôpital Pitié-Salpêtrière, APHP, Paris; Centre de Ressources et de Compétences SEP Paris (E.M.); CHU de Montpellier (P.L.), MS Unit; University of Montpellier (MUSE) (P.L.); CHU Lille (H.Z.), CRCSEP Lille, Univ Lille, U1172; Fondation Rotschild (C. Papeix), Department of Neurology, Paris; CHU de Caen (G.D.), MS Expert Centre, Department of Neurology, Avenue de La Côte-de-Nacre, Normandy University, Caen; Neurology (C.L.-F.), UR2CA, Centre Hospitalier Universitaire Pasteur2, Université Nice Côte d'Azur, Nice; CHU de Dijon (T.M.), Department of Neurology, EA4184; CHU de Nantes (D.A.L.), Service de Neurologie & CIC015 INSERM; CRTI-Inserm U1064 (D.A.L.), Nantes; CHU de Besançon (E.B.), Service de Neurologie; Sorbonne Universités (B.S.), UPMC Paris 06, Brain and Spine Institute, ICM, Hôpital de La Pitié Salpêtrière, Inserm UMR S 1127, CNRS UMR 7225, and Department of Neurology, AP-HP, Saint-Antoine Hospital; CHU Clermont-Ferrand (Pierre Clavelou), Department of Neurology, F-63000 Clermont-Ferrand Université Clermont Auvergne, Inserm, Neuro-Dol, F-63000 Clermont-Ferrand; Department of Neurology (E.T.), Nimes University Hospital; Institut de Génomique Fonctionnelle (E.T.), UMR5203, INSERM 1191, Univ. Montpellier; Hôpital de Poissy (O.H.), Department of Neurology; Aix Marseille Univ (J.P.), APHM, Hôpital de La Timone, Pôle de Neurosciences Cliniques, Service de Neurologie; CHU d'Amiens (A.A.K.), Department of Neurology; CHU Grenoble Alpes (O.C.), Department of Neurology, La Tronche/Grenoble; CHU de Rouen (B.B.), Department of Neurology; CHU de La Martinique (Philippe Cabre), Department of Neurology, Fort-de-France; APHP (A.W.), Hôpital Henri Mondor, Department of Neurology, Créteil; CHU de Limoges (L.M.), Hôpital Dupuytren, Department of Neurology; CHU de Saint-Étienne (J.-P.C.), Hôpital Nord, Department of Neurology; CHU de Tours (A.M.), Hôpital Bretonneau, CRC SEP and Department of Neurology; CHU de Reims (S.M.), CRC-SEP, Department of Neurology; Hôpital Sud Francilien (N.H.B.), Department of Neurology, Corbeil Essonnes; CHU Bicêtre (D.D.B.), Department of Neurology, Le Kremlin Bicêtre; Department of Neurology (K.H.), Hôpital Pierre Delafontaine, Centre Hospitalier de Saint-Denis; CHU La Milétrie (J.-P.N.), Hôpital Jean Bernard, Department of Neurology, Poitiers; CH de Pontoise (C. Pottier), Hôpital René Dubos, Department of Neurology; and Centre Hospitalier de Versailles (C.N.), Department of Neurology, F-78150 Le Chesnay, France
| | - Christine Lebrun-Frenay
- From the Service de Neurologie (A.G., F.R., R.C., S.V.), Sclérose en Plaques, Pathologies de La Myéline et Neuro-inflammation, Hôpital Neurologique Pierre-Wertheimer, Hospices Civils de Lyon, Bron; Université de Lyon (A.G., M.R., F.S.), Université Claude Bernard Lyon 1, CNRS, Laboratoire de Biométrie et Biologie Évolutive UMR 5558, Villeurbanne; Service de Biostatistique-Bioinformatique (A.G., M.R., F.S.), Hospices Civils de Lyon; Université de Lyon (F.R., R.C., S.V.), Université Claude Bernard Lyon 1; Observatoire Français de La Sclérose en Plaques (F.R., R.C., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., R.C., S.V.), State-approved Foundation, Bron; Nancy University Hospital (M.D.), Department of Neurology, Université de Lorraine, APEMAC; CHU Pontchaillou (E.L.P.), CIC1414 INSERM, Rennes; CHU de Toulouse (J.C.), Hôpital Pierre-Paul Riquet, Department of Neurology, CRC-SEP, Toulouse; Infinity (J.C.), INSERM UMR1291-CNRS UMR5051, Université Toulouse III; CHU de Strasbourg (J.D.S.), Department of Neurology and Clinical Investigation Center, CIC 1434, INSERM 1434; Univ. Bordeaux (A.R.), F-33000 Bordeaux INSERM U1215, Neurocentre Magendie, F-33000 Bordeaux CHU de Bordeaux, Department of Neurology, CIC Bordeaux CIC1401; Département de Neurologie (E.M.), Hôpital Pitié-Salpêtrière, APHP, Paris; Centre de Ressources et de Compétences SEP Paris (E.M.); CHU de Montpellier (P.L.), MS Unit; University of Montpellier (MUSE) (P.L.); CHU Lille (H.Z.), CRCSEP Lille, Univ Lille, U1172; Fondation Rotschild (C. Papeix), Department of Neurology, Paris; CHU de Caen (G.D.), MS Expert Centre, Department of Neurology, Avenue de La Côte-de-Nacre, Normandy University, Caen; Neurology (C.L.-F.), UR2CA, Centre Hospitalier Universitaire Pasteur2, Université Nice Côte d'Azur, Nice; CHU de Dijon (T.M.), Department of Neurology, EA4184; CHU de Nantes (D.A.L.), Service de Neurologie & CIC015 INSERM; CRTI-Inserm U1064 (D.A.L.), Nantes; CHU de Besançon (E.B.), Service de Neurologie; Sorbonne Universités (B.S.), UPMC Paris 06, Brain and Spine Institute, ICM, Hôpital de La Pitié Salpêtrière, Inserm UMR S 1127, CNRS UMR 7225, and Department of Neurology, AP-HP, Saint-Antoine Hospital; CHU Clermont-Ferrand (Pierre Clavelou), Department of Neurology, F-63000 Clermont-Ferrand Université Clermont Auvergne, Inserm, Neuro-Dol, F-63000 Clermont-Ferrand; Department of Neurology (E.T.), Nimes University Hospital; Institut de Génomique Fonctionnelle (E.T.), UMR5203, INSERM 1191, Univ. Montpellier; Hôpital de Poissy (O.H.), Department of Neurology; Aix Marseille Univ (J.P.), APHM, Hôpital de La Timone, Pôle de Neurosciences Cliniques, Service de Neurologie; CHU d'Amiens (A.A.K.), Department of Neurology; CHU Grenoble Alpes (O.C.), Department of Neurology, La Tronche/Grenoble; CHU de Rouen (B.B.), Department of Neurology; CHU de La Martinique (Philippe Cabre), Department of Neurology, Fort-de-France; APHP (A.W.), Hôpital Henri Mondor, Department of Neurology, Créteil; CHU de Limoges (L.M.), Hôpital Dupuytren, Department of Neurology; CHU de Saint-Étienne (J.-P.C.), Hôpital Nord, Department of Neurology; CHU de Tours (A.M.), Hôpital Bretonneau, CRC SEP and Department of Neurology; CHU de Reims (S.M.), CRC-SEP, Department of Neurology; Hôpital Sud Francilien (N.H.B.), Department of Neurology, Corbeil Essonnes; CHU Bicêtre (D.D.B.), Department of Neurology, Le Kremlin Bicêtre; Department of Neurology (K.H.), Hôpital Pierre Delafontaine, Centre Hospitalier de Saint-Denis; CHU La Milétrie (J.-P.N.), Hôpital Jean Bernard, Department of Neurology, Poitiers; CH de Pontoise (C. Pottier), Hôpital René Dubos, Department of Neurology; and Centre Hospitalier de Versailles (C.N.), Department of Neurology, F-78150 Le Chesnay, France
| | - Thibault Moreau
- From the Service de Neurologie (A.G., F.R., R.C., S.V.), Sclérose en Plaques, Pathologies de La Myéline et Neuro-inflammation, Hôpital Neurologique Pierre-Wertheimer, Hospices Civils de Lyon, Bron; Université de Lyon (A.G., M.R., F.S.), Université Claude Bernard Lyon 1, CNRS, Laboratoire de Biométrie et Biologie Évolutive UMR 5558, Villeurbanne; Service de Biostatistique-Bioinformatique (A.G., M.R., F.S.), Hospices Civils de Lyon; Université de Lyon (F.R., R.C., S.V.), Université Claude Bernard Lyon 1; Observatoire Français de La Sclérose en Plaques (F.R., R.C., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., R.C., S.V.), State-approved Foundation, Bron; Nancy University Hospital (M.D.), Department of Neurology, Université de Lorraine, APEMAC; CHU Pontchaillou (E.L.P.), CIC1414 INSERM, Rennes; CHU de Toulouse (J.C.), Hôpital Pierre-Paul Riquet, Department of Neurology, CRC-SEP, Toulouse; Infinity (J.C.), INSERM UMR1291-CNRS UMR5051, Université Toulouse III; CHU de Strasbourg (J.D.S.), Department of Neurology and Clinical Investigation Center, CIC 1434, INSERM 1434; Univ. Bordeaux (A.R.), F-33000 Bordeaux INSERM U1215, Neurocentre Magendie, F-33000 Bordeaux CHU de Bordeaux, Department of Neurology, CIC Bordeaux CIC1401; Département de Neurologie (E.M.), Hôpital Pitié-Salpêtrière, APHP, Paris; Centre de Ressources et de Compétences SEP Paris (E.M.); CHU de Montpellier (P.L.), MS Unit; University of Montpellier (MUSE) (P.L.); CHU Lille (H.Z.), CRCSEP Lille, Univ Lille, U1172; Fondation Rotschild (C. Papeix), Department of Neurology, Paris; CHU de Caen (G.D.), MS Expert Centre, Department of Neurology, Avenue de La Côte-de-Nacre, Normandy University, Caen; Neurology (C.L.-F.), UR2CA, Centre Hospitalier Universitaire Pasteur2, Université Nice Côte d'Azur, Nice; CHU de Dijon (T.M.), Department of Neurology, EA4184; CHU de Nantes (D.A.L.), Service de Neurologie & CIC015 INSERM; CRTI-Inserm U1064 (D.A.L.), Nantes; CHU de Besançon (E.B.), Service de Neurologie; Sorbonne Universités (B.S.), UPMC Paris 06, Brain and Spine Institute, ICM, Hôpital de La Pitié Salpêtrière, Inserm UMR S 1127, CNRS UMR 7225, and Department of Neurology, AP-HP, Saint-Antoine Hospital; CHU Clermont-Ferrand (Pierre Clavelou), Department of Neurology, F-63000 Clermont-Ferrand Université Clermont Auvergne, Inserm, Neuro-Dol, F-63000 Clermont-Ferrand; Department of Neurology (E.T.), Nimes University Hospital; Institut de Génomique Fonctionnelle (E.T.), UMR5203, INSERM 1191, Univ. Montpellier; Hôpital de Poissy (O.H.), Department of Neurology; Aix Marseille Univ (J.P.), APHM, Hôpital de La Timone, Pôle de Neurosciences Cliniques, Service de Neurologie; CHU d'Amiens (A.A.K.), Department of Neurology; CHU Grenoble Alpes (O.C.), Department of Neurology, La Tronche/Grenoble; CHU de Rouen (B.B.), Department of Neurology; CHU de La Martinique (Philippe Cabre), Department of Neurology, Fort-de-France; APHP (A.W.), Hôpital Henri Mondor, Department of Neurology, Créteil; CHU de Limoges (L.M.), Hôpital Dupuytren, Department of Neurology; CHU de Saint-Étienne (J.-P.C.), Hôpital Nord, Department of Neurology; CHU de Tours (A.M.), Hôpital Bretonneau, CRC SEP and Department of Neurology; CHU de Reims (S.M.), CRC-SEP, Department of Neurology; Hôpital Sud Francilien (N.H.B.), Department of Neurology, Corbeil Essonnes; CHU Bicêtre (D.D.B.), Department of Neurology, Le Kremlin Bicêtre; Department of Neurology (K.H.), Hôpital Pierre Delafontaine, Centre Hospitalier de Saint-Denis; CHU La Milétrie (J.-P.N.), Hôpital Jean Bernard, Department of Neurology, Poitiers; CH de Pontoise (C. Pottier), Hôpital René Dubos, Department of Neurology; and Centre Hospitalier de Versailles (C.N.), Department of Neurology, F-78150 Le Chesnay, France
| | - David Axel Laplaud
- From the Service de Neurologie (A.G., F.R., R.C., S.V.), Sclérose en Plaques, Pathologies de La Myéline et Neuro-inflammation, Hôpital Neurologique Pierre-Wertheimer, Hospices Civils de Lyon, Bron; Université de Lyon (A.G., M.R., F.S.), Université Claude Bernard Lyon 1, CNRS, Laboratoire de Biométrie et Biologie Évolutive UMR 5558, Villeurbanne; Service de Biostatistique-Bioinformatique (A.G., M.R., F.S.), Hospices Civils de Lyon; Université de Lyon (F.R., R.C., S.V.), Université Claude Bernard Lyon 1; Observatoire Français de La Sclérose en Plaques (F.R., R.C., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., R.C., S.V.), State-approved Foundation, Bron; Nancy University Hospital (M.D.), Department of Neurology, Université de Lorraine, APEMAC; CHU Pontchaillou (E.L.P.), CIC1414 INSERM, Rennes; CHU de Toulouse (J.C.), Hôpital Pierre-Paul Riquet, Department of Neurology, CRC-SEP, Toulouse; Infinity (J.C.), INSERM UMR1291-CNRS UMR5051, Université Toulouse III; CHU de Strasbourg (J.D.S.), Department of Neurology and Clinical Investigation Center, CIC 1434, INSERM 1434; Univ. Bordeaux (A.R.), F-33000 Bordeaux INSERM U1215, Neurocentre Magendie, F-33000 Bordeaux CHU de Bordeaux, Department of Neurology, CIC Bordeaux CIC1401; Département de Neurologie (E.M.), Hôpital Pitié-Salpêtrière, APHP, Paris; Centre de Ressources et de Compétences SEP Paris (E.M.); CHU de Montpellier (P.L.), MS Unit; University of Montpellier (MUSE) (P.L.); CHU Lille (H.Z.), CRCSEP Lille, Univ Lille, U1172; Fondation Rotschild (C. Papeix), Department of Neurology, Paris; CHU de Caen (G.D.), MS Expert Centre, Department of Neurology, Avenue de La Côte-de-Nacre, Normandy University, Caen; Neurology (C.L.-F.), UR2CA, Centre Hospitalier Universitaire Pasteur2, Université Nice Côte d'Azur, Nice; CHU de Dijon (T.M.), Department of Neurology, EA4184; CHU de Nantes (D.A.L.), Service de Neurologie & CIC015 INSERM; CRTI-Inserm U1064 (D.A.L.), Nantes; CHU de Besançon (E.B.), Service de Neurologie; Sorbonne Universités (B.S.), UPMC Paris 06, Brain and Spine Institute, ICM, Hôpital de La Pitié Salpêtrière, Inserm UMR S 1127, CNRS UMR 7225, and Department of Neurology, AP-HP, Saint-Antoine Hospital; CHU Clermont-Ferrand (Pierre Clavelou), Department of Neurology, F-63000 Clermont-Ferrand Université Clermont Auvergne, Inserm, Neuro-Dol, F-63000 Clermont-Ferrand; Department of Neurology (E.T.), Nimes University Hospital; Institut de Génomique Fonctionnelle (E.T.), UMR5203, INSERM 1191, Univ. Montpellier; Hôpital de Poissy (O.H.), Department of Neurology; Aix Marseille Univ (J.P.), APHM, Hôpital de La Timone, Pôle de Neurosciences Cliniques, Service de Neurologie; CHU d'Amiens (A.A.K.), Department of Neurology; CHU Grenoble Alpes (O.C.), Department of Neurology, La Tronche/Grenoble; CHU de Rouen (B.B.), Department of Neurology; CHU de La Martinique (Philippe Cabre), Department of Neurology, Fort-de-France; APHP (A.W.), Hôpital Henri Mondor, Department of Neurology, Créteil; CHU de Limoges (L.M.), Hôpital Dupuytren, Department of Neurology; CHU de Saint-Étienne (J.-P.C.), Hôpital Nord, Department of Neurology; CHU de Tours (A.M.), Hôpital Bretonneau, CRC SEP and Department of Neurology; CHU de Reims (S.M.), CRC-SEP, Department of Neurology; Hôpital Sud Francilien (N.H.B.), Department of Neurology, Corbeil Essonnes; CHU Bicêtre (D.D.B.), Department of Neurology, Le Kremlin Bicêtre; Department of Neurology (K.H.), Hôpital Pierre Delafontaine, Centre Hospitalier de Saint-Denis; CHU La Milétrie (J.-P.N.), Hôpital Jean Bernard, Department of Neurology, Poitiers; CH de Pontoise (C. Pottier), Hôpital René Dubos, Department of Neurology; and Centre Hospitalier de Versailles (C.N.), Department of Neurology, F-78150 Le Chesnay, France
| | - Eric Berger
- From the Service de Neurologie (A.G., F.R., R.C., S.V.), Sclérose en Plaques, Pathologies de La Myéline et Neuro-inflammation, Hôpital Neurologique Pierre-Wertheimer, Hospices Civils de Lyon, Bron; Université de Lyon (A.G., M.R., F.S.), Université Claude Bernard Lyon 1, CNRS, Laboratoire de Biométrie et Biologie Évolutive UMR 5558, Villeurbanne; Service de Biostatistique-Bioinformatique (A.G., M.R., F.S.), Hospices Civils de Lyon; Université de Lyon (F.R., R.C., S.V.), Université Claude Bernard Lyon 1; Observatoire Français de La Sclérose en Plaques (F.R., R.C., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., R.C., S.V.), State-approved Foundation, Bron; Nancy University Hospital (M.D.), Department of Neurology, Université de Lorraine, APEMAC; CHU Pontchaillou (E.L.P.), CIC1414 INSERM, Rennes; CHU de Toulouse (J.C.), Hôpital Pierre-Paul Riquet, Department of Neurology, CRC-SEP, Toulouse; Infinity (J.C.), INSERM UMR1291-CNRS UMR5051, Université Toulouse III; CHU de Strasbourg (J.D.S.), Department of Neurology and Clinical Investigation Center, CIC 1434, INSERM 1434; Univ. Bordeaux (A.R.), F-33000 Bordeaux INSERM U1215, Neurocentre Magendie, F-33000 Bordeaux CHU de Bordeaux, Department of Neurology, CIC Bordeaux CIC1401; Département de Neurologie (E.M.), Hôpital Pitié-Salpêtrière, APHP, Paris; Centre de Ressources et de Compétences SEP Paris (E.M.); CHU de Montpellier (P.L.), MS Unit; University of Montpellier (MUSE) (P.L.); CHU Lille (H.Z.), CRCSEP Lille, Univ Lille, U1172; Fondation Rotschild (C. Papeix), Department of Neurology, Paris; CHU de Caen (G.D.), MS Expert Centre, Department of Neurology, Avenue de La Côte-de-Nacre, Normandy University, Caen; Neurology (C.L.-F.), UR2CA, Centre Hospitalier Universitaire Pasteur2, Université Nice Côte d'Azur, Nice; CHU de Dijon (T.M.), Department of Neurology, EA4184; CHU de Nantes (D.A.L.), Service de Neurologie & CIC015 INSERM; CRTI-Inserm U1064 (D.A.L.), Nantes; CHU de Besançon (E.B.), Service de Neurologie; Sorbonne Universités (B.S.), UPMC Paris 06, Brain and Spine Institute, ICM, Hôpital de La Pitié Salpêtrière, Inserm UMR S 1127, CNRS UMR 7225, and Department of Neurology, AP-HP, Saint-Antoine Hospital; CHU Clermont-Ferrand (Pierre Clavelou), Department of Neurology, F-63000 Clermont-Ferrand Université Clermont Auvergne, Inserm, Neuro-Dol, F-63000 Clermont-Ferrand; Department of Neurology (E.T.), Nimes University Hospital; Institut de Génomique Fonctionnelle (E.T.), UMR5203, INSERM 1191, Univ. Montpellier; Hôpital de Poissy (O.H.), Department of Neurology; Aix Marseille Univ (J.P.), APHM, Hôpital de La Timone, Pôle de Neurosciences Cliniques, Service de Neurologie; CHU d'Amiens (A.A.K.), Department of Neurology; CHU Grenoble Alpes (O.C.), Department of Neurology, La Tronche/Grenoble; CHU de Rouen (B.B.), Department of Neurology; CHU de La Martinique (Philippe Cabre), Department of Neurology, Fort-de-France; APHP (A.W.), Hôpital Henri Mondor, Department of Neurology, Créteil; CHU de Limoges (L.M.), Hôpital Dupuytren, Department of Neurology; CHU de Saint-Étienne (J.-P.C.), Hôpital Nord, Department of Neurology; CHU de Tours (A.M.), Hôpital Bretonneau, CRC SEP and Department of Neurology; CHU de Reims (S.M.), CRC-SEP, Department of Neurology; Hôpital Sud Francilien (N.H.B.), Department of Neurology, Corbeil Essonnes; CHU Bicêtre (D.D.B.), Department of Neurology, Le Kremlin Bicêtre; Department of Neurology (K.H.), Hôpital Pierre Delafontaine, Centre Hospitalier de Saint-Denis; CHU La Milétrie (J.-P.N.), Hôpital Jean Bernard, Department of Neurology, Poitiers; CH de Pontoise (C. Pottier), Hôpital René Dubos, Department of Neurology; and Centre Hospitalier de Versailles (C.N.), Department of Neurology, F-78150 Le Chesnay, France
| | - Bruno Stankoff
- From the Service de Neurologie (A.G., F.R., R.C., S.V.), Sclérose en Plaques, Pathologies de La Myéline et Neuro-inflammation, Hôpital Neurologique Pierre-Wertheimer, Hospices Civils de Lyon, Bron; Université de Lyon (A.G., M.R., F.S.), Université Claude Bernard Lyon 1, CNRS, Laboratoire de Biométrie et Biologie Évolutive UMR 5558, Villeurbanne; Service de Biostatistique-Bioinformatique (A.G., M.R., F.S.), Hospices Civils de Lyon; Université de Lyon (F.R., R.C., S.V.), Université Claude Bernard Lyon 1; Observatoire Français de La Sclérose en Plaques (F.R., R.C., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., R.C., S.V.), State-approved Foundation, Bron; Nancy University Hospital (M.D.), Department of Neurology, Université de Lorraine, APEMAC; CHU Pontchaillou (E.L.P.), CIC1414 INSERM, Rennes; CHU de Toulouse (J.C.), Hôpital Pierre-Paul Riquet, Department of Neurology, CRC-SEP, Toulouse; Infinity (J.C.), INSERM UMR1291-CNRS UMR5051, Université Toulouse III; CHU de Strasbourg (J.D.S.), Department of Neurology and Clinical Investigation Center, CIC 1434, INSERM 1434; Univ. Bordeaux (A.R.), F-33000 Bordeaux INSERM U1215, Neurocentre Magendie, F-33000 Bordeaux CHU de Bordeaux, Department of Neurology, CIC Bordeaux CIC1401; Département de Neurologie (E.M.), Hôpital Pitié-Salpêtrière, APHP, Paris; Centre de Ressources et de Compétences SEP Paris (E.M.); CHU de Montpellier (P.L.), MS Unit; University of Montpellier (MUSE) (P.L.); CHU Lille (H.Z.), CRCSEP Lille, Univ Lille, U1172; Fondation Rotschild (C. Papeix), Department of Neurology, Paris; CHU de Caen (G.D.), MS Expert Centre, Department of Neurology, Avenue de La Côte-de-Nacre, Normandy University, Caen; Neurology (C.L.-F.), UR2CA, Centre Hospitalier Universitaire Pasteur2, Université Nice Côte d'Azur, Nice; CHU de Dijon (T.M.), Department of Neurology, EA4184; CHU de Nantes (D.A.L.), Service de Neurologie & CIC015 INSERM; CRTI-Inserm U1064 (D.A.L.), Nantes; CHU de Besançon (E.B.), Service de Neurologie; Sorbonne Universités (B.S.), UPMC Paris 06, Brain and Spine Institute, ICM, Hôpital de La Pitié Salpêtrière, Inserm UMR S 1127, CNRS UMR 7225, and Department of Neurology, AP-HP, Saint-Antoine Hospital; CHU Clermont-Ferrand (Pierre Clavelou), Department of Neurology, F-63000 Clermont-Ferrand Université Clermont Auvergne, Inserm, Neuro-Dol, F-63000 Clermont-Ferrand; Department of Neurology (E.T.), Nimes University Hospital; Institut de Génomique Fonctionnelle (E.T.), UMR5203, INSERM 1191, Univ. Montpellier; Hôpital de Poissy (O.H.), Department of Neurology; Aix Marseille Univ (J.P.), APHM, Hôpital de La Timone, Pôle de Neurosciences Cliniques, Service de Neurologie; CHU d'Amiens (A.A.K.), Department of Neurology; CHU Grenoble Alpes (O.C.), Department of Neurology, La Tronche/Grenoble; CHU de Rouen (B.B.), Department of Neurology; CHU de La Martinique (Philippe Cabre), Department of Neurology, Fort-de-France; APHP (A.W.), Hôpital Henri Mondor, Department of Neurology, Créteil; CHU de Limoges (L.M.), Hôpital Dupuytren, Department of Neurology; CHU de Saint-Étienne (J.-P.C.), Hôpital Nord, Department of Neurology; CHU de Tours (A.M.), Hôpital Bretonneau, CRC SEP and Department of Neurology; CHU de Reims (S.M.), CRC-SEP, Department of Neurology; Hôpital Sud Francilien (N.H.B.), Department of Neurology, Corbeil Essonnes; CHU Bicêtre (D.D.B.), Department of Neurology, Le Kremlin Bicêtre; Department of Neurology (K.H.), Hôpital Pierre Delafontaine, Centre Hospitalier de Saint-Denis; CHU La Milétrie (J.-P.N.), Hôpital Jean Bernard, Department of Neurology, Poitiers; CH de Pontoise (C. Pottier), Hôpital René Dubos, Department of Neurology; and Centre Hospitalier de Versailles (C.N.), Department of Neurology, F-78150 Le Chesnay, France
| | - Pierre Clavelou
- From the Service de Neurologie (A.G., F.R., R.C., S.V.), Sclérose en Plaques, Pathologies de La Myéline et Neuro-inflammation, Hôpital Neurologique Pierre-Wertheimer, Hospices Civils de Lyon, Bron; Université de Lyon (A.G., M.R., F.S.), Université Claude Bernard Lyon 1, CNRS, Laboratoire de Biométrie et Biologie Évolutive UMR 5558, Villeurbanne; Service de Biostatistique-Bioinformatique (A.G., M.R., F.S.), Hospices Civils de Lyon; Université de Lyon (F.R., R.C., S.V.), Université Claude Bernard Lyon 1; Observatoire Français de La Sclérose en Plaques (F.R., R.C., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., R.C., S.V.), State-approved Foundation, Bron; Nancy University Hospital (M.D.), Department of Neurology, Université de Lorraine, APEMAC; CHU Pontchaillou (E.L.P.), CIC1414 INSERM, Rennes; CHU de Toulouse (J.C.), Hôpital Pierre-Paul Riquet, Department of Neurology, CRC-SEP, Toulouse; Infinity (J.C.), INSERM UMR1291-CNRS UMR5051, Université Toulouse III; CHU de Strasbourg (J.D.S.), Department of Neurology and Clinical Investigation Center, CIC 1434, INSERM 1434; Univ. Bordeaux (A.R.), F-33000 Bordeaux INSERM U1215, Neurocentre Magendie, F-33000 Bordeaux CHU de Bordeaux, Department of Neurology, CIC Bordeaux CIC1401; Département de Neurologie (E.M.), Hôpital Pitié-Salpêtrière, APHP, Paris; Centre de Ressources et de Compétences SEP Paris (E.M.); CHU de Montpellier (P.L.), MS Unit; University of Montpellier (MUSE) (P.L.); CHU Lille (H.Z.), CRCSEP Lille, Univ Lille, U1172; Fondation Rotschild (C. Papeix), Department of Neurology, Paris; CHU de Caen (G.D.), MS Expert Centre, Department of Neurology, Avenue de La Côte-de-Nacre, Normandy University, Caen; Neurology (C.L.-F.), UR2CA, Centre Hospitalier Universitaire Pasteur2, Université Nice Côte d'Azur, Nice; CHU de Dijon (T.M.), Department of Neurology, EA4184; CHU de Nantes (D.A.L.), Service de Neurologie & CIC015 INSERM; CRTI-Inserm U1064 (D.A.L.), Nantes; CHU de Besançon (E.B.), Service de Neurologie; Sorbonne Universités (B.S.), UPMC Paris 06, Brain and Spine Institute, ICM, Hôpital de La Pitié Salpêtrière, Inserm UMR S 1127, CNRS UMR 7225, and Department of Neurology, AP-HP, Saint-Antoine Hospital; CHU Clermont-Ferrand (Pierre Clavelou), Department of Neurology, F-63000 Clermont-Ferrand Université Clermont Auvergne, Inserm, Neuro-Dol, F-63000 Clermont-Ferrand; Department of Neurology (E.T.), Nimes University Hospital; Institut de Génomique Fonctionnelle (E.T.), UMR5203, INSERM 1191, Univ. Montpellier; Hôpital de Poissy (O.H.), Department of Neurology; Aix Marseille Univ (J.P.), APHM, Hôpital de La Timone, Pôle de Neurosciences Cliniques, Service de Neurologie; CHU d'Amiens (A.A.K.), Department of Neurology; CHU Grenoble Alpes (O.C.), Department of Neurology, La Tronche/Grenoble; CHU de Rouen (B.B.), Department of Neurology; CHU de La Martinique (Philippe Cabre), Department of Neurology, Fort-de-France; APHP (A.W.), Hôpital Henri Mondor, Department of Neurology, Créteil; CHU de Limoges (L.M.), Hôpital Dupuytren, Department of Neurology; CHU de Saint-Étienne (J.-P.C.), Hôpital Nord, Department of Neurology; CHU de Tours (A.M.), Hôpital Bretonneau, CRC SEP and Department of Neurology; CHU de Reims (S.M.), CRC-SEP, Department of Neurology; Hôpital Sud Francilien (N.H.B.), Department of Neurology, Corbeil Essonnes; CHU Bicêtre (D.D.B.), Department of Neurology, Le Kremlin Bicêtre; Department of Neurology (K.H.), Hôpital Pierre Delafontaine, Centre Hospitalier de Saint-Denis; CHU La Milétrie (J.-P.N.), Hôpital Jean Bernard, Department of Neurology, Poitiers; CH de Pontoise (C. Pottier), Hôpital René Dubos, Department of Neurology; and Centre Hospitalier de Versailles (C.N.), Department of Neurology, F-78150 Le Chesnay, France
| | - Eric Thouvenot
- From the Service de Neurologie (A.G., F.R., R.C., S.V.), Sclérose en Plaques, Pathologies de La Myéline et Neuro-inflammation, Hôpital Neurologique Pierre-Wertheimer, Hospices Civils de Lyon, Bron; Université de Lyon (A.G., M.R., F.S.), Université Claude Bernard Lyon 1, CNRS, Laboratoire de Biométrie et Biologie Évolutive UMR 5558, Villeurbanne; Service de Biostatistique-Bioinformatique (A.G., M.R., F.S.), Hospices Civils de Lyon; Université de Lyon (F.R., R.C., S.V.), Université Claude Bernard Lyon 1; Observatoire Français de La Sclérose en Plaques (F.R., R.C., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., R.C., S.V.), State-approved Foundation, Bron; Nancy University Hospital (M.D.), Department of Neurology, Université de Lorraine, APEMAC; CHU Pontchaillou (E.L.P.), CIC1414 INSERM, Rennes; CHU de Toulouse (J.C.), Hôpital Pierre-Paul Riquet, Department of Neurology, CRC-SEP, Toulouse; Infinity (J.C.), INSERM UMR1291-CNRS UMR5051, Université Toulouse III; CHU de Strasbourg (J.D.S.), Department of Neurology and Clinical Investigation Center, CIC 1434, INSERM 1434; Univ. Bordeaux (A.R.), F-33000 Bordeaux INSERM U1215, Neurocentre Magendie, F-33000 Bordeaux CHU de Bordeaux, Department of Neurology, CIC Bordeaux CIC1401; Département de Neurologie (E.M.), Hôpital Pitié-Salpêtrière, APHP, Paris; Centre de Ressources et de Compétences SEP Paris (E.M.); CHU de Montpellier (P.L.), MS Unit; University of Montpellier (MUSE) (P.L.); CHU Lille (H.Z.), CRCSEP Lille, Univ Lille, U1172; Fondation Rotschild (C. Papeix), Department of Neurology, Paris; CHU de Caen (G.D.), MS Expert Centre, Department of Neurology, Avenue de La Côte-de-Nacre, Normandy University, Caen; Neurology (C.L.-F.), UR2CA, Centre Hospitalier Universitaire Pasteur2, Université Nice Côte d'Azur, Nice; CHU de Dijon (T.M.), Department of Neurology, EA4184; CHU de Nantes (D.A.L.), Service de Neurologie & CIC015 INSERM; CRTI-Inserm U1064 (D.A.L.), Nantes; CHU de Besançon (E.B.), Service de Neurologie; Sorbonne Universités (B.S.), UPMC Paris 06, Brain and Spine Institute, ICM, Hôpital de La Pitié Salpêtrière, Inserm UMR S 1127, CNRS UMR 7225, and Department of Neurology, AP-HP, Saint-Antoine Hospital; CHU Clermont-Ferrand (Pierre Clavelou), Department of Neurology, F-63000 Clermont-Ferrand Université Clermont Auvergne, Inserm, Neuro-Dol, F-63000 Clermont-Ferrand; Department of Neurology (E.T.), Nimes University Hospital; Institut de Génomique Fonctionnelle (E.T.), UMR5203, INSERM 1191, Univ. Montpellier; Hôpital de Poissy (O.H.), Department of Neurology; Aix Marseille Univ (J.P.), APHM, Hôpital de La Timone, Pôle de Neurosciences Cliniques, Service de Neurologie; CHU d'Amiens (A.A.K.), Department of Neurology; CHU Grenoble Alpes (O.C.), Department of Neurology, La Tronche/Grenoble; CHU de Rouen (B.B.), Department of Neurology; CHU de La Martinique (Philippe Cabre), Department of Neurology, Fort-de-France; APHP (A.W.), Hôpital Henri Mondor, Department of Neurology, Créteil; CHU de Limoges (L.M.), Hôpital Dupuytren, Department of Neurology; CHU de Saint-Étienne (J.-P.C.), Hôpital Nord, Department of Neurology; CHU de Tours (A.M.), Hôpital Bretonneau, CRC SEP and Department of Neurology; CHU de Reims (S.M.), CRC-SEP, Department of Neurology; Hôpital Sud Francilien (N.H.B.), Department of Neurology, Corbeil Essonnes; CHU Bicêtre (D.D.B.), Department of Neurology, Le Kremlin Bicêtre; Department of Neurology (K.H.), Hôpital Pierre Delafontaine, Centre Hospitalier de Saint-Denis; CHU La Milétrie (J.-P.N.), Hôpital Jean Bernard, Department of Neurology, Poitiers; CH de Pontoise (C. Pottier), Hôpital René Dubos, Department of Neurology; and Centre Hospitalier de Versailles (C.N.), Department of Neurology, F-78150 Le Chesnay, France
| | - Olivier Heinzlef
- From the Service de Neurologie (A.G., F.R., R.C., S.V.), Sclérose en Plaques, Pathologies de La Myéline et Neuro-inflammation, Hôpital Neurologique Pierre-Wertheimer, Hospices Civils de Lyon, Bron; Université de Lyon (A.G., M.R., F.S.), Université Claude Bernard Lyon 1, CNRS, Laboratoire de Biométrie et Biologie Évolutive UMR 5558, Villeurbanne; Service de Biostatistique-Bioinformatique (A.G., M.R., F.S.), Hospices Civils de Lyon; Université de Lyon (F.R., R.C., S.V.), Université Claude Bernard Lyon 1; Observatoire Français de La Sclérose en Plaques (F.R., R.C., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., R.C., S.V.), State-approved Foundation, Bron; Nancy University Hospital (M.D.), Department of Neurology, Université de Lorraine, APEMAC; CHU Pontchaillou (E.L.P.), CIC1414 INSERM, Rennes; CHU de Toulouse (J.C.), Hôpital Pierre-Paul Riquet, Department of Neurology, CRC-SEP, Toulouse; Infinity (J.C.), INSERM UMR1291-CNRS UMR5051, Université Toulouse III; CHU de Strasbourg (J.D.S.), Department of Neurology and Clinical Investigation Center, CIC 1434, INSERM 1434; Univ. Bordeaux (A.R.), F-33000 Bordeaux INSERM U1215, Neurocentre Magendie, F-33000 Bordeaux CHU de Bordeaux, Department of Neurology, CIC Bordeaux CIC1401; Département de Neurologie (E.M.), Hôpital Pitié-Salpêtrière, APHP, Paris; Centre de Ressources et de Compétences SEP Paris (E.M.); CHU de Montpellier (P.L.), MS Unit; University of Montpellier (MUSE) (P.L.); CHU Lille (H.Z.), CRCSEP Lille, Univ Lille, U1172; Fondation Rotschild (C. Papeix), Department of Neurology, Paris; CHU de Caen (G.D.), MS Expert Centre, Department of Neurology, Avenue de La Côte-de-Nacre, Normandy University, Caen; Neurology (C.L.-F.), UR2CA, Centre Hospitalier Universitaire Pasteur2, Université Nice Côte d'Azur, Nice; CHU de Dijon (T.M.), Department of Neurology, EA4184; CHU de Nantes (D.A.L.), Service de Neurologie & CIC015 INSERM; CRTI-Inserm U1064 (D.A.L.), Nantes; CHU de Besançon (E.B.), Service de Neurologie; Sorbonne Universités (B.S.), UPMC Paris 06, Brain and Spine Institute, ICM, Hôpital de La Pitié Salpêtrière, Inserm UMR S 1127, CNRS UMR 7225, and Department of Neurology, AP-HP, Saint-Antoine Hospital; CHU Clermont-Ferrand (Pierre Clavelou), Department of Neurology, F-63000 Clermont-Ferrand Université Clermont Auvergne, Inserm, Neuro-Dol, F-63000 Clermont-Ferrand; Department of Neurology (E.T.), Nimes University Hospital; Institut de Génomique Fonctionnelle (E.T.), UMR5203, INSERM 1191, Univ. Montpellier; Hôpital de Poissy (O.H.), Department of Neurology; Aix Marseille Univ (J.P.), APHM, Hôpital de La Timone, Pôle de Neurosciences Cliniques, Service de Neurologie; CHU d'Amiens (A.A.K.), Department of Neurology; CHU Grenoble Alpes (O.C.), Department of Neurology, La Tronche/Grenoble; CHU de Rouen (B.B.), Department of Neurology; CHU de La Martinique (Philippe Cabre), Department of Neurology, Fort-de-France; APHP (A.W.), Hôpital Henri Mondor, Department of Neurology, Créteil; CHU de Limoges (L.M.), Hôpital Dupuytren, Department of Neurology; CHU de Saint-Étienne (J.-P.C.), Hôpital Nord, Department of Neurology; CHU de Tours (A.M.), Hôpital Bretonneau, CRC SEP and Department of Neurology; CHU de Reims (S.M.), CRC-SEP, Department of Neurology; Hôpital Sud Francilien (N.H.B.), Department of Neurology, Corbeil Essonnes; CHU Bicêtre (D.D.B.), Department of Neurology, Le Kremlin Bicêtre; Department of Neurology (K.H.), Hôpital Pierre Delafontaine, Centre Hospitalier de Saint-Denis; CHU La Milétrie (J.-P.N.), Hôpital Jean Bernard, Department of Neurology, Poitiers; CH de Pontoise (C. Pottier), Hôpital René Dubos, Department of Neurology; and Centre Hospitalier de Versailles (C.N.), Department of Neurology, F-78150 Le Chesnay, France
| | - Jean Pelletier
- From the Service de Neurologie (A.G., F.R., R.C., S.V.), Sclérose en Plaques, Pathologies de La Myéline et Neuro-inflammation, Hôpital Neurologique Pierre-Wertheimer, Hospices Civils de Lyon, Bron; Université de Lyon (A.G., M.R., F.S.), Université Claude Bernard Lyon 1, CNRS, Laboratoire de Biométrie et Biologie Évolutive UMR 5558, Villeurbanne; Service de Biostatistique-Bioinformatique (A.G., M.R., F.S.), Hospices Civils de Lyon; Université de Lyon (F.R., R.C., S.V.), Université Claude Bernard Lyon 1; Observatoire Français de La Sclérose en Plaques (F.R., R.C., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., R.C., S.V.), State-approved Foundation, Bron; Nancy University Hospital (M.D.), Department of Neurology, Université de Lorraine, APEMAC; CHU Pontchaillou (E.L.P.), CIC1414 INSERM, Rennes; CHU de Toulouse (J.C.), Hôpital Pierre-Paul Riquet, Department of Neurology, CRC-SEP, Toulouse; Infinity (J.C.), INSERM UMR1291-CNRS UMR5051, Université Toulouse III; CHU de Strasbourg (J.D.S.), Department of Neurology and Clinical Investigation Center, CIC 1434, INSERM 1434; Univ. Bordeaux (A.R.), F-33000 Bordeaux INSERM U1215, Neurocentre Magendie, F-33000 Bordeaux CHU de Bordeaux, Department of Neurology, CIC Bordeaux CIC1401; Département de Neurologie (E.M.), Hôpital Pitié-Salpêtrière, APHP, Paris; Centre de Ressources et de Compétences SEP Paris (E.M.); CHU de Montpellier (P.L.), MS Unit; University of Montpellier (MUSE) (P.L.); CHU Lille (H.Z.), CRCSEP Lille, Univ Lille, U1172; Fondation Rotschild (C. Papeix), Department of Neurology, Paris; CHU de Caen (G.D.), MS Expert Centre, Department of Neurology, Avenue de La Côte-de-Nacre, Normandy University, Caen; Neurology (C.L.-F.), UR2CA, Centre Hospitalier Universitaire Pasteur2, Université Nice Côte d'Azur, Nice; CHU de Dijon (T.M.), Department of Neurology, EA4184; CHU de Nantes (D.A.L.), Service de Neurologie & CIC015 INSERM; CRTI-Inserm U1064 (D.A.L.), Nantes; CHU de Besançon (E.B.), Service de Neurologie; Sorbonne Universités (B.S.), UPMC Paris 06, Brain and Spine Institute, ICM, Hôpital de La Pitié Salpêtrière, Inserm UMR S 1127, CNRS UMR 7225, and Department of Neurology, AP-HP, Saint-Antoine Hospital; CHU Clermont-Ferrand (Pierre Clavelou), Department of Neurology, F-63000 Clermont-Ferrand Université Clermont Auvergne, Inserm, Neuro-Dol, F-63000 Clermont-Ferrand; Department of Neurology (E.T.), Nimes University Hospital; Institut de Génomique Fonctionnelle (E.T.), UMR5203, INSERM 1191, Univ. Montpellier; Hôpital de Poissy (O.H.), Department of Neurology; Aix Marseille Univ (J.P.), APHM, Hôpital de La Timone, Pôle de Neurosciences Cliniques, Service de Neurologie; CHU d'Amiens (A.A.K.), Department of Neurology; CHU Grenoble Alpes (O.C.), Department of Neurology, La Tronche/Grenoble; CHU de Rouen (B.B.), Department of Neurology; CHU de La Martinique (Philippe Cabre), Department of Neurology, Fort-de-France; APHP (A.W.), Hôpital Henri Mondor, Department of Neurology, Créteil; CHU de Limoges (L.M.), Hôpital Dupuytren, Department of Neurology; CHU de Saint-Étienne (J.-P.C.), Hôpital Nord, Department of Neurology; CHU de Tours (A.M.), Hôpital Bretonneau, CRC SEP and Department of Neurology; CHU de Reims (S.M.), CRC-SEP, Department of Neurology; Hôpital Sud Francilien (N.H.B.), Department of Neurology, Corbeil Essonnes; CHU Bicêtre (D.D.B.), Department of Neurology, Le Kremlin Bicêtre; Department of Neurology (K.H.), Hôpital Pierre Delafontaine, Centre Hospitalier de Saint-Denis; CHU La Milétrie (J.-P.N.), Hôpital Jean Bernard, Department of Neurology, Poitiers; CH de Pontoise (C. Pottier), Hôpital René Dubos, Department of Neurology; and Centre Hospitalier de Versailles (C.N.), Department of Neurology, F-78150 Le Chesnay, France
| | - Abdullatif Al Khedr
- From the Service de Neurologie (A.G., F.R., R.C., S.V.), Sclérose en Plaques, Pathologies de La Myéline et Neuro-inflammation, Hôpital Neurologique Pierre-Wertheimer, Hospices Civils de Lyon, Bron; Université de Lyon (A.G., M.R., F.S.), Université Claude Bernard Lyon 1, CNRS, Laboratoire de Biométrie et Biologie Évolutive UMR 5558, Villeurbanne; Service de Biostatistique-Bioinformatique (A.G., M.R., F.S.), Hospices Civils de Lyon; Université de Lyon (F.R., R.C., S.V.), Université Claude Bernard Lyon 1; Observatoire Français de La Sclérose en Plaques (F.R., R.C., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., R.C., S.V.), State-approved Foundation, Bron; Nancy University Hospital (M.D.), Department of Neurology, Université de Lorraine, APEMAC; CHU Pontchaillou (E.L.P.), CIC1414 INSERM, Rennes; CHU de Toulouse (J.C.), Hôpital Pierre-Paul Riquet, Department of Neurology, CRC-SEP, Toulouse; Infinity (J.C.), INSERM UMR1291-CNRS UMR5051, Université Toulouse III; CHU de Strasbourg (J.D.S.), Department of Neurology and Clinical Investigation Center, CIC 1434, INSERM 1434; Univ. Bordeaux (A.R.), F-33000 Bordeaux INSERM U1215, Neurocentre Magendie, F-33000 Bordeaux CHU de Bordeaux, Department of Neurology, CIC Bordeaux CIC1401; Département de Neurologie (E.M.), Hôpital Pitié-Salpêtrière, APHP, Paris; Centre de Ressources et de Compétences SEP Paris (E.M.); CHU de Montpellier (P.L.), MS Unit; University of Montpellier (MUSE) (P.L.); CHU Lille (H.Z.), CRCSEP Lille, Univ Lille, U1172; Fondation Rotschild (C. Papeix), Department of Neurology, Paris; CHU de Caen (G.D.), MS Expert Centre, Department of Neurology, Avenue de La Côte-de-Nacre, Normandy University, Caen; Neurology (C.L.-F.), UR2CA, Centre Hospitalier Universitaire Pasteur2, Université Nice Côte d'Azur, Nice; CHU de Dijon (T.M.), Department of Neurology, EA4184; CHU de Nantes (D.A.L.), Service de Neurologie & CIC015 INSERM; CRTI-Inserm U1064 (D.A.L.), Nantes; CHU de Besançon (E.B.), Service de Neurologie; Sorbonne Universités (B.S.), UPMC Paris 06, Brain and Spine Institute, ICM, Hôpital de La Pitié Salpêtrière, Inserm UMR S 1127, CNRS UMR 7225, and Department of Neurology, AP-HP, Saint-Antoine Hospital; CHU Clermont-Ferrand (Pierre Clavelou), Department of Neurology, F-63000 Clermont-Ferrand Université Clermont Auvergne, Inserm, Neuro-Dol, F-63000 Clermont-Ferrand; Department of Neurology (E.T.), Nimes University Hospital; Institut de Génomique Fonctionnelle (E.T.), UMR5203, INSERM 1191, Univ. Montpellier; Hôpital de Poissy (O.H.), Department of Neurology; Aix Marseille Univ (J.P.), APHM, Hôpital de La Timone, Pôle de Neurosciences Cliniques, Service de Neurologie; CHU d'Amiens (A.A.K.), Department of Neurology; CHU Grenoble Alpes (O.C.), Department of Neurology, La Tronche/Grenoble; CHU de Rouen (B.B.), Department of Neurology; CHU de La Martinique (Philippe Cabre), Department of Neurology, Fort-de-France; APHP (A.W.), Hôpital Henri Mondor, Department of Neurology, Créteil; CHU de Limoges (L.M.), Hôpital Dupuytren, Department of Neurology; CHU de Saint-Étienne (J.-P.C.), Hôpital Nord, Department of Neurology; CHU de Tours (A.M.), Hôpital Bretonneau, CRC SEP and Department of Neurology; CHU de Reims (S.M.), CRC-SEP, Department of Neurology; Hôpital Sud Francilien (N.H.B.), Department of Neurology, Corbeil Essonnes; CHU Bicêtre (D.D.B.), Department of Neurology, Le Kremlin Bicêtre; Department of Neurology (K.H.), Hôpital Pierre Delafontaine, Centre Hospitalier de Saint-Denis; CHU La Milétrie (J.-P.N.), Hôpital Jean Bernard, Department of Neurology, Poitiers; CH de Pontoise (C. Pottier), Hôpital René Dubos, Department of Neurology; and Centre Hospitalier de Versailles (C.N.), Department of Neurology, F-78150 Le Chesnay, France
| | - Olivier Casez
- From the Service de Neurologie (A.G., F.R., R.C., S.V.), Sclérose en Plaques, Pathologies de La Myéline et Neuro-inflammation, Hôpital Neurologique Pierre-Wertheimer, Hospices Civils de Lyon, Bron; Université de Lyon (A.G., M.R., F.S.), Université Claude Bernard Lyon 1, CNRS, Laboratoire de Biométrie et Biologie Évolutive UMR 5558, Villeurbanne; Service de Biostatistique-Bioinformatique (A.G., M.R., F.S.), Hospices Civils de Lyon; Université de Lyon (F.R., R.C., S.V.), Université Claude Bernard Lyon 1; Observatoire Français de La Sclérose en Plaques (F.R., R.C., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., R.C., S.V.), State-approved Foundation, Bron; Nancy University Hospital (M.D.), Department of Neurology, Université de Lorraine, APEMAC; CHU Pontchaillou (E.L.P.), CIC1414 INSERM, Rennes; CHU de Toulouse (J.C.), Hôpital Pierre-Paul Riquet, Department of Neurology, CRC-SEP, Toulouse; Infinity (J.C.), INSERM UMR1291-CNRS UMR5051, Université Toulouse III; CHU de Strasbourg (J.D.S.), Department of Neurology and Clinical Investigation Center, CIC 1434, INSERM 1434; Univ. Bordeaux (A.R.), F-33000 Bordeaux INSERM U1215, Neurocentre Magendie, F-33000 Bordeaux CHU de Bordeaux, Department of Neurology, CIC Bordeaux CIC1401; Département de Neurologie (E.M.), Hôpital Pitié-Salpêtrière, APHP, Paris; Centre de Ressources et de Compétences SEP Paris (E.M.); CHU de Montpellier (P.L.), MS Unit; University of Montpellier (MUSE) (P.L.); CHU Lille (H.Z.), CRCSEP Lille, Univ Lille, U1172; Fondation Rotschild (C. Papeix), Department of Neurology, Paris; CHU de Caen (G.D.), MS Expert Centre, Department of Neurology, Avenue de La Côte-de-Nacre, Normandy University, Caen; Neurology (C.L.-F.), UR2CA, Centre Hospitalier Universitaire Pasteur2, Université Nice Côte d'Azur, Nice; CHU de Dijon (T.M.), Department of Neurology, EA4184; CHU de Nantes (D.A.L.), Service de Neurologie & CIC015 INSERM; CRTI-Inserm U1064 (D.A.L.), Nantes; CHU de Besançon (E.B.), Service de Neurologie; Sorbonne Universités (B.S.), UPMC Paris 06, Brain and Spine Institute, ICM, Hôpital de La Pitié Salpêtrière, Inserm UMR S 1127, CNRS UMR 7225, and Department of Neurology, AP-HP, Saint-Antoine Hospital; CHU Clermont-Ferrand (Pierre Clavelou), Department of Neurology, F-63000 Clermont-Ferrand Université Clermont Auvergne, Inserm, Neuro-Dol, F-63000 Clermont-Ferrand; Department of Neurology (E.T.), Nimes University Hospital; Institut de Génomique Fonctionnelle (E.T.), UMR5203, INSERM 1191, Univ. Montpellier; Hôpital de Poissy (O.H.), Department of Neurology; Aix Marseille Univ (J.P.), APHM, Hôpital de La Timone, Pôle de Neurosciences Cliniques, Service de Neurologie; CHU d'Amiens (A.A.K.), Department of Neurology; CHU Grenoble Alpes (O.C.), Department of Neurology, La Tronche/Grenoble; CHU de Rouen (B.B.), Department of Neurology; CHU de La Martinique (Philippe Cabre), Department of Neurology, Fort-de-France; APHP (A.W.), Hôpital Henri Mondor, Department of Neurology, Créteil; CHU de Limoges (L.M.), Hôpital Dupuytren, Department of Neurology; CHU de Saint-Étienne (J.-P.C.), Hôpital Nord, Department of Neurology; CHU de Tours (A.M.), Hôpital Bretonneau, CRC SEP and Department of Neurology; CHU de Reims (S.M.), CRC-SEP, Department of Neurology; Hôpital Sud Francilien (N.H.B.), Department of Neurology, Corbeil Essonnes; CHU Bicêtre (D.D.B.), Department of Neurology, Le Kremlin Bicêtre; Department of Neurology (K.H.), Hôpital Pierre Delafontaine, Centre Hospitalier de Saint-Denis; CHU La Milétrie (J.-P.N.), Hôpital Jean Bernard, Department of Neurology, Poitiers; CH de Pontoise (C. Pottier), Hôpital René Dubos, Department of Neurology; and Centre Hospitalier de Versailles (C.N.), Department of Neurology, F-78150 Le Chesnay, France
| | - Bertrand Bourre
- From the Service de Neurologie (A.G., F.R., R.C., S.V.), Sclérose en Plaques, Pathologies de La Myéline et Neuro-inflammation, Hôpital Neurologique Pierre-Wertheimer, Hospices Civils de Lyon, Bron; Université de Lyon (A.G., M.R., F.S.), Université Claude Bernard Lyon 1, CNRS, Laboratoire de Biométrie et Biologie Évolutive UMR 5558, Villeurbanne; Service de Biostatistique-Bioinformatique (A.G., M.R., F.S.), Hospices Civils de Lyon; Université de Lyon (F.R., R.C., S.V.), Université Claude Bernard Lyon 1; Observatoire Français de La Sclérose en Plaques (F.R., R.C., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., R.C., S.V.), State-approved Foundation, Bron; Nancy University Hospital (M.D.), Department of Neurology, Université de Lorraine, APEMAC; CHU Pontchaillou (E.L.P.), CIC1414 INSERM, Rennes; CHU de Toulouse (J.C.), Hôpital Pierre-Paul Riquet, Department of Neurology, CRC-SEP, Toulouse; Infinity (J.C.), INSERM UMR1291-CNRS UMR5051, Université Toulouse III; CHU de Strasbourg (J.D.S.), Department of Neurology and Clinical Investigation Center, CIC 1434, INSERM 1434; Univ. Bordeaux (A.R.), F-33000 Bordeaux INSERM U1215, Neurocentre Magendie, F-33000 Bordeaux CHU de Bordeaux, Department of Neurology, CIC Bordeaux CIC1401; Département de Neurologie (E.M.), Hôpital Pitié-Salpêtrière, APHP, Paris; Centre de Ressources et de Compétences SEP Paris (E.M.); CHU de Montpellier (P.L.), MS Unit; University of Montpellier (MUSE) (P.L.); CHU Lille (H.Z.), CRCSEP Lille, Univ Lille, U1172; Fondation Rotschild (C. Papeix), Department of Neurology, Paris; CHU de Caen (G.D.), MS Expert Centre, Department of Neurology, Avenue de La Côte-de-Nacre, Normandy University, Caen; Neurology (C.L.-F.), UR2CA, Centre Hospitalier Universitaire Pasteur2, Université Nice Côte d'Azur, Nice; CHU de Dijon (T.M.), Department of Neurology, EA4184; CHU de Nantes (D.A.L.), Service de Neurologie & CIC015 INSERM; CRTI-Inserm U1064 (D.A.L.), Nantes; CHU de Besançon (E.B.), Service de Neurologie; Sorbonne Universités (B.S.), UPMC Paris 06, Brain and Spine Institute, ICM, Hôpital de La Pitié Salpêtrière, Inserm UMR S 1127, CNRS UMR 7225, and Department of Neurology, AP-HP, Saint-Antoine Hospital; CHU Clermont-Ferrand (Pierre Clavelou), Department of Neurology, F-63000 Clermont-Ferrand Université Clermont Auvergne, Inserm, Neuro-Dol, F-63000 Clermont-Ferrand; Department of Neurology (E.T.), Nimes University Hospital; Institut de Génomique Fonctionnelle (E.T.), UMR5203, INSERM 1191, Univ. Montpellier; Hôpital de Poissy (O.H.), Department of Neurology; Aix Marseille Univ (J.P.), APHM, Hôpital de La Timone, Pôle de Neurosciences Cliniques, Service de Neurologie; CHU d'Amiens (A.A.K.), Department of Neurology; CHU Grenoble Alpes (O.C.), Department of Neurology, La Tronche/Grenoble; CHU de Rouen (B.B.), Department of Neurology; CHU de La Martinique (Philippe Cabre), Department of Neurology, Fort-de-France; APHP (A.W.), Hôpital Henri Mondor, Department of Neurology, Créteil; CHU de Limoges (L.M.), Hôpital Dupuytren, Department of Neurology; CHU de Saint-Étienne (J.-P.C.), Hôpital Nord, Department of Neurology; CHU de Tours (A.M.), Hôpital Bretonneau, CRC SEP and Department of Neurology; CHU de Reims (S.M.), CRC-SEP, Department of Neurology; Hôpital Sud Francilien (N.H.B.), Department of Neurology, Corbeil Essonnes; CHU Bicêtre (D.D.B.), Department of Neurology, Le Kremlin Bicêtre; Department of Neurology (K.H.), Hôpital Pierre Delafontaine, Centre Hospitalier de Saint-Denis; CHU La Milétrie (J.-P.N.), Hôpital Jean Bernard, Department of Neurology, Poitiers; CH de Pontoise (C. Pottier), Hôpital René Dubos, Department of Neurology; and Centre Hospitalier de Versailles (C.N.), Department of Neurology, F-78150 Le Chesnay, France
| | - Philippe Cabre
- From the Service de Neurologie (A.G., F.R., R.C., S.V.), Sclérose en Plaques, Pathologies de La Myéline et Neuro-inflammation, Hôpital Neurologique Pierre-Wertheimer, Hospices Civils de Lyon, Bron; Université de Lyon (A.G., M.R., F.S.), Université Claude Bernard Lyon 1, CNRS, Laboratoire de Biométrie et Biologie Évolutive UMR 5558, Villeurbanne; Service de Biostatistique-Bioinformatique (A.G., M.R., F.S.), Hospices Civils de Lyon; Université de Lyon (F.R., R.C., S.V.), Université Claude Bernard Lyon 1; Observatoire Français de La Sclérose en Plaques (F.R., R.C., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., R.C., S.V.), State-approved Foundation, Bron; Nancy University Hospital (M.D.), Department of Neurology, Université de Lorraine, APEMAC; CHU Pontchaillou (E.L.P.), CIC1414 INSERM, Rennes; CHU de Toulouse (J.C.), Hôpital Pierre-Paul Riquet, Department of Neurology, CRC-SEP, Toulouse; Infinity (J.C.), INSERM UMR1291-CNRS UMR5051, Université Toulouse III; CHU de Strasbourg (J.D.S.), Department of Neurology and Clinical Investigation Center, CIC 1434, INSERM 1434; Univ. Bordeaux (A.R.), F-33000 Bordeaux INSERM U1215, Neurocentre Magendie, F-33000 Bordeaux CHU de Bordeaux, Department of Neurology, CIC Bordeaux CIC1401; Département de Neurologie (E.M.), Hôpital Pitié-Salpêtrière, APHP, Paris; Centre de Ressources et de Compétences SEP Paris (E.M.); CHU de Montpellier (P.L.), MS Unit; University of Montpellier (MUSE) (P.L.); CHU Lille (H.Z.), CRCSEP Lille, Univ Lille, U1172; Fondation Rotschild (C. Papeix), Department of Neurology, Paris; CHU de Caen (G.D.), MS Expert Centre, Department of Neurology, Avenue de La Côte-de-Nacre, Normandy University, Caen; Neurology (C.L.-F.), UR2CA, Centre Hospitalier Universitaire Pasteur2, Université Nice Côte d'Azur, Nice; CHU de Dijon (T.M.), Department of Neurology, EA4184; CHU de Nantes (D.A.L.), Service de Neurologie & CIC015 INSERM; CRTI-Inserm U1064 (D.A.L.), Nantes; CHU de Besançon (E.B.), Service de Neurologie; Sorbonne Universités (B.S.), UPMC Paris 06, Brain and Spine Institute, ICM, Hôpital de La Pitié Salpêtrière, Inserm UMR S 1127, CNRS UMR 7225, and Department of Neurology, AP-HP, Saint-Antoine Hospital; CHU Clermont-Ferrand (Pierre Clavelou), Department of Neurology, F-63000 Clermont-Ferrand Université Clermont Auvergne, Inserm, Neuro-Dol, F-63000 Clermont-Ferrand; Department of Neurology (E.T.), Nimes University Hospital; Institut de Génomique Fonctionnelle (E.T.), UMR5203, INSERM 1191, Univ. Montpellier; Hôpital de Poissy (O.H.), Department of Neurology; Aix Marseille Univ (J.P.), APHM, Hôpital de La Timone, Pôle de Neurosciences Cliniques, Service de Neurologie; CHU d'Amiens (A.A.K.), Department of Neurology; CHU Grenoble Alpes (O.C.), Department of Neurology, La Tronche/Grenoble; CHU de Rouen (B.B.), Department of Neurology; CHU de La Martinique (Philippe Cabre), Department of Neurology, Fort-de-France; APHP (A.W.), Hôpital Henri Mondor, Department of Neurology, Créteil; CHU de Limoges (L.M.), Hôpital Dupuytren, Department of Neurology; CHU de Saint-Étienne (J.-P.C.), Hôpital Nord, Department of Neurology; CHU de Tours (A.M.), Hôpital Bretonneau, CRC SEP and Department of Neurology; CHU de Reims (S.M.), CRC-SEP, Department of Neurology; Hôpital Sud Francilien (N.H.B.), Department of Neurology, Corbeil Essonnes; CHU Bicêtre (D.D.B.), Department of Neurology, Le Kremlin Bicêtre; Department of Neurology (K.H.), Hôpital Pierre Delafontaine, Centre Hospitalier de Saint-Denis; CHU La Milétrie (J.-P.N.), Hôpital Jean Bernard, Department of Neurology, Poitiers; CH de Pontoise (C. Pottier), Hôpital René Dubos, Department of Neurology; and Centre Hospitalier de Versailles (C.N.), Department of Neurology, F-78150 Le Chesnay, France
| | - Abir Wahab
- From the Service de Neurologie (A.G., F.R., R.C., S.V.), Sclérose en Plaques, Pathologies de La Myéline et Neuro-inflammation, Hôpital Neurologique Pierre-Wertheimer, Hospices Civils de Lyon, Bron; Université de Lyon (A.G., M.R., F.S.), Université Claude Bernard Lyon 1, CNRS, Laboratoire de Biométrie et Biologie Évolutive UMR 5558, Villeurbanne; Service de Biostatistique-Bioinformatique (A.G., M.R., F.S.), Hospices Civils de Lyon; Université de Lyon (F.R., R.C., S.V.), Université Claude Bernard Lyon 1; Observatoire Français de La Sclérose en Plaques (F.R., R.C., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., R.C., S.V.), State-approved Foundation, Bron; Nancy University Hospital (M.D.), Department of Neurology, Université de Lorraine, APEMAC; CHU Pontchaillou (E.L.P.), CIC1414 INSERM, Rennes; CHU de Toulouse (J.C.), Hôpital Pierre-Paul Riquet, Department of Neurology, CRC-SEP, Toulouse; Infinity (J.C.), INSERM UMR1291-CNRS UMR5051, Université Toulouse III; CHU de Strasbourg (J.D.S.), Department of Neurology and Clinical Investigation Center, CIC 1434, INSERM 1434; Univ. Bordeaux (A.R.), F-33000 Bordeaux INSERM U1215, Neurocentre Magendie, F-33000 Bordeaux CHU de Bordeaux, Department of Neurology, CIC Bordeaux CIC1401; Département de Neurologie (E.M.), Hôpital Pitié-Salpêtrière, APHP, Paris; Centre de Ressources et de Compétences SEP Paris (E.M.); CHU de Montpellier (P.L.), MS Unit; University of Montpellier (MUSE) (P.L.); CHU Lille (H.Z.), CRCSEP Lille, Univ Lille, U1172; Fondation Rotschild (C. Papeix), Department of Neurology, Paris; CHU de Caen (G.D.), MS Expert Centre, Department of Neurology, Avenue de La Côte-de-Nacre, Normandy University, Caen; Neurology (C.L.-F.), UR2CA, Centre Hospitalier Universitaire Pasteur2, Université Nice Côte d'Azur, Nice; CHU de Dijon (T.M.), Department of Neurology, EA4184; CHU de Nantes (D.A.L.), Service de Neurologie & CIC015 INSERM; CRTI-Inserm U1064 (D.A.L.), Nantes; CHU de Besançon (E.B.), Service de Neurologie; Sorbonne Universités (B.S.), UPMC Paris 06, Brain and Spine Institute, ICM, Hôpital de La Pitié Salpêtrière, Inserm UMR S 1127, CNRS UMR 7225, and Department of Neurology, AP-HP, Saint-Antoine Hospital; CHU Clermont-Ferrand (Pierre Clavelou), Department of Neurology, F-63000 Clermont-Ferrand Université Clermont Auvergne, Inserm, Neuro-Dol, F-63000 Clermont-Ferrand; Department of Neurology (E.T.), Nimes University Hospital; Institut de Génomique Fonctionnelle (E.T.), UMR5203, INSERM 1191, Univ. Montpellier; Hôpital de Poissy (O.H.), Department of Neurology; Aix Marseille Univ (J.P.), APHM, Hôpital de La Timone, Pôle de Neurosciences Cliniques, Service de Neurologie; CHU d'Amiens (A.A.K.), Department of Neurology; CHU Grenoble Alpes (O.C.), Department of Neurology, La Tronche/Grenoble; CHU de Rouen (B.B.), Department of Neurology; CHU de La Martinique (Philippe Cabre), Department of Neurology, Fort-de-France; APHP (A.W.), Hôpital Henri Mondor, Department of Neurology, Créteil; CHU de Limoges (L.M.), Hôpital Dupuytren, Department of Neurology; CHU de Saint-Étienne (J.-P.C.), Hôpital Nord, Department of Neurology; CHU de Tours (A.M.), Hôpital Bretonneau, CRC SEP and Department of Neurology; CHU de Reims (S.M.), CRC-SEP, Department of Neurology; Hôpital Sud Francilien (N.H.B.), Department of Neurology, Corbeil Essonnes; CHU Bicêtre (D.D.B.), Department of Neurology, Le Kremlin Bicêtre; Department of Neurology (K.H.), Hôpital Pierre Delafontaine, Centre Hospitalier de Saint-Denis; CHU La Milétrie (J.-P.N.), Hôpital Jean Bernard, Department of Neurology, Poitiers; CH de Pontoise (C. Pottier), Hôpital René Dubos, Department of Neurology; and Centre Hospitalier de Versailles (C.N.), Department of Neurology, F-78150 Le Chesnay, France
| | - Laurent Magy
- From the Service de Neurologie (A.G., F.R., R.C., S.V.), Sclérose en Plaques, Pathologies de La Myéline et Neuro-inflammation, Hôpital Neurologique Pierre-Wertheimer, Hospices Civils de Lyon, Bron; Université de Lyon (A.G., M.R., F.S.), Université Claude Bernard Lyon 1, CNRS, Laboratoire de Biométrie et Biologie Évolutive UMR 5558, Villeurbanne; Service de Biostatistique-Bioinformatique (A.G., M.R., F.S.), Hospices Civils de Lyon; Université de Lyon (F.R., R.C., S.V.), Université Claude Bernard Lyon 1; Observatoire Français de La Sclérose en Plaques (F.R., R.C., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., R.C., S.V.), State-approved Foundation, Bron; Nancy University Hospital (M.D.), Department of Neurology, Université de Lorraine, APEMAC; CHU Pontchaillou (E.L.P.), CIC1414 INSERM, Rennes; CHU de Toulouse (J.C.), Hôpital Pierre-Paul Riquet, Department of Neurology, CRC-SEP, Toulouse; Infinity (J.C.), INSERM UMR1291-CNRS UMR5051, Université Toulouse III; CHU de Strasbourg (J.D.S.), Department of Neurology and Clinical Investigation Center, CIC 1434, INSERM 1434; Univ. Bordeaux (A.R.), F-33000 Bordeaux INSERM U1215, Neurocentre Magendie, F-33000 Bordeaux CHU de Bordeaux, Department of Neurology, CIC Bordeaux CIC1401; Département de Neurologie (E.M.), Hôpital Pitié-Salpêtrière, APHP, Paris; Centre de Ressources et de Compétences SEP Paris (E.M.); CHU de Montpellier (P.L.), MS Unit; University of Montpellier (MUSE) (P.L.); CHU Lille (H.Z.), CRCSEP Lille, Univ Lille, U1172; Fondation Rotschild (C. Papeix), Department of Neurology, Paris; CHU de Caen (G.D.), MS Expert Centre, Department of Neurology, Avenue de La Côte-de-Nacre, Normandy University, Caen; Neurology (C.L.-F.), UR2CA, Centre Hospitalier Universitaire Pasteur2, Université Nice Côte d'Azur, Nice; CHU de Dijon (T.M.), Department of Neurology, EA4184; CHU de Nantes (D.A.L.), Service de Neurologie & CIC015 INSERM; CRTI-Inserm U1064 (D.A.L.), Nantes; CHU de Besançon (E.B.), Service de Neurologie; Sorbonne Universités (B.S.), UPMC Paris 06, Brain and Spine Institute, ICM, Hôpital de La Pitié Salpêtrière, Inserm UMR S 1127, CNRS UMR 7225, and Department of Neurology, AP-HP, Saint-Antoine Hospital; CHU Clermont-Ferrand (Pierre Clavelou), Department of Neurology, F-63000 Clermont-Ferrand Université Clermont Auvergne, Inserm, Neuro-Dol, F-63000 Clermont-Ferrand; Department of Neurology (E.T.), Nimes University Hospital; Institut de Génomique Fonctionnelle (E.T.), UMR5203, INSERM 1191, Univ. Montpellier; Hôpital de Poissy (O.H.), Department of Neurology; Aix Marseille Univ (J.P.), APHM, Hôpital de La Timone, Pôle de Neurosciences Cliniques, Service de Neurologie; CHU d'Amiens (A.A.K.), Department of Neurology; CHU Grenoble Alpes (O.C.), Department of Neurology, La Tronche/Grenoble; CHU de Rouen (B.B.), Department of Neurology; CHU de La Martinique (Philippe Cabre), Department of Neurology, Fort-de-France; APHP (A.W.), Hôpital Henri Mondor, Department of Neurology, Créteil; CHU de Limoges (L.M.), Hôpital Dupuytren, Department of Neurology; CHU de Saint-Étienne (J.-P.C.), Hôpital Nord, Department of Neurology; CHU de Tours (A.M.), Hôpital Bretonneau, CRC SEP and Department of Neurology; CHU de Reims (S.M.), CRC-SEP, Department of Neurology; Hôpital Sud Francilien (N.H.B.), Department of Neurology, Corbeil Essonnes; CHU Bicêtre (D.D.B.), Department of Neurology, Le Kremlin Bicêtre; Department of Neurology (K.H.), Hôpital Pierre Delafontaine, Centre Hospitalier de Saint-Denis; CHU La Milétrie (J.-P.N.), Hôpital Jean Bernard, Department of Neurology, Poitiers; CH de Pontoise (C. Pottier), Hôpital René Dubos, Department of Neurology; and Centre Hospitalier de Versailles (C.N.), Department of Neurology, F-78150 Le Chesnay, France
| | - Jean-Philippe Camdessanche
- From the Service de Neurologie (A.G., F.R., R.C., S.V.), Sclérose en Plaques, Pathologies de La Myéline et Neuro-inflammation, Hôpital Neurologique Pierre-Wertheimer, Hospices Civils de Lyon, Bron; Université de Lyon (A.G., M.R., F.S.), Université Claude Bernard Lyon 1, CNRS, Laboratoire de Biométrie et Biologie Évolutive UMR 5558, Villeurbanne; Service de Biostatistique-Bioinformatique (A.G., M.R., F.S.), Hospices Civils de Lyon; Université de Lyon (F.R., R.C., S.V.), Université Claude Bernard Lyon 1; Observatoire Français de La Sclérose en Plaques (F.R., R.C., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., R.C., S.V.), State-approved Foundation, Bron; Nancy University Hospital (M.D.), Department of Neurology, Université de Lorraine, APEMAC; CHU Pontchaillou (E.L.P.), CIC1414 INSERM, Rennes; CHU de Toulouse (J.C.), Hôpital Pierre-Paul Riquet, Department of Neurology, CRC-SEP, Toulouse; Infinity (J.C.), INSERM UMR1291-CNRS UMR5051, Université Toulouse III; CHU de Strasbourg (J.D.S.), Department of Neurology and Clinical Investigation Center, CIC 1434, INSERM 1434; Univ. Bordeaux (A.R.), F-33000 Bordeaux INSERM U1215, Neurocentre Magendie, F-33000 Bordeaux CHU de Bordeaux, Department of Neurology, CIC Bordeaux CIC1401; Département de Neurologie (E.M.), Hôpital Pitié-Salpêtrière, APHP, Paris; Centre de Ressources et de Compétences SEP Paris (E.M.); CHU de Montpellier (P.L.), MS Unit; University of Montpellier (MUSE) (P.L.); CHU Lille (H.Z.), CRCSEP Lille, Univ Lille, U1172; Fondation Rotschild (C. Papeix), Department of Neurology, Paris; CHU de Caen (G.D.), MS Expert Centre, Department of Neurology, Avenue de La Côte-de-Nacre, Normandy University, Caen; Neurology (C.L.-F.), UR2CA, Centre Hospitalier Universitaire Pasteur2, Université Nice Côte d'Azur, Nice; CHU de Dijon (T.M.), Department of Neurology, EA4184; CHU de Nantes (D.A.L.), Service de Neurologie & CIC015 INSERM; CRTI-Inserm U1064 (D.A.L.), Nantes; CHU de Besançon (E.B.), Service de Neurologie; Sorbonne Universités (B.S.), UPMC Paris 06, Brain and Spine Institute, ICM, Hôpital de La Pitié Salpêtrière, Inserm UMR S 1127, CNRS UMR 7225, and Department of Neurology, AP-HP, Saint-Antoine Hospital; CHU Clermont-Ferrand (Pierre Clavelou), Department of Neurology, F-63000 Clermont-Ferrand Université Clermont Auvergne, Inserm, Neuro-Dol, F-63000 Clermont-Ferrand; Department of Neurology (E.T.), Nimes University Hospital; Institut de Génomique Fonctionnelle (E.T.), UMR5203, INSERM 1191, Univ. Montpellier; Hôpital de Poissy (O.H.), Department of Neurology; Aix Marseille Univ (J.P.), APHM, Hôpital de La Timone, Pôle de Neurosciences Cliniques, Service de Neurologie; CHU d'Amiens (A.A.K.), Department of Neurology; CHU Grenoble Alpes (O.C.), Department of Neurology, La Tronche/Grenoble; CHU de Rouen (B.B.), Department of Neurology; CHU de La Martinique (Philippe Cabre), Department of Neurology, Fort-de-France; APHP (A.W.), Hôpital Henri Mondor, Department of Neurology, Créteil; CHU de Limoges (L.M.), Hôpital Dupuytren, Department of Neurology; CHU de Saint-Étienne (J.-P.C.), Hôpital Nord, Department of Neurology; CHU de Tours (A.M.), Hôpital Bretonneau, CRC SEP and Department of Neurology; CHU de Reims (S.M.), CRC-SEP, Department of Neurology; Hôpital Sud Francilien (N.H.B.), Department of Neurology, Corbeil Essonnes; CHU Bicêtre (D.D.B.), Department of Neurology, Le Kremlin Bicêtre; Department of Neurology (K.H.), Hôpital Pierre Delafontaine, Centre Hospitalier de Saint-Denis; CHU La Milétrie (J.-P.N.), Hôpital Jean Bernard, Department of Neurology, Poitiers; CH de Pontoise (C. Pottier), Hôpital René Dubos, Department of Neurology; and Centre Hospitalier de Versailles (C.N.), Department of Neurology, F-78150 Le Chesnay, France
| | - Aude Maurousset
- From the Service de Neurologie (A.G., F.R., R.C., S.V.), Sclérose en Plaques, Pathologies de La Myéline et Neuro-inflammation, Hôpital Neurologique Pierre-Wertheimer, Hospices Civils de Lyon, Bron; Université de Lyon (A.G., M.R., F.S.), Université Claude Bernard Lyon 1, CNRS, Laboratoire de Biométrie et Biologie Évolutive UMR 5558, Villeurbanne; Service de Biostatistique-Bioinformatique (A.G., M.R., F.S.), Hospices Civils de Lyon; Université de Lyon (F.R., R.C., S.V.), Université Claude Bernard Lyon 1; Observatoire Français de La Sclérose en Plaques (F.R., R.C., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., R.C., S.V.), State-approved Foundation, Bron; Nancy University Hospital (M.D.), Department of Neurology, Université de Lorraine, APEMAC; CHU Pontchaillou (E.L.P.), CIC1414 INSERM, Rennes; CHU de Toulouse (J.C.), Hôpital Pierre-Paul Riquet, Department of Neurology, CRC-SEP, Toulouse; Infinity (J.C.), INSERM UMR1291-CNRS UMR5051, Université Toulouse III; CHU de Strasbourg (J.D.S.), Department of Neurology and Clinical Investigation Center, CIC 1434, INSERM 1434; Univ. Bordeaux (A.R.), F-33000 Bordeaux INSERM U1215, Neurocentre Magendie, F-33000 Bordeaux CHU de Bordeaux, Department of Neurology, CIC Bordeaux CIC1401; Département de Neurologie (E.M.), Hôpital Pitié-Salpêtrière, APHP, Paris; Centre de Ressources et de Compétences SEP Paris (E.M.); CHU de Montpellier (P.L.), MS Unit; University of Montpellier (MUSE) (P.L.); CHU Lille (H.Z.), CRCSEP Lille, Univ Lille, U1172; Fondation Rotschild (C. Papeix), Department of Neurology, Paris; CHU de Caen (G.D.), MS Expert Centre, Department of Neurology, Avenue de La Côte-de-Nacre, Normandy University, Caen; Neurology (C.L.-F.), UR2CA, Centre Hospitalier Universitaire Pasteur2, Université Nice Côte d'Azur, Nice; CHU de Dijon (T.M.), Department of Neurology, EA4184; CHU de Nantes (D.A.L.), Service de Neurologie & CIC015 INSERM; CRTI-Inserm U1064 (D.A.L.), Nantes; CHU de Besançon (E.B.), Service de Neurologie; Sorbonne Universités (B.S.), UPMC Paris 06, Brain and Spine Institute, ICM, Hôpital de La Pitié Salpêtrière, Inserm UMR S 1127, CNRS UMR 7225, and Department of Neurology, AP-HP, Saint-Antoine Hospital; CHU Clermont-Ferrand (Pierre Clavelou), Department of Neurology, F-63000 Clermont-Ferrand Université Clermont Auvergne, Inserm, Neuro-Dol, F-63000 Clermont-Ferrand; Department of Neurology (E.T.), Nimes University Hospital; Institut de Génomique Fonctionnelle (E.T.), UMR5203, INSERM 1191, Univ. Montpellier; Hôpital de Poissy (O.H.), Department of Neurology; Aix Marseille Univ (J.P.), APHM, Hôpital de La Timone, Pôle de Neurosciences Cliniques, Service de Neurologie; CHU d'Amiens (A.A.K.), Department of Neurology; CHU Grenoble Alpes (O.C.), Department of Neurology, La Tronche/Grenoble; CHU de Rouen (B.B.), Department of Neurology; CHU de La Martinique (Philippe Cabre), Department of Neurology, Fort-de-France; APHP (A.W.), Hôpital Henri Mondor, Department of Neurology, Créteil; CHU de Limoges (L.M.), Hôpital Dupuytren, Department of Neurology; CHU de Saint-Étienne (J.-P.C.), Hôpital Nord, Department of Neurology; CHU de Tours (A.M.), Hôpital Bretonneau, CRC SEP and Department of Neurology; CHU de Reims (S.M.), CRC-SEP, Department of Neurology; Hôpital Sud Francilien (N.H.B.), Department of Neurology, Corbeil Essonnes; CHU Bicêtre (D.D.B.), Department of Neurology, Le Kremlin Bicêtre; Department of Neurology (K.H.), Hôpital Pierre Delafontaine, Centre Hospitalier de Saint-Denis; CHU La Milétrie (J.-P.N.), Hôpital Jean Bernard, Department of Neurology, Poitiers; CH de Pontoise (C. Pottier), Hôpital René Dubos, Department of Neurology; and Centre Hospitalier de Versailles (C.N.), Department of Neurology, F-78150 Le Chesnay, France
| | - Solène Moulin
- From the Service de Neurologie (A.G., F.R., R.C., S.V.), Sclérose en Plaques, Pathologies de La Myéline et Neuro-inflammation, Hôpital Neurologique Pierre-Wertheimer, Hospices Civils de Lyon, Bron; Université de Lyon (A.G., M.R., F.S.), Université Claude Bernard Lyon 1, CNRS, Laboratoire de Biométrie et Biologie Évolutive UMR 5558, Villeurbanne; Service de Biostatistique-Bioinformatique (A.G., M.R., F.S.), Hospices Civils de Lyon; Université de Lyon (F.R., R.C., S.V.), Université Claude Bernard Lyon 1; Observatoire Français de La Sclérose en Plaques (F.R., R.C., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., R.C., S.V.), State-approved Foundation, Bron; Nancy University Hospital (M.D.), Department of Neurology, Université de Lorraine, APEMAC; CHU Pontchaillou (E.L.P.), CIC1414 INSERM, Rennes; CHU de Toulouse (J.C.), Hôpital Pierre-Paul Riquet, Department of Neurology, CRC-SEP, Toulouse; Infinity (J.C.), INSERM UMR1291-CNRS UMR5051, Université Toulouse III; CHU de Strasbourg (J.D.S.), Department of Neurology and Clinical Investigation Center, CIC 1434, INSERM 1434; Univ. Bordeaux (A.R.), F-33000 Bordeaux INSERM U1215, Neurocentre Magendie, F-33000 Bordeaux CHU de Bordeaux, Department of Neurology, CIC Bordeaux CIC1401; Département de Neurologie (E.M.), Hôpital Pitié-Salpêtrière, APHP, Paris; Centre de Ressources et de Compétences SEP Paris (E.M.); CHU de Montpellier (P.L.), MS Unit; University of Montpellier (MUSE) (P.L.); CHU Lille (H.Z.), CRCSEP Lille, Univ Lille, U1172; Fondation Rotschild (C. Papeix), Department of Neurology, Paris; CHU de Caen (G.D.), MS Expert Centre, Department of Neurology, Avenue de La Côte-de-Nacre, Normandy University, Caen; Neurology (C.L.-F.), UR2CA, Centre Hospitalier Universitaire Pasteur2, Université Nice Côte d'Azur, Nice; CHU de Dijon (T.M.), Department of Neurology, EA4184; CHU de Nantes (D.A.L.), Service de Neurologie & CIC015 INSERM; CRTI-Inserm U1064 (D.A.L.), Nantes; CHU de Besançon (E.B.), Service de Neurologie; Sorbonne Universités (B.S.), UPMC Paris 06, Brain and Spine Institute, ICM, Hôpital de La Pitié Salpêtrière, Inserm UMR S 1127, CNRS UMR 7225, and Department of Neurology, AP-HP, Saint-Antoine Hospital; CHU Clermont-Ferrand (Pierre Clavelou), Department of Neurology, F-63000 Clermont-Ferrand Université Clermont Auvergne, Inserm, Neuro-Dol, F-63000 Clermont-Ferrand; Department of Neurology (E.T.), Nimes University Hospital; Institut de Génomique Fonctionnelle (E.T.), UMR5203, INSERM 1191, Univ. Montpellier; Hôpital de Poissy (O.H.), Department of Neurology; Aix Marseille Univ (J.P.), APHM, Hôpital de La Timone, Pôle de Neurosciences Cliniques, Service de Neurologie; CHU d'Amiens (A.A.K.), Department of Neurology; CHU Grenoble Alpes (O.C.), Department of Neurology, La Tronche/Grenoble; CHU de Rouen (B.B.), Department of Neurology; CHU de La Martinique (Philippe Cabre), Department of Neurology, Fort-de-France; APHP (A.W.), Hôpital Henri Mondor, Department of Neurology, Créteil; CHU de Limoges (L.M.), Hôpital Dupuytren, Department of Neurology; CHU de Saint-Étienne (J.-P.C.), Hôpital Nord, Department of Neurology; CHU de Tours (A.M.), Hôpital Bretonneau, CRC SEP and Department of Neurology; CHU de Reims (S.M.), CRC-SEP, Department of Neurology; Hôpital Sud Francilien (N.H.B.), Department of Neurology, Corbeil Essonnes; CHU Bicêtre (D.D.B.), Department of Neurology, Le Kremlin Bicêtre; Department of Neurology (K.H.), Hôpital Pierre Delafontaine, Centre Hospitalier de Saint-Denis; CHU La Milétrie (J.-P.N.), Hôpital Jean Bernard, Department of Neurology, Poitiers; CH de Pontoise (C. Pottier), Hôpital René Dubos, Department of Neurology; and Centre Hospitalier de Versailles (C.N.), Department of Neurology, F-78150 Le Chesnay, France
| | - Nasr Haifa Ben
- From the Service de Neurologie (A.G., F.R., R.C., S.V.), Sclérose en Plaques, Pathologies de La Myéline et Neuro-inflammation, Hôpital Neurologique Pierre-Wertheimer, Hospices Civils de Lyon, Bron; Université de Lyon (A.G., M.R., F.S.), Université Claude Bernard Lyon 1, CNRS, Laboratoire de Biométrie et Biologie Évolutive UMR 5558, Villeurbanne; Service de Biostatistique-Bioinformatique (A.G., M.R., F.S.), Hospices Civils de Lyon; Université de Lyon (F.R., R.C., S.V.), Université Claude Bernard Lyon 1; Observatoire Français de La Sclérose en Plaques (F.R., R.C., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., R.C., S.V.), State-approved Foundation, Bron; Nancy University Hospital (M.D.), Department of Neurology, Université de Lorraine, APEMAC; CHU Pontchaillou (E.L.P.), CIC1414 INSERM, Rennes; CHU de Toulouse (J.C.), Hôpital Pierre-Paul Riquet, Department of Neurology, CRC-SEP, Toulouse; Infinity (J.C.), INSERM UMR1291-CNRS UMR5051, Université Toulouse III; CHU de Strasbourg (J.D.S.), Department of Neurology and Clinical Investigation Center, CIC 1434, INSERM 1434; Univ. Bordeaux (A.R.), F-33000 Bordeaux INSERM U1215, Neurocentre Magendie, F-33000 Bordeaux CHU de Bordeaux, Department of Neurology, CIC Bordeaux CIC1401; Département de Neurologie (E.M.), Hôpital Pitié-Salpêtrière, APHP, Paris; Centre de Ressources et de Compétences SEP Paris (E.M.); CHU de Montpellier (P.L.), MS Unit; University of Montpellier (MUSE) (P.L.); CHU Lille (H.Z.), CRCSEP Lille, Univ Lille, U1172; Fondation Rotschild (C. Papeix), Department of Neurology, Paris; CHU de Caen (G.D.), MS Expert Centre, Department of Neurology, Avenue de La Côte-de-Nacre, Normandy University, Caen; Neurology (C.L.-F.), UR2CA, Centre Hospitalier Universitaire Pasteur2, Université Nice Côte d'Azur, Nice; CHU de Dijon (T.M.), Department of Neurology, EA4184; CHU de Nantes (D.A.L.), Service de Neurologie & CIC015 INSERM; CRTI-Inserm U1064 (D.A.L.), Nantes; CHU de Besançon (E.B.), Service de Neurologie; Sorbonne Universités (B.S.), UPMC Paris 06, Brain and Spine Institute, ICM, Hôpital de La Pitié Salpêtrière, Inserm UMR S 1127, CNRS UMR 7225, and Department of Neurology, AP-HP, Saint-Antoine Hospital; CHU Clermont-Ferrand (Pierre Clavelou), Department of Neurology, F-63000 Clermont-Ferrand Université Clermont Auvergne, Inserm, Neuro-Dol, F-63000 Clermont-Ferrand; Department of Neurology (E.T.), Nimes University Hospital; Institut de Génomique Fonctionnelle (E.T.), UMR5203, INSERM 1191, Univ. Montpellier; Hôpital de Poissy (O.H.), Department of Neurology; Aix Marseille Univ (J.P.), APHM, Hôpital de La Timone, Pôle de Neurosciences Cliniques, Service de Neurologie; CHU d'Amiens (A.A.K.), Department of Neurology; CHU Grenoble Alpes (O.C.), Department of Neurology, La Tronche/Grenoble; CHU de Rouen (B.B.), Department of Neurology; CHU de La Martinique (Philippe Cabre), Department of Neurology, Fort-de-France; APHP (A.W.), Hôpital Henri Mondor, Department of Neurology, Créteil; CHU de Limoges (L.M.), Hôpital Dupuytren, Department of Neurology; CHU de Saint-Étienne (J.-P.C.), Hôpital Nord, Department of Neurology; CHU de Tours (A.M.), Hôpital Bretonneau, CRC SEP and Department of Neurology; CHU de Reims (S.M.), CRC-SEP, Department of Neurology; Hôpital Sud Francilien (N.H.B.), Department of Neurology, Corbeil Essonnes; CHU Bicêtre (D.D.B.), Department of Neurology, Le Kremlin Bicêtre; Department of Neurology (K.H.), Hôpital Pierre Delafontaine, Centre Hospitalier de Saint-Denis; CHU La Milétrie (J.-P.N.), Hôpital Jean Bernard, Department of Neurology, Poitiers; CH de Pontoise (C. Pottier), Hôpital René Dubos, Department of Neurology; and Centre Hospitalier de Versailles (C.N.), Department of Neurology, F-78150 Le Chesnay, France
| | - Dalia Dimitri Boulos
- From the Service de Neurologie (A.G., F.R., R.C., S.V.), Sclérose en Plaques, Pathologies de La Myéline et Neuro-inflammation, Hôpital Neurologique Pierre-Wertheimer, Hospices Civils de Lyon, Bron; Université de Lyon (A.G., M.R., F.S.), Université Claude Bernard Lyon 1, CNRS, Laboratoire de Biométrie et Biologie Évolutive UMR 5558, Villeurbanne; Service de Biostatistique-Bioinformatique (A.G., M.R., F.S.), Hospices Civils de Lyon; Université de Lyon (F.R., R.C., S.V.), Université Claude Bernard Lyon 1; Observatoire Français de La Sclérose en Plaques (F.R., R.C., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., R.C., S.V.), State-approved Foundation, Bron; Nancy University Hospital (M.D.), Department of Neurology, Université de Lorraine, APEMAC; CHU Pontchaillou (E.L.P.), CIC1414 INSERM, Rennes; CHU de Toulouse (J.C.), Hôpital Pierre-Paul Riquet, Department of Neurology, CRC-SEP, Toulouse; Infinity (J.C.), INSERM UMR1291-CNRS UMR5051, Université Toulouse III; CHU de Strasbourg (J.D.S.), Department of Neurology and Clinical Investigation Center, CIC 1434, INSERM 1434; Univ. Bordeaux (A.R.), F-33000 Bordeaux INSERM U1215, Neurocentre Magendie, F-33000 Bordeaux CHU de Bordeaux, Department of Neurology, CIC Bordeaux CIC1401; Département de Neurologie (E.M.), Hôpital Pitié-Salpêtrière, APHP, Paris; Centre de Ressources et de Compétences SEP Paris (E.M.); CHU de Montpellier (P.L.), MS Unit; University of Montpellier (MUSE) (P.L.); CHU Lille (H.Z.), CRCSEP Lille, Univ Lille, U1172; Fondation Rotschild (C. Papeix), Department of Neurology, Paris; CHU de Caen (G.D.), MS Expert Centre, Department of Neurology, Avenue de La Côte-de-Nacre, Normandy University, Caen; Neurology (C.L.-F.), UR2CA, Centre Hospitalier Universitaire Pasteur2, Université Nice Côte d'Azur, Nice; CHU de Dijon (T.M.), Department of Neurology, EA4184; CHU de Nantes (D.A.L.), Service de Neurologie & CIC015 INSERM; CRTI-Inserm U1064 (D.A.L.), Nantes; CHU de Besançon (E.B.), Service de Neurologie; Sorbonne Universités (B.S.), UPMC Paris 06, Brain and Spine Institute, ICM, Hôpital de La Pitié Salpêtrière, Inserm UMR S 1127, CNRS UMR 7225, and Department of Neurology, AP-HP, Saint-Antoine Hospital; CHU Clermont-Ferrand (Pierre Clavelou), Department of Neurology, F-63000 Clermont-Ferrand Université Clermont Auvergne, Inserm, Neuro-Dol, F-63000 Clermont-Ferrand; Department of Neurology (E.T.), Nimes University Hospital; Institut de Génomique Fonctionnelle (E.T.), UMR5203, INSERM 1191, Univ. Montpellier; Hôpital de Poissy (O.H.), Department of Neurology; Aix Marseille Univ (J.P.), APHM, Hôpital de La Timone, Pôle de Neurosciences Cliniques, Service de Neurologie; CHU d'Amiens (A.A.K.), Department of Neurology; CHU Grenoble Alpes (O.C.), Department of Neurology, La Tronche/Grenoble; CHU de Rouen (B.B.), Department of Neurology; CHU de La Martinique (Philippe Cabre), Department of Neurology, Fort-de-France; APHP (A.W.), Hôpital Henri Mondor, Department of Neurology, Créteil; CHU de Limoges (L.M.), Hôpital Dupuytren, Department of Neurology; CHU de Saint-Étienne (J.-P.C.), Hôpital Nord, Department of Neurology; CHU de Tours (A.M.), Hôpital Bretonneau, CRC SEP and Department of Neurology; CHU de Reims (S.M.), CRC-SEP, Department of Neurology; Hôpital Sud Francilien (N.H.B.), Department of Neurology, Corbeil Essonnes; CHU Bicêtre (D.D.B.), Department of Neurology, Le Kremlin Bicêtre; Department of Neurology (K.H.), Hôpital Pierre Delafontaine, Centre Hospitalier de Saint-Denis; CHU La Milétrie (J.-P.N.), Hôpital Jean Bernard, Department of Neurology, Poitiers; CH de Pontoise (C. Pottier), Hôpital René Dubos, Department of Neurology; and Centre Hospitalier de Versailles (C.N.), Department of Neurology, F-78150 Le Chesnay, France
| | - Karolina Hankiewicz
- From the Service de Neurologie (A.G., F.R., R.C., S.V.), Sclérose en Plaques, Pathologies de La Myéline et Neuro-inflammation, Hôpital Neurologique Pierre-Wertheimer, Hospices Civils de Lyon, Bron; Université de Lyon (A.G., M.R., F.S.), Université Claude Bernard Lyon 1, CNRS, Laboratoire de Biométrie et Biologie Évolutive UMR 5558, Villeurbanne; Service de Biostatistique-Bioinformatique (A.G., M.R., F.S.), Hospices Civils de Lyon; Université de Lyon (F.R., R.C., S.V.), Université Claude Bernard Lyon 1; Observatoire Français de La Sclérose en Plaques (F.R., R.C., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., R.C., S.V.), State-approved Foundation, Bron; Nancy University Hospital (M.D.), Department of Neurology, Université de Lorraine, APEMAC; CHU Pontchaillou (E.L.P.), CIC1414 INSERM, Rennes; CHU de Toulouse (J.C.), Hôpital Pierre-Paul Riquet, Department of Neurology, CRC-SEP, Toulouse; Infinity (J.C.), INSERM UMR1291-CNRS UMR5051, Université Toulouse III; CHU de Strasbourg (J.D.S.), Department of Neurology and Clinical Investigation Center, CIC 1434, INSERM 1434; Univ. Bordeaux (A.R.), F-33000 Bordeaux INSERM U1215, Neurocentre Magendie, F-33000 Bordeaux CHU de Bordeaux, Department of Neurology, CIC Bordeaux CIC1401; Département de Neurologie (E.M.), Hôpital Pitié-Salpêtrière, APHP, Paris; Centre de Ressources et de Compétences SEP Paris (E.M.); CHU de Montpellier (P.L.), MS Unit; University of Montpellier (MUSE) (P.L.); CHU Lille (H.Z.), CRCSEP Lille, Univ Lille, U1172; Fondation Rotschild (C. Papeix), Department of Neurology, Paris; CHU de Caen (G.D.), MS Expert Centre, Department of Neurology, Avenue de La Côte-de-Nacre, Normandy University, Caen; Neurology (C.L.-F.), UR2CA, Centre Hospitalier Universitaire Pasteur2, Université Nice Côte d'Azur, Nice; CHU de Dijon (T.M.), Department of Neurology, EA4184; CHU de Nantes (D.A.L.), Service de Neurologie & CIC015 INSERM; CRTI-Inserm U1064 (D.A.L.), Nantes; CHU de Besançon (E.B.), Service de Neurologie; Sorbonne Universités (B.S.), UPMC Paris 06, Brain and Spine Institute, ICM, Hôpital de La Pitié Salpêtrière, Inserm UMR S 1127, CNRS UMR 7225, and Department of Neurology, AP-HP, Saint-Antoine Hospital; CHU Clermont-Ferrand (Pierre Clavelou), Department of Neurology, F-63000 Clermont-Ferrand Université Clermont Auvergne, Inserm, Neuro-Dol, F-63000 Clermont-Ferrand; Department of Neurology (E.T.), Nimes University Hospital; Institut de Génomique Fonctionnelle (E.T.), UMR5203, INSERM 1191, Univ. Montpellier; Hôpital de Poissy (O.H.), Department of Neurology; Aix Marseille Univ (J.P.), APHM, Hôpital de La Timone, Pôle de Neurosciences Cliniques, Service de Neurologie; CHU d'Amiens (A.A.K.), Department of Neurology; CHU Grenoble Alpes (O.C.), Department of Neurology, La Tronche/Grenoble; CHU de Rouen (B.B.), Department of Neurology; CHU de La Martinique (Philippe Cabre), Department of Neurology, Fort-de-France; APHP (A.W.), Hôpital Henri Mondor, Department of Neurology, Créteil; CHU de Limoges (L.M.), Hôpital Dupuytren, Department of Neurology; CHU de Saint-Étienne (J.-P.C.), Hôpital Nord, Department of Neurology; CHU de Tours (A.M.), Hôpital Bretonneau, CRC SEP and Department of Neurology; CHU de Reims (S.M.), CRC-SEP, Department of Neurology; Hôpital Sud Francilien (N.H.B.), Department of Neurology, Corbeil Essonnes; CHU Bicêtre (D.D.B.), Department of Neurology, Le Kremlin Bicêtre; Department of Neurology (K.H.), Hôpital Pierre Delafontaine, Centre Hospitalier de Saint-Denis; CHU La Milétrie (J.-P.N.), Hôpital Jean Bernard, Department of Neurology, Poitiers; CH de Pontoise (C. Pottier), Hôpital René Dubos, Department of Neurology; and Centre Hospitalier de Versailles (C.N.), Department of Neurology, F-78150 Le Chesnay, France
| | - Jean-Philippe Neau
- From the Service de Neurologie (A.G., F.R., R.C., S.V.), Sclérose en Plaques, Pathologies de La Myéline et Neuro-inflammation, Hôpital Neurologique Pierre-Wertheimer, Hospices Civils de Lyon, Bron; Université de Lyon (A.G., M.R., F.S.), Université Claude Bernard Lyon 1, CNRS, Laboratoire de Biométrie et Biologie Évolutive UMR 5558, Villeurbanne; Service de Biostatistique-Bioinformatique (A.G., M.R., F.S.), Hospices Civils de Lyon; Université de Lyon (F.R., R.C., S.V.), Université Claude Bernard Lyon 1; Observatoire Français de La Sclérose en Plaques (F.R., R.C., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., R.C., S.V.), State-approved Foundation, Bron; Nancy University Hospital (M.D.), Department of Neurology, Université de Lorraine, APEMAC; CHU Pontchaillou (E.L.P.), CIC1414 INSERM, Rennes; CHU de Toulouse (J.C.), Hôpital Pierre-Paul Riquet, Department of Neurology, CRC-SEP, Toulouse; Infinity (J.C.), INSERM UMR1291-CNRS UMR5051, Université Toulouse III; CHU de Strasbourg (J.D.S.), Department of Neurology and Clinical Investigation Center, CIC 1434, INSERM 1434; Univ. Bordeaux (A.R.), F-33000 Bordeaux INSERM U1215, Neurocentre Magendie, F-33000 Bordeaux CHU de Bordeaux, Department of Neurology, CIC Bordeaux CIC1401; Département de Neurologie (E.M.), Hôpital Pitié-Salpêtrière, APHP, Paris; Centre de Ressources et de Compétences SEP Paris (E.M.); CHU de Montpellier (P.L.), MS Unit; University of Montpellier (MUSE) (P.L.); CHU Lille (H.Z.), CRCSEP Lille, Univ Lille, U1172; Fondation Rotschild (C. Papeix), Department of Neurology, Paris; CHU de Caen (G.D.), MS Expert Centre, Department of Neurology, Avenue de La Côte-de-Nacre, Normandy University, Caen; Neurology (C.L.-F.), UR2CA, Centre Hospitalier Universitaire Pasteur2, Université Nice Côte d'Azur, Nice; CHU de Dijon (T.M.), Department of Neurology, EA4184; CHU de Nantes (D.A.L.), Service de Neurologie & CIC015 INSERM; CRTI-Inserm U1064 (D.A.L.), Nantes; CHU de Besançon (E.B.), Service de Neurologie; Sorbonne Universités (B.S.), UPMC Paris 06, Brain and Spine Institute, ICM, Hôpital de La Pitié Salpêtrière, Inserm UMR S 1127, CNRS UMR 7225, and Department of Neurology, AP-HP, Saint-Antoine Hospital; CHU Clermont-Ferrand (Pierre Clavelou), Department of Neurology, F-63000 Clermont-Ferrand Université Clermont Auvergne, Inserm, Neuro-Dol, F-63000 Clermont-Ferrand; Department of Neurology (E.T.), Nimes University Hospital; Institut de Génomique Fonctionnelle (E.T.), UMR5203, INSERM 1191, Univ. Montpellier; Hôpital de Poissy (O.H.), Department of Neurology; Aix Marseille Univ (J.P.), APHM, Hôpital de La Timone, Pôle de Neurosciences Cliniques, Service de Neurologie; CHU d'Amiens (A.A.K.), Department of Neurology; CHU Grenoble Alpes (O.C.), Department of Neurology, La Tronche/Grenoble; CHU de Rouen (B.B.), Department of Neurology; CHU de La Martinique (Philippe Cabre), Department of Neurology, Fort-de-France; APHP (A.W.), Hôpital Henri Mondor, Department of Neurology, Créteil; CHU de Limoges (L.M.), Hôpital Dupuytren, Department of Neurology; CHU de Saint-Étienne (J.-P.C.), Hôpital Nord, Department of Neurology; CHU de Tours (A.M.), Hôpital Bretonneau, CRC SEP and Department of Neurology; CHU de Reims (S.M.), CRC-SEP, Department of Neurology; Hôpital Sud Francilien (N.H.B.), Department of Neurology, Corbeil Essonnes; CHU Bicêtre (D.D.B.), Department of Neurology, Le Kremlin Bicêtre; Department of Neurology (K.H.), Hôpital Pierre Delafontaine, Centre Hospitalier de Saint-Denis; CHU La Milétrie (J.-P.N.), Hôpital Jean Bernard, Department of Neurology, Poitiers; CH de Pontoise (C. Pottier), Hôpital René Dubos, Department of Neurology; and Centre Hospitalier de Versailles (C.N.), Department of Neurology, F-78150 Le Chesnay, France
| | - Corinne Pottier
- From the Service de Neurologie (A.G., F.R., R.C., S.V.), Sclérose en Plaques, Pathologies de La Myéline et Neuro-inflammation, Hôpital Neurologique Pierre-Wertheimer, Hospices Civils de Lyon, Bron; Université de Lyon (A.G., M.R., F.S.), Université Claude Bernard Lyon 1, CNRS, Laboratoire de Biométrie et Biologie Évolutive UMR 5558, Villeurbanne; Service de Biostatistique-Bioinformatique (A.G., M.R., F.S.), Hospices Civils de Lyon; Université de Lyon (F.R., R.C., S.V.), Université Claude Bernard Lyon 1; Observatoire Français de La Sclérose en Plaques (F.R., R.C., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., R.C., S.V.), State-approved Foundation, Bron; Nancy University Hospital (M.D.), Department of Neurology, Université de Lorraine, APEMAC; CHU Pontchaillou (E.L.P.), CIC1414 INSERM, Rennes; CHU de Toulouse (J.C.), Hôpital Pierre-Paul Riquet, Department of Neurology, CRC-SEP, Toulouse; Infinity (J.C.), INSERM UMR1291-CNRS UMR5051, Université Toulouse III; CHU de Strasbourg (J.D.S.), Department of Neurology and Clinical Investigation Center, CIC 1434, INSERM 1434; Univ. Bordeaux (A.R.), F-33000 Bordeaux INSERM U1215, Neurocentre Magendie, F-33000 Bordeaux CHU de Bordeaux, Department of Neurology, CIC Bordeaux CIC1401; Département de Neurologie (E.M.), Hôpital Pitié-Salpêtrière, APHP, Paris; Centre de Ressources et de Compétences SEP Paris (E.M.); CHU de Montpellier (P.L.), MS Unit; University of Montpellier (MUSE) (P.L.); CHU Lille (H.Z.), CRCSEP Lille, Univ Lille, U1172; Fondation Rotschild (C. Papeix), Department of Neurology, Paris; CHU de Caen (G.D.), MS Expert Centre, Department of Neurology, Avenue de La Côte-de-Nacre, Normandy University, Caen; Neurology (C.L.-F.), UR2CA, Centre Hospitalier Universitaire Pasteur2, Université Nice Côte d'Azur, Nice; CHU de Dijon (T.M.), Department of Neurology, EA4184; CHU de Nantes (D.A.L.), Service de Neurologie & CIC015 INSERM; CRTI-Inserm U1064 (D.A.L.), Nantes; CHU de Besançon (E.B.), Service de Neurologie; Sorbonne Universités (B.S.), UPMC Paris 06, Brain and Spine Institute, ICM, Hôpital de La Pitié Salpêtrière, Inserm UMR S 1127, CNRS UMR 7225, and Department of Neurology, AP-HP, Saint-Antoine Hospital; CHU Clermont-Ferrand (Pierre Clavelou), Department of Neurology, F-63000 Clermont-Ferrand Université Clermont Auvergne, Inserm, Neuro-Dol, F-63000 Clermont-Ferrand; Department of Neurology (E.T.), Nimes University Hospital; Institut de Génomique Fonctionnelle (E.T.), UMR5203, INSERM 1191, Univ. Montpellier; Hôpital de Poissy (O.H.), Department of Neurology; Aix Marseille Univ (J.P.), APHM, Hôpital de La Timone, Pôle de Neurosciences Cliniques, Service de Neurologie; CHU d'Amiens (A.A.K.), Department of Neurology; CHU Grenoble Alpes (O.C.), Department of Neurology, La Tronche/Grenoble; CHU de Rouen (B.B.), Department of Neurology; CHU de La Martinique (Philippe Cabre), Department of Neurology, Fort-de-France; APHP (A.W.), Hôpital Henri Mondor, Department of Neurology, Créteil; CHU de Limoges (L.M.), Hôpital Dupuytren, Department of Neurology; CHU de Saint-Étienne (J.-P.C.), Hôpital Nord, Department of Neurology; CHU de Tours (A.M.), Hôpital Bretonneau, CRC SEP and Department of Neurology; CHU de Reims (S.M.), CRC-SEP, Department of Neurology; Hôpital Sud Francilien (N.H.B.), Department of Neurology, Corbeil Essonnes; CHU Bicêtre (D.D.B.), Department of Neurology, Le Kremlin Bicêtre; Department of Neurology (K.H.), Hôpital Pierre Delafontaine, Centre Hospitalier de Saint-Denis; CHU La Milétrie (J.-P.N.), Hôpital Jean Bernard, Department of Neurology, Poitiers; CH de Pontoise (C. Pottier), Hôpital René Dubos, Department of Neurology; and Centre Hospitalier de Versailles (C.N.), Department of Neurology, F-78150 Le Chesnay, France
| | - Chantal Nifle
- From the Service de Neurologie (A.G., F.R., R.C., S.V.), Sclérose en Plaques, Pathologies de La Myéline et Neuro-inflammation, Hôpital Neurologique Pierre-Wertheimer, Hospices Civils de Lyon, Bron; Université de Lyon (A.G., M.R., F.S.), Université Claude Bernard Lyon 1, CNRS, Laboratoire de Biométrie et Biologie Évolutive UMR 5558, Villeurbanne; Service de Biostatistique-Bioinformatique (A.G., M.R., F.S.), Hospices Civils de Lyon; Université de Lyon (F.R., R.C., S.V.), Université Claude Bernard Lyon 1; Observatoire Français de La Sclérose en Plaques (F.R., R.C., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., R.C., S.V.), State-approved Foundation, Bron; Nancy University Hospital (M.D.), Department of Neurology, Université de Lorraine, APEMAC; CHU Pontchaillou (E.L.P.), CIC1414 INSERM, Rennes; CHU de Toulouse (J.C.), Hôpital Pierre-Paul Riquet, Department of Neurology, CRC-SEP, Toulouse; Infinity (J.C.), INSERM UMR1291-CNRS UMR5051, Université Toulouse III; CHU de Strasbourg (J.D.S.), Department of Neurology and Clinical Investigation Center, CIC 1434, INSERM 1434; Univ. Bordeaux (A.R.), F-33000 Bordeaux INSERM U1215, Neurocentre Magendie, F-33000 Bordeaux CHU de Bordeaux, Department of Neurology, CIC Bordeaux CIC1401; Département de Neurologie (E.M.), Hôpital Pitié-Salpêtrière, APHP, Paris; Centre de Ressources et de Compétences SEP Paris (E.M.); CHU de Montpellier (P.L.), MS Unit; University of Montpellier (MUSE) (P.L.); CHU Lille (H.Z.), CRCSEP Lille, Univ Lille, U1172; Fondation Rotschild (C. Papeix), Department of Neurology, Paris; CHU de Caen (G.D.), MS Expert Centre, Department of Neurology, Avenue de La Côte-de-Nacre, Normandy University, Caen; Neurology (C.L.-F.), UR2CA, Centre Hospitalier Universitaire Pasteur2, Université Nice Côte d'Azur, Nice; CHU de Dijon (T.M.), Department of Neurology, EA4184; CHU de Nantes (D.A.L.), Service de Neurologie & CIC015 INSERM; CRTI-Inserm U1064 (D.A.L.), Nantes; CHU de Besançon (E.B.), Service de Neurologie; Sorbonne Universités (B.S.), UPMC Paris 06, Brain and Spine Institute, ICM, Hôpital de La Pitié Salpêtrière, Inserm UMR S 1127, CNRS UMR 7225, and Department of Neurology, AP-HP, Saint-Antoine Hospital; CHU Clermont-Ferrand (Pierre Clavelou), Department of Neurology, F-63000 Clermont-Ferrand Université Clermont Auvergne, Inserm, Neuro-Dol, F-63000 Clermont-Ferrand; Department of Neurology (E.T.), Nimes University Hospital; Institut de Génomique Fonctionnelle (E.T.), UMR5203, INSERM 1191, Univ. Montpellier; Hôpital de Poissy (O.H.), Department of Neurology; Aix Marseille Univ (J.P.), APHM, Hôpital de La Timone, Pôle de Neurosciences Cliniques, Service de Neurologie; CHU d'Amiens (A.A.K.), Department of Neurology; CHU Grenoble Alpes (O.C.), Department of Neurology, La Tronche/Grenoble; CHU de Rouen (B.B.), Department of Neurology; CHU de La Martinique (Philippe Cabre), Department of Neurology, Fort-de-France; APHP (A.W.), Hôpital Henri Mondor, Department of Neurology, Créteil; CHU de Limoges (L.M.), Hôpital Dupuytren, Department of Neurology; CHU de Saint-Étienne (J.-P.C.), Hôpital Nord, Department of Neurology; CHU de Tours (A.M.), Hôpital Bretonneau, CRC SEP and Department of Neurology; CHU de Reims (S.M.), CRC-SEP, Department of Neurology; Hôpital Sud Francilien (N.H.B.), Department of Neurology, Corbeil Essonnes; CHU Bicêtre (D.D.B.), Department of Neurology, Le Kremlin Bicêtre; Department of Neurology (K.H.), Hôpital Pierre Delafontaine, Centre Hospitalier de Saint-Denis; CHU La Milétrie (J.-P.N.), Hôpital Jean Bernard, Department of Neurology, Poitiers; CH de Pontoise (C. Pottier), Hôpital René Dubos, Department of Neurology; and Centre Hospitalier de Versailles (C.N.), Department of Neurology, F-78150 Le Chesnay, France
| | - Muriel Rabilloud
- From the Service de Neurologie (A.G., F.R., R.C., S.V.), Sclérose en Plaques, Pathologies de La Myéline et Neuro-inflammation, Hôpital Neurologique Pierre-Wertheimer, Hospices Civils de Lyon, Bron; Université de Lyon (A.G., M.R., F.S.), Université Claude Bernard Lyon 1, CNRS, Laboratoire de Biométrie et Biologie Évolutive UMR 5558, Villeurbanne; Service de Biostatistique-Bioinformatique (A.G., M.R., F.S.), Hospices Civils de Lyon; Université de Lyon (F.R., R.C., S.V.), Université Claude Bernard Lyon 1; Observatoire Français de La Sclérose en Plaques (F.R., R.C., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., R.C., S.V.), State-approved Foundation, Bron; Nancy University Hospital (M.D.), Department of Neurology, Université de Lorraine, APEMAC; CHU Pontchaillou (E.L.P.), CIC1414 INSERM, Rennes; CHU de Toulouse (J.C.), Hôpital Pierre-Paul Riquet, Department of Neurology, CRC-SEP, Toulouse; Infinity (J.C.), INSERM UMR1291-CNRS UMR5051, Université Toulouse III; CHU de Strasbourg (J.D.S.), Department of Neurology and Clinical Investigation Center, CIC 1434, INSERM 1434; Univ. Bordeaux (A.R.), F-33000 Bordeaux INSERM U1215, Neurocentre Magendie, F-33000 Bordeaux CHU de Bordeaux, Department of Neurology, CIC Bordeaux CIC1401; Département de Neurologie (E.M.), Hôpital Pitié-Salpêtrière, APHP, Paris; Centre de Ressources et de Compétences SEP Paris (E.M.); CHU de Montpellier (P.L.), MS Unit; University of Montpellier (MUSE) (P.L.); CHU Lille (H.Z.), CRCSEP Lille, Univ Lille, U1172; Fondation Rotschild (C. Papeix), Department of Neurology, Paris; CHU de Caen (G.D.), MS Expert Centre, Department of Neurology, Avenue de La Côte-de-Nacre, Normandy University, Caen; Neurology (C.L.-F.), UR2CA, Centre Hospitalier Universitaire Pasteur2, Université Nice Côte d'Azur, Nice; CHU de Dijon (T.M.), Department of Neurology, EA4184; CHU de Nantes (D.A.L.), Service de Neurologie & CIC015 INSERM; CRTI-Inserm U1064 (D.A.L.), Nantes; CHU de Besançon (E.B.), Service de Neurologie; Sorbonne Universités (B.S.), UPMC Paris 06, Brain and Spine Institute, ICM, Hôpital de La Pitié Salpêtrière, Inserm UMR S 1127, CNRS UMR 7225, and Department of Neurology, AP-HP, Saint-Antoine Hospital; CHU Clermont-Ferrand (Pierre Clavelou), Department of Neurology, F-63000 Clermont-Ferrand Université Clermont Auvergne, Inserm, Neuro-Dol, F-63000 Clermont-Ferrand; Department of Neurology (E.T.), Nimes University Hospital; Institut de Génomique Fonctionnelle (E.T.), UMR5203, INSERM 1191, Univ. Montpellier; Hôpital de Poissy (O.H.), Department of Neurology; Aix Marseille Univ (J.P.), APHM, Hôpital de La Timone, Pôle de Neurosciences Cliniques, Service de Neurologie; CHU d'Amiens (A.A.K.), Department of Neurology; CHU Grenoble Alpes (O.C.), Department of Neurology, La Tronche/Grenoble; CHU de Rouen (B.B.), Department of Neurology; CHU de La Martinique (Philippe Cabre), Department of Neurology, Fort-de-France; APHP (A.W.), Hôpital Henri Mondor, Department of Neurology, Créteil; CHU de Limoges (L.M.), Hôpital Dupuytren, Department of Neurology; CHU de Saint-Étienne (J.-P.C.), Hôpital Nord, Department of Neurology; CHU de Tours (A.M.), Hôpital Bretonneau, CRC SEP and Department of Neurology; CHU de Reims (S.M.), CRC-SEP, Department of Neurology; Hôpital Sud Francilien (N.H.B.), Department of Neurology, Corbeil Essonnes; CHU Bicêtre (D.D.B.), Department of Neurology, Le Kremlin Bicêtre; Department of Neurology (K.H.), Hôpital Pierre Delafontaine, Centre Hospitalier de Saint-Denis; CHU La Milétrie (J.-P.N.), Hôpital Jean Bernard, Department of Neurology, Poitiers; CH de Pontoise (C. Pottier), Hôpital René Dubos, Department of Neurology; and Centre Hospitalier de Versailles (C.N.), Department of Neurology, F-78150 Le Chesnay, France
| | - Fabien Subtil
- From the Service de Neurologie (A.G., F.R., R.C., S.V.), Sclérose en Plaques, Pathologies de La Myéline et Neuro-inflammation, Hôpital Neurologique Pierre-Wertheimer, Hospices Civils de Lyon, Bron; Université de Lyon (A.G., M.R., F.S.), Université Claude Bernard Lyon 1, CNRS, Laboratoire de Biométrie et Biologie Évolutive UMR 5558, Villeurbanne; Service de Biostatistique-Bioinformatique (A.G., M.R., F.S.), Hospices Civils de Lyon; Université de Lyon (F.R., R.C., S.V.), Université Claude Bernard Lyon 1; Observatoire Français de La Sclérose en Plaques (F.R., R.C., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., R.C., S.V.), State-approved Foundation, Bron; Nancy University Hospital (M.D.), Department of Neurology, Université de Lorraine, APEMAC; CHU Pontchaillou (E.L.P.), CIC1414 INSERM, Rennes; CHU de Toulouse (J.C.), Hôpital Pierre-Paul Riquet, Department of Neurology, CRC-SEP, Toulouse; Infinity (J.C.), INSERM UMR1291-CNRS UMR5051, Université Toulouse III; CHU de Strasbourg (J.D.S.), Department of Neurology and Clinical Investigation Center, CIC 1434, INSERM 1434; Univ. Bordeaux (A.R.), F-33000 Bordeaux INSERM U1215, Neurocentre Magendie, F-33000 Bordeaux CHU de Bordeaux, Department of Neurology, CIC Bordeaux CIC1401; Département de Neurologie (E.M.), Hôpital Pitié-Salpêtrière, APHP, Paris; Centre de Ressources et de Compétences SEP Paris (E.M.); CHU de Montpellier (P.L.), MS Unit; University of Montpellier (MUSE) (P.L.); CHU Lille (H.Z.), CRCSEP Lille, Univ Lille, U1172; Fondation Rotschild (C. Papeix), Department of Neurology, Paris; CHU de Caen (G.D.), MS Expert Centre, Department of Neurology, Avenue de La Côte-de-Nacre, Normandy University, Caen; Neurology (C.L.-F.), UR2CA, Centre Hospitalier Universitaire Pasteur2, Université Nice Côte d'Azur, Nice; CHU de Dijon (T.M.), Department of Neurology, EA4184; CHU de Nantes (D.A.L.), Service de Neurologie & CIC015 INSERM; CRTI-Inserm U1064 (D.A.L.), Nantes; CHU de Besançon (E.B.), Service de Neurologie; Sorbonne Universités (B.S.), UPMC Paris 06, Brain and Spine Institute, ICM, Hôpital de La Pitié Salpêtrière, Inserm UMR S 1127, CNRS UMR 7225, and Department of Neurology, AP-HP, Saint-Antoine Hospital; CHU Clermont-Ferrand (Pierre Clavelou), Department of Neurology, F-63000 Clermont-Ferrand Université Clermont Auvergne, Inserm, Neuro-Dol, F-63000 Clermont-Ferrand; Department of Neurology (E.T.), Nimes University Hospital; Institut de Génomique Fonctionnelle (E.T.), UMR5203, INSERM 1191, Univ. Montpellier; Hôpital de Poissy (O.H.), Department of Neurology; Aix Marseille Univ (J.P.), APHM, Hôpital de La Timone, Pôle de Neurosciences Cliniques, Service de Neurologie; CHU d'Amiens (A.A.K.), Department of Neurology; CHU Grenoble Alpes (O.C.), Department of Neurology, La Tronche/Grenoble; CHU de Rouen (B.B.), Department of Neurology; CHU de La Martinique (Philippe Cabre), Department of Neurology, Fort-de-France; APHP (A.W.), Hôpital Henri Mondor, Department of Neurology, Créteil; CHU de Limoges (L.M.), Hôpital Dupuytren, Department of Neurology; CHU de Saint-Étienne (J.-P.C.), Hôpital Nord, Department of Neurology; CHU de Tours (A.M.), Hôpital Bretonneau, CRC SEP and Department of Neurology; CHU de Reims (S.M.), CRC-SEP, Department of Neurology; Hôpital Sud Francilien (N.H.B.), Department of Neurology, Corbeil Essonnes; CHU Bicêtre (D.D.B.), Department of Neurology, Le Kremlin Bicêtre; Department of Neurology (K.H.), Hôpital Pierre Delafontaine, Centre Hospitalier de Saint-Denis; CHU La Milétrie (J.-P.N.), Hôpital Jean Bernard, Department of Neurology, Poitiers; CH de Pontoise (C. Pottier), Hôpital René Dubos, Department of Neurology; and Centre Hospitalier de Versailles (C.N.), Department of Neurology, F-78150 Le Chesnay, France
| | - Sandra Vukusic
- From the Service de Neurologie (A.G., F.R., R.C., S.V.), Sclérose en Plaques, Pathologies de La Myéline et Neuro-inflammation, Hôpital Neurologique Pierre-Wertheimer, Hospices Civils de Lyon, Bron; Université de Lyon (A.G., M.R., F.S.), Université Claude Bernard Lyon 1, CNRS, Laboratoire de Biométrie et Biologie Évolutive UMR 5558, Villeurbanne; Service de Biostatistique-Bioinformatique (A.G., M.R., F.S.), Hospices Civils de Lyon; Université de Lyon (F.R., R.C., S.V.), Université Claude Bernard Lyon 1; Observatoire Français de La Sclérose en Plaques (F.R., R.C., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., R.C., S.V.), State-approved Foundation, Bron; Nancy University Hospital (M.D.), Department of Neurology, Université de Lorraine, APEMAC; CHU Pontchaillou (E.L.P.), CIC1414 INSERM, Rennes; CHU de Toulouse (J.C.), Hôpital Pierre-Paul Riquet, Department of Neurology, CRC-SEP, Toulouse; Infinity (J.C.), INSERM UMR1291-CNRS UMR5051, Université Toulouse III; CHU de Strasbourg (J.D.S.), Department of Neurology and Clinical Investigation Center, CIC 1434, INSERM 1434; Univ. Bordeaux (A.R.), F-33000 Bordeaux INSERM U1215, Neurocentre Magendie, F-33000 Bordeaux CHU de Bordeaux, Department of Neurology, CIC Bordeaux CIC1401; Département de Neurologie (E.M.), Hôpital Pitié-Salpêtrière, APHP, Paris; Centre de Ressources et de Compétences SEP Paris (E.M.); CHU de Montpellier (P.L.), MS Unit; University of Montpellier (MUSE) (P.L.); CHU Lille (H.Z.), CRCSEP Lille, Univ Lille, U1172; Fondation Rotschild (C. Papeix), Department of Neurology, Paris; CHU de Caen (G.D.), MS Expert Centre, Department of Neurology, Avenue de La Côte-de-Nacre, Normandy University, Caen; Neurology (C.L.-F.), UR2CA, Centre Hospitalier Universitaire Pasteur2, Université Nice Côte d'Azur, Nice; CHU de Dijon (T.M.), Department of Neurology, EA4184; CHU de Nantes (D.A.L.), Service de Neurologie & CIC015 INSERM; CRTI-Inserm U1064 (D.A.L.), Nantes; CHU de Besançon (E.B.), Service de Neurologie; Sorbonne Universités (B.S.), UPMC Paris 06, Brain and Spine Institute, ICM, Hôpital de La Pitié Salpêtrière, Inserm UMR S 1127, CNRS UMR 7225, and Department of Neurology, AP-HP, Saint-Antoine Hospital; CHU Clermont-Ferrand (Pierre Clavelou), Department of Neurology, F-63000 Clermont-Ferrand Université Clermont Auvergne, Inserm, Neuro-Dol, F-63000 Clermont-Ferrand; Department of Neurology (E.T.), Nimes University Hospital; Institut de Génomique Fonctionnelle (E.T.), UMR5203, INSERM 1191, Univ. Montpellier; Hôpital de Poissy (O.H.), Department of Neurology; Aix Marseille Univ (J.P.), APHM, Hôpital de La Timone, Pôle de Neurosciences Cliniques, Service de Neurologie; CHU d'Amiens (A.A.K.), Department of Neurology; CHU Grenoble Alpes (O.C.), Department of Neurology, La Tronche/Grenoble; CHU de Rouen (B.B.), Department of Neurology; CHU de La Martinique (Philippe Cabre), Department of Neurology, Fort-de-France; APHP (A.W.), Hôpital Henri Mondor, Department of Neurology, Créteil; CHU de Limoges (L.M.), Hôpital Dupuytren, Department of Neurology; CHU de Saint-Étienne (J.-P.C.), Hôpital Nord, Department of Neurology; CHU de Tours (A.M.), Hôpital Bretonneau, CRC SEP and Department of Neurology; CHU de Reims (S.M.), CRC-SEP, Department of Neurology; Hôpital Sud Francilien (N.H.B.), Department of Neurology, Corbeil Essonnes; CHU Bicêtre (D.D.B.), Department of Neurology, Le Kremlin Bicêtre; Department of Neurology (K.H.), Hôpital Pierre Delafontaine, Centre Hospitalier de Saint-Denis; CHU La Milétrie (J.-P.N.), Hôpital Jean Bernard, Department of Neurology, Poitiers; CH de Pontoise (C. Pottier), Hôpital René Dubos, Department of Neurology; and Centre Hospitalier de Versailles (C.N.), Department of Neurology, F-78150 Le Chesnay, France
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Calocer F, Ng HS, Zhu F, Zhao Y, Dejardin O, Leray E, Defer G, Evans C, Fisk JD, Marrie RA, Tremlett H. Low socioeconomic status was associated with a higher mortality risk in multiple sclerosis. Mult Scler 2023; 29:466-470. [PMID: 36281835 DOI: 10.1177/13524585221129963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND The relationship between socioeconomic status (SES) and mortality among persons with multiple sclerosis (PwMS) is poorly understood. OBJECTIVE To investigate the association between SES and mortality risk in PwMS. METHODS From health-administrative data, we identified 12,126 incident MS cases with a first demyelinating event (MS 'onset') occurring between 1994 and 2017. Cox proportional hazard model assessed the association between socioeconomic status quintiles (SES-Qs) at MS onset and all-cause mortality. RESULTS Lower SES-Qs were associated with higher mortality risk; adjusted hazard ratios: SES-Q1 (most deprived) =1.61 (95% confidence interval (CI) = 1.36-1.91); SES-Q2 = 1.26 (95% CI = 1.05-1.50); SES-Q3 = 1.22 (95% CI = 1.02-1.46); SES-Q4 = 1.13 (95% CI = 0.94-1.35) versus SES-Q5 (least deprived). CONCLUSION A lower SES was associated with higher mortality risk in PwMS.
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Affiliation(s)
- Floriane Calocer
- Department of Medicine, Division of Neurology and the Djavad Mowafaghian Centre for Brain Health, University of British Columbia, UBC Hospital, Vancouver, BC, Canada
| | - Huah Shin Ng
- Department of Medicine, Division of Neurology and the Djavad Mowafaghian Centre for Brain Health, University of British Columbia, UBC Hospital, Vancouver, BC, Canada
| | - Feng Zhu
- Department of Medicine, Division of Neurology and the Djavad Mowafaghian Centre for Brain Health, University of British Columbia, UBC Hospital, Vancouver, BC, Canada
| | - Yinshan Zhao
- Department of Medicine, Division of Neurology and the Djavad Mowafaghian Centre for Brain Health, University of British Columbia, UBC Hospital, Vancouver, BC, Canada
| | - Olivier Dejardin
- UNICAEN, CHU de Caen, INSERM U1086 ANTICIPE, Pôle de Recherche, Normandie University, Caen, France
| | - Emmanuelle Leray
- EHESP Rennes, Sorbonne Paris Cité, Rennes, France; CIC-P 1414, CHU Rennes, West Neuroscience Network of Excellence (WENNE), Rennes, France
| | - Gilles Defer
- UNICAEN, CHU de Caen Normandie Department of Neurology, MS Expert Center, Normandie University, Caen, France; Réseau Bas-Normand Pour la Prise en Charge de la SEP, Caen, France
| | - Charity Evans
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK, Canada
| | - John D Fisk
- Nova Scotia Health Authority and the Departments of Psychiatry, Psychology and Neuroscience, and Medicine, Dalhousie University, Halifax, NS, Canada
| | - Ruth Ann Marrie
- Departments of Internal Medicine and Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Helen Tremlett
- Department of Medicine, Division of Neurology and the Djavad Mowafaghian Centre for Brain Health, University of British Columbia, UBC Hospital, Vancouver, BC, Canada
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12
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Ryerson LZ, Foley JF, Defer G, Cohen JA, Arnold DL, Butzkueven H, Cutter G, Giovannoni G, Killestein J, Wiendl H, Sinks S, Kuhelj R, Bodhinathan K, Lasky T. Exploratory clinical efficacy and patient-reported outcomes from NOVA: A randomized controlled study of intravenous natalizumab 6-week dosing versus continued 4-week dosing for relapsing-remitting multiple sclerosis. Mult Scler Relat Disord 2023; 72:104561. [PMID: 36931078 DOI: 10.1016/j.msard.2023.104561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 02/09/2023] [Indexed: 02/12/2023]
Abstract
BACKGROUND Natalizumab (TYSABRI®) 300 mg administered intravenously every-4-weeks (Q4W) is approved for treatment of relapsing-remitting multiple sclerosis but is associated with increased risk of progressive multifocal leukoencephalopathy (PML). Extended natalizumab dosing intervals of approximately every-6-weeks (Q6W) are associated with a lower risk of PML. Primary and secondary clinical outcomes from the NOVA randomized clinical trial (NCT03689972) suggest that effective disease control is maintained in patients who were stable during treatment with natalizumab Q4W for ≥12 months and who then switched to Q6W dosing. We compared additional exploratory clinical and patient-reported outcomes (PROs) from NOVA to assess the efficacy of Q6W dosing. METHODS Prespecified exploratory clinical efficacy endpoints in NOVA included change from baseline in Expanded Disability Status Scale (EDSS) score, Timed 25-Foot Walk (T25FW), dominant- and nondominant-hand 9-Hole Peg Test (9HPT), and Symbol Digit Modalities Test (SDMT). Exploratory patient-reported outcome (PRO) efficacy endpoints included change from baseline in the Treatment Satisfaction Questionnaire for Medication (TSQM), Neuro-QoL fatigue questionnaire, Multiple Sclerosis Impact Scale (MSIS-29), EuroQol 5 Dimensions (EQ-5D-5 L) index score, Clinical Global Impression (CGI)-Improvement (patient- and clinician-assessed) and CGI-Severity (clinician-assessed) rating scales. Estimated proportions of patients with confirmed EDSS improvement were based on Kaplan-Meier methods. Estimates of mean treatment differences for Q6W versus Q4W in other outcomes were assessed by least squares mean (LSM) and analyzed using a linear mixed model of repeated measures or ordinal logistic regression (CGI-scale). RESULTS Exploratory clinical and patient-reported outcomes were assessed in patients who received ≥1 dose of randomly assigned study treatment and had ≥1 postbaseline efficacy assessment (Q6W group, n = 247, and Q4W group, n = 242). Estimated proportions of patients with EDSS improvement at week 72 were similar for Q6W and Q4W groups (11.7% [19/163] vs 10.8% [17/158]; HR 1.02 [95% confidence interval [CI], 0.53-1.98]; P = 0.9501). At week 72, there were no significant differences between Q6W and Q4W groups in LSM change from baseline for T25FW (0.00, P = 0.975), 9HPT (dominant [0.22, P = 0.533] or nondominant [0.09, P = 0.862] hand), or SDMT (-1.03, P = 0.194). Similarly, there were no significant differences between Q6W and Q4W groups in LSM change from baseline for any PRO (TSQM, -1.00, P = 0.410; Neuro-QoL fatigue, 0.52, P = 0.292; MSIS-29 Psychological, 0.67, P = 0.572; MSIS-29 Physical, 0.74, P = 0.429; EQ-5D-5 L, 0.00, P = 0.978). For the EQ-5D-5 L, a higher proportion of Q6W patients than Q4W patients demonstrated worsening (≥0.5 standard deviation increase in the EQ-5D-5 L index score; P = 0.0475). From baseline to week 72 for Q6W versus Q4W, odds ratio (ORs) of LSM change in CGI scores did not show meaningful differences between groups (CGI-Improvement [patient]: OR [95% CI] 1.2 [0.80-1.73]; CGI-Improvement [physician]: 0.8 [0.47-1.36]; CGI-Severity [physician]: 1.0 [0.71-1.54]). CONCLUSIONS No significant differences were observed in change from baseline to week 72 between natalizumab Q6W and Q4W groups for all exploratory clinical or PRO-related endpoints assessed. For the EQ-5D-5 L, a higher proportion of Q6W than Q4W patients demonstrated worsening.
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Affiliation(s)
- Lana Zhovtis Ryerson
- Hackensack Meridian Medical Group - Neurology, Jersey Shore University Medical Center, Neptune City, NJ, United States of America.
| | - John F Foley
- Rocky Mountain MS Clinic, Salt Lake City, UT, United States of America
| | - Gilles Defer
- Department of Neurology, Centre Hospitalier Universitaire de Caen, Caen, France
| | - Jeffrey A Cohen
- Mellen MS Center, Neurological Institute, Cleveland Clinic, Cleveland, OH, United States of America
| | - Douglas L Arnold
- Montréal Neurological Institute, McGill University, Montréal, QC, Canada; NeuroRx Research, Montréal, QC, Canada
| | - Helmut Butzkueven
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC, Australia
| | - Gary Cutter
- University of Alabama at Birmingham, School of Public Health, Birmingham, AL, United States of America
| | - Gavin Giovannoni
- Blizard Institute, Barts and The London School of Medicine and Dentistry, London, UK; Queen Mary University of London, London, UK
| | - Joep Killestein
- Department of Neurology, Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam, Netherlands
| | - Heinz Wiendl
- Department of Neurology with Institute of Translational Neurology, University of Münster, Münster, Germany
| | - Susie Sinks
- Biogen, Cambridge, MA, United States of America
| | | | | | - Tyler Lasky
- Biogen, Cambridge, MA, United States of America
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13
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Pelle J, Briant AR, Branger P, Derache N, Arnaud C, Lebrun-Frenay C, Cohen M, Mondot L, De Seze J, Bigaut K, Collongues N, Kremer L, Ricard D, Bompaire F, Ohlmann C, Sallansonnet-Froment M, Ciron J, Biotti D, Pignolet B, Parienti JJ, Defer G. Real-World Effectiveness of Natalizumab Extended Interval Dosing in a French Cohort. Neurol Ther 2023; 12:529-542. [PMID: 36763307 PMCID: PMC10043118 DOI: 10.1007/s40120-023-00440-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 01/19/2023] [Indexed: 02/11/2023] Open
Abstract
INTRODUCTION Natalizumab, a therapy for relapsing-remitting multiple sclerosis (RRMS), is associated with a risk of progressive multifocal leukoencephalopathy (PML). Over the last several years, practitioners have used off-label extended interval dosing (EID) of natalizumab to reduce PML risk, despite the absence of a large-scale efficacy evaluation. METHODS We conducted a retrospective, multicenter cohort study among adults with RRMS receiving stable standard interval dosing (SID), defined as a ≥ 12-month consecutive period of ≥ 11 natalizumab infusions/year in France. We compared the 12-month risk difference of remaining relapse-free (primary endpoint) between patients who switched to EID (≤ 9 natalizumab infusions) and those who remained on SID, with a noninferiority margin of - 11%. We used propensity score methods such as inverse probability treatment weighting (IPTW) and 1:1 propensity score matching (PSM). Secondary endpoints were annualized relapse rate, disease progression, and safety. RESULTS Baseline characteristics were similar between patients receiving EID (n = 147) and SID (n = 156). The proportion of relapse-free patients 12 months postbaseline was 142/147 in the EID (96.6%) and 144/156 in the SID group (92.3%); risk difference (95% CI) 4.3% (- 1.3 to 9.8%); p < 0.001 for non-inferiority. There were no significant differences between relapse rates (0.043 vs. 0.083 per year, respectively; p = 0.14) or Expanded Disability Status Scale mean scores (2.43 vs. 2.72, respectively; p = 0.18); anti-JC virus index values were similar (p = 0.23); and no instances of PML were reported. The comparisons using IPTW (n = 306) and PSM (n = 204) were consistent. CONCLUSION These results support the pertinence of using an EID strategy for RRMS patients treated with natalizumab. CLINICAL TRIALS gov identifier (NCT04580381).
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Affiliation(s)
- Juliette Pelle
- Centre de Ressources et Compétence Sclérose en Plaques (CRCSEP), Service de Neurologie, CHU de la Côte de Nacre, 14000, Caen, France
| | - Anais R Briant
- Unité de Biostatistiques et de Recherche Clinique, CHU de Caen-Cote de Nacre, Caen, France
| | - Pierre Branger
- Centre de Ressources et Compétence Sclérose en Plaques (CRCSEP), Service de Neurologie, CHU de la Côte de Nacre, 14000, Caen, France
| | - Nathalie Derache
- Centre de Ressources et Compétence Sclérose en Plaques (CRCSEP), Service de Neurologie, CHU de la Côte de Nacre, 14000, Caen, France
| | - Charlotte Arnaud
- Centre de Ressources et Compétence Sclérose en Plaques (CRCSEP), Service de Neurologie, CHU de la Côte de Nacre, 14000, Caen, France
| | - Christine Lebrun-Frenay
- Centre de Ressources et Compétence Sclérose en Plaques (CRCSEP), Unité de Recherche Clinique Côte d'azur (UR2CA), Équipe URRIS, CHU Pasteur 2, Nice, France
| | - Mikael Cohen
- Centre de Ressources et Compétence Sclérose en Plaques (CRCSEP), Unité de Recherche Clinique Côte d'azur (UR2CA), Équipe URRIS, CHU Pasteur 2, Nice, France
| | - Lydiane Mondot
- Centre de Ressources et Compétence Sclérose en Plaques (CRCSEP), Unité de Recherche Clinique Côte d'azur (UR2CA), Équipe URRIS, CHU Pasteur 2, Nice, France
| | - Jerome De Seze
- Centre de Ressources et Compétence Sclérose en Plaques (CRCSEP), Département de Neurologie, CHRU de Strasbourg Hôpital de Hautepierre, Strasbourg, France
| | - Kevin Bigaut
- Centre de Ressources et Compétence Sclérose en Plaques (CRCSEP), Département de Neurologie, CHRU de Strasbourg Hôpital de Hautepierre, Strasbourg, France
| | - Nicolas Collongues
- Centre de Ressources et Compétence Sclérose en Plaques (CRCSEP), Département de Neurologie, CHRU de Strasbourg Hôpital de Hautepierre, Strasbourg, France
| | - Laurent Kremer
- Centre de Ressources et Compétence Sclérose en Plaques (CRCSEP), Département de Neurologie, CHRU de Strasbourg Hôpital de Hautepierre, Strasbourg, France
| | - Damien Ricard
- Département de Neurologie, Hôpital d'Instruction des Armées Percy, Service de Santé des Armées, Clamart, France
| | - Flavie Bompaire
- Département de Neurologie, Hôpital d'Instruction des Armées Percy, Service de Santé des Armées, Clamart, France
| | - Charlotte Ohlmann
- Département de Radiologie, Hôpital d'Instruction des Armées Percy, Service de Santé des Armées, Clamart, France
| | - Magali Sallansonnet-Froment
- Département de Neurologie, Hôpital d'Instruction des Armées Percy, Service de Santé des Armées, Clamart, France
| | - Jonathan Ciron
- Centre de Ressources et Compétence Sclérose en Plaques (CRCSEP)-Département des Neurosciences, CHU Toulouse-Purpan, and Toulouse Institute for Infectious and Inflammatory Diseases (Infinity), University of Toulouse, CNRS, INSERM, UPS, Toulouse, France
| | - Damien Biotti
- Centre de Ressources et Compétence Sclérose en Plaques (CRCSEP)-Département des Neurosciences, CHU Toulouse-Purpan, and Toulouse Institute for Infectious and Inflammatory Diseases (Infinity), University of Toulouse, CNRS, INSERM, UPS, Toulouse, France
| | - Beatrice Pignolet
- Centre de Ressources et Compétence Sclérose en Plaques (CRCSEP)-Département des Neurosciences, CHU Toulouse-Purpan, and Toulouse Institute for Infectious and Inflammatory Diseases (Infinity), University of Toulouse, CNRS, INSERM, UPS, Toulouse, France
| | - Jean-Jacques Parienti
- Unité de Biostatistiques et de Recherche Clinique, CHU de Caen-Cote de Nacre, Caen, France
| | - Gilles Defer
- Centre de Ressources et Compétence Sclérose en Plaques (CRCSEP), Service de Neurologie, CHU de la Côte de Nacre, 14000, Caen, France.
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14
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Sabathé C, Casey R, Vukusic S, Leray E, Mathey G, De Sèze J, Ciron J, Wiertlewski S, Ruet A, Pelletier J, Zéphir H, Michel L, Lebrun-Frenay C, Moisset X, Thouvenot E, Camdessanché JP, Bakchine S, Stankoff B, Al Khedr A, Cabre P, Maillart E, Berger E, Heinzlef O, Hankiewicz K, Moreau T, Gout O, Bourre B, Wahab A, Labauge P, Montcuquet A, Defer G, Maurousset A, Maubeuge N, Dimitri Boulos D, Ben Nasr H, Nifle C, Casez O, Laplaud DA, Foucher Y. Improving the decision to switch from first- to second-line therapy in multiple sclerosis: A dynamic scoring system. Mult Scler 2023; 29:236-247. [PMID: 36515394 DOI: 10.1177/13524585221139156] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND In relapsing-remitting multiple sclerosis (RRMS), early identification of suboptimal responders can prevent disability progression. OBJECTIVE We aimed to develop and validate a dynamic score to guide the early decision to switch from first- to second-line therapy. METHODS Using time-dependent propensity scores (PS) from a French cohort of 12,823 patients with RRMS, we constructed one training and two validation PS-matched cohorts to compare the switched patients to second-line treatment and the maintained patients. We used a frailty Cox model for predicting individual hazard ratios (iHRs). RESULTS From the validation PS-matched cohort of 348 independent patients with iHR ⩽ 0.69, we reported the 5-year relapse-free survival at 0.14 (95% confidence interval (CI) 0.09-0.22) for the waiting group and 0.40 (95% CI 0.32-0.51) for the switched group. From the validation PS-matched cohort of 518 independent patients with iHR > 0.69, these values were 0.37 (95% CI 0.30-0.46) and 0.44 (95% CI 0.37-0.52), respectively. CONCLUSIONS By using the proposed dynamic score, we estimated that at least one-third of patients could benefit from an earlier switch to prevent relapse.
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Affiliation(s)
- Camille Sabathé
- Université de Nantes, Université de Tours, Inserm, UMR1246 Sphere, Nantes, France
| | - Romain Casey
- Université de Lyon, Université Claude Bernard Lyon 1, Lyon, France/Hospices Civils de Lyon, Service de Neurologie, sclérose en plaques, pathologies de la myéline et neuro-inflammation, Lyon, France/Observatoire Français de la Sclérose en Plaques, Centre de Recherche en Neurosciences de Lyon, Lyon, France/EUGENE DEVIC EDMUS Foundation against Multiple Sclerosis, State-Approved Foundation, Lyon, France
| | - Sandra Vukusic
- Hospices Civils de Lyon, Service de Neurologie, sclérose en plaques, pathologies de la myéline et neuro-inflammation, Lyon, France/Observatoire Français de la Sclérose en Plaques, Centre de Recherche en Neurosciences de Lyon, Lyon, France/Faculté de médecine Lyon Est, Université Claude Bernard Lyon 1, Lyon, France
| | | | - Guillaume Mathey
- Department of Neurology, Nancy University Hospital, Hôpital Central, Service de Neurologie, Nancy, France/Université de Lorraine, Nancy, France
| | - Jérôme De Sèze
- Department of Neurology and Clinical Investigation Center, CHU de Strasbourg, Strasbourg, France
| | - Jonathan Ciron
- Department of Neurology, Hôpital Pierre-Paul Riquet, CHU de Toulouse, Toulouse, France
| | - Sandrine Wiertlewski
- Université de Nantes, Nantes, France/Service de Neurologie, Centre de Ressources et de Compétences Sclérose en Plaques, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - Aurélie Ruet
- University of Bordeaux, Bordeaux, France/Department of Neurology, CHU de Bordeaux, Bordeaux, France
| | - Jean Pelletier
- Aix Marseille University, APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, Marseille, France
| | | | - Laure Michel
- Clinical Neuroscience Centre, Rennes University Hospital, Rennes, France/Microenvironment, Cell Differentiation, Immunology and Cancer Unit, Rennes, France/Neurology Department, Rennes University Hospital, Rennes, France
| | | | - Xavier Moisset
- Université Clermont Auvergne, CHU de Clermont-Ferrand, Inserm, Neuro-Dol, Clermont-Ferrand, France
| | - Eric Thouvenot
- Department of Neurology, Nimes University Hospital, Nimes, France/Institut de Génomique Fonctionnelle, Université de Montpellier, Montpellier, France
| | | | | | - Bruno Stankoff
- Sorbonne Universités, Brain and Spine Institute, ICM, Hôpital de la Pitié Salpêtrière, Paris, France/Department of Neurology, AP-HP, Saint-Antoine Hospital, Paris, France
| | | | - Philippe Cabre
- Department of Neurology, CHU de la Martinique, Fort-de-France, France
| | - Elisabeth Maillart
- Département de Neurologie, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France/Centre de Ressources et de Compétences SEP, Paris, France
| | - Eric Berger
- Service de Neurologie Besançon, CHU de Besançon, Besançon, France
| | | | - Karolina Hankiewicz
- Department of Neurology, Centre Hospitalier de Saint-Denis, Hôpital Pierre Delafontaine, Saint-Denis, France
| | | | - Olivier Gout
- Department of Neurology, Fondation Rothschild, Paris, France
| | | | - Abir Wahab
- Department of Neurology, AP-HP, Hôpital Henri Mondor, Créteil, France
| | - Pierre Labauge
- CRC SEP, Montpellier University Hospital, INSERM, Université de Montpellier, Montpellier, France
| | - Alexis Montcuquet
- Department of Neurology, Hôpital Dupuytren, CHU de Limoges, Limoges, France
| | - Gilles Defer
- CHU de Caen, MS Expert Centre, Department of Neurology, Normandy University, Caen, France
| | - Aude Maurousset
- CRC SEP and Department of Neurology, Hôpital Bretonneau, CHU de Tours, Tours, France
| | - Nicolas Maubeuge
- Department of Neurology, Hôpital Jean Bernard, CHU La Milétrie, Poitiers, France
| | | | - Haïfa Ben Nasr
- Department of Neurology, Hôpital Sud Francilien, Corbeil-Essonnes, France
| | - Chantal Nifle
- Department of Neurology, Hopital Andre Mignot, Le Chesnay, France
| | - Olivier Casez
- Department of Neurology, CHU Grenoble Alpes, Grenoble, France
| | - David-Axel Laplaud
- Université de Nantes, Nantes, France/Service de Neurologie, Centre de Ressources et de Compétences Sclérose en Plaques, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - Yohann Foucher
- Yohann Foucher CIC 1402, CHU de Poitiers, Université de Poitiers, Poitiers, France
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15
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Wilson S, Calocer F, Rollot F, Fauvernier M, Remontet L, Tron L, Vukusic S, Le Page E, Debouverie M, Ciron J, Ruet A, De Sèze J, Zephir H, Moreau T, Lebrun-Frénay C, Laplaud DA, Clavelou P, Labauge P, Berger E, Pelletier J, Heinzlef O, Thouvenot E, Camdessanché JP, Leray E, Dejardin O, Defer G. Effects of socioeconomic status on excess mortality in patients with multiple sclerosis in France: A retrospective observational cohort study. Lancet Reg Health Eur 2023; 24:100542. [PMID: 36426377 PMCID: PMC9678948 DOI: 10.1016/j.lanepe.2022.100542] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 10/21/2022] [Accepted: 10/25/2022] [Indexed: 11/19/2022] Open
Abstract
Background The effects of socio-economic status on mortality in patients with multiple sclerosis is not well known. The objective was to examine mortality due to multiple sclerosis according to socio-economic status. Methods A retrospective observational cohort design was used with recruitment from 18 French multiple sclerosis expert centers participating in the Observatoire Français de la Sclérose en Plaques. All patients lived in metropolitan France and had a definite or probable diagnosis of multiple sclerosis according to either Poser or McDonald criteria with an onset of disease between 1960 and 2015. Initial phenotype was either relapsing-onset or primary progressive onset. Vital status was updated on January 1st 2016. Socio-economic status was measured by an ecological index, the European Deprivation Index and was attributed to each patient according to their home address. Excess death rates were studied according to socio-economic status using additive excess hazard models with multidimensional penalised splines. The initial hypothesis was a potential socio-economic gradient in excess mortality. Findings A total of 34,169 multiple sclerosis patients were included (88% relapsing onset (n = 30,083), 12% progressive onset (n = 4086)), female/male sex ratio 2.7 for relapsing-onset and 1.3 for progressive-onset). Mean age at disease onset was 31.6 (SD = 9.8) for relapsing-onset and 42.7 (SD = 10.8) for progressive-onset. At the end of follow-up, 1849 patients had died (4.4% for relapsing-onset (n = 1311) and 13.2% for progressive-onset (n = 538)). A socio-economic gradient was found for relapsing-onset patients; more deprived patients had a greater excess death rate. At thirty years of disease duration and a year of onset of symptoms of 1980, survival probability difference (or deprivation gap) between less deprived relapsing-onset patients (EDI = −6) and more deprived relapsing-onset patients (EDI = 12) was 16.6% (95% confidence interval (CI) [10.3%–22.9%]) for men and 12.3% (95%CI [7.6%–17.0%]) for women. No clear socio-economic mortality gradient was found in progressive-onset patients. Interpretation Socio-economic status was associated with mortality due to multiple sclerosis in relapsing-onset patients. Improvements in overall care of more socio-economically deprived patients with multiple sclerosis could help reduce these socio-economic inequalities in multiple sclerosis-related mortality. Funding This study was funded by the ARSEP foundation “Fondation pour l'aide à la recherche sur la Sclérose en Plaques” (Grant Reference Number 1122). Data collection has been supported by a grant provided by the French State and handled by the “Agence Nationale de la Recherche,” within the framework of the “Investments for the Future” programme, under the reference ANR-10-COHO-002, Observatoire Français de la Sclérose en Plaques (OFSEP).
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Affiliation(s)
- Sarah Wilson
- UNICAEN, CHU de Caen, INSERM U1086 ANTICIPE, Pôle de Recherche, Normandy University, Caen 14000, France
- Corresponding author. INSERM UMR 1086 “ANTICIPE”, University of Caen Normandy, Comprehensive Cancer Center Francois Baclesse, Avenue du General Harris, 14076 Caen Cedex 5, France.
| | - Floriane Calocer
- Department of Neurology, UNICAEN, Normandy University, MS Expert Center, CHU de Caen Normandy, Caen 14000, France
| | - Fabien Rollot
- Université de Lyon, Université Claude Bernard Lyon 1, Lyon 69000, France
- Hospices Civils de Lyon, Hôpital Neurologique, Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-Inflammation, Bron 69500, France
- Observatoire Français de la Sclérose en Plaques, Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR 5292, Lyon 69000, France
- EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis, State-Approved Foundation, Bron, France
| | - Mathieu Fauvernier
- Service de Biostatistique–Bioinformatique, Pôle Santé Publique, Hospices Civils de Lyon, Lyon 69000, France
- Université Lyon 1, CNRS, UMR 5558, Laboratoire de Biométrie et Biologie Evolutive, Lyon 69000, France
| | - Laurent Remontet
- Service de Biostatistique–Bioinformatique, Pôle Santé Publique, Hospices Civils de Lyon, Lyon 69000, France
- Université Lyon 1, CNRS, UMR 5558, Laboratoire de Biométrie et Biologie Evolutive, Lyon 69000, France
| | - Laure Tron
- UNICAEN, CHU de Caen, INSERM U1086 ANTICIPE, Pôle de Recherche, Normandy University, Caen 14000, France
| | - Sandra Vukusic
- Université de Lyon, Université Claude Bernard Lyon 1, Lyon 69000, France
- Hospices Civils de Lyon, Hôpital Neurologique, Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-Inflammation, Bron 69500, France
- Observatoire Français de la Sclérose en Plaques, Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR 5292, Lyon 69000, France
- EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis, State-Approved Foundation, Bron, France
| | | | - Marc Debouverie
- Department of Neurology, Nancy University Hospital, Nancy, France
- Université de Lorraine, APEMAC, Nancy F-54000, France
| | - Jonathan Ciron
- Department of Neurology, CHU de Toulouse, CRC-SEP, Toulouse Cedex 9 F-31059, France
- Université Toulouse III, Infinity, INSERM UMR1291 - CNRS UMR5051, Toulouse Cedex 3 F-31024, France
| | - Aurélie Ruet
- Univ. Bordeaux, Bordeaux F-33000, France
- INSERM U1215, Neurocentre Magendie, Bordeaux F-33000, France
- Department of Neurology, CHU de Bordeaux, CIC Bordeaux CIC1401, Bordeaux F-33000, France
| | - Jérôme De Sèze
- Department of Neurology and Clinical Investigation Center, CHU de Strasbourg, CIC 1434, INSERM 1434, Strasbourg F-67000, France
| | - Hélène Zephir
- CHU Lille, CRCSEP Lille, Univ Lille, U1172, Lille F-59000, France
| | - Thibault Moreau
- Department of Neurology, CHU de Dijon, EA4184, Dijon F-21000, France
| | - Christine Lebrun-Frénay
- Neurology, UR2CA, Centre Hospitalier Universitaire Pasteur2, Université Nice Côte d’Azur, Nice, France
| | - David-Axel Laplaud
- Nantes Université, CHU Nantes, INSERM, Center for Research in Transplantation and Translational Immunology, UMR 1064, CIC INSERM 1413, Service de Neurologie, Nantes F-44000, France
| | - Pierre Clavelou
- Department of Neurology, CHU Clermont-Ferrand, Clermont-Ferrand F-63000, France
- Université Clermont Auvergne, Inserm, Neuro-Dol, Clermont-Ferrand F-63000, France
| | - Pierre Labauge
- MS Unit, CHU de Montpellier, Montpellier Cedex 5 F-34295, France
- University of Montpellier (MUSE), Montpellier F-34000, France
| | - Eric Berger
- CHU de Besançon, Service de Neurologie 25 030, Besançon, France
| | - Jean Pelletier
- Aix Marseille Univ, APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, Marseille 13005, France
| | - Olivier Heinzlef
- Departement of Neurology, Hôpital de Poissy, Poissy F-78300, France
| | - Eric Thouvenot
- Department of Neurology, Nimes University Hospital, Nimes Cedex 9 F-30029, France
- Institut de Génomique Fonctionnelle, UMR5203, INSERM 1191, Univ. Montpellier, Montpellier Cedex 5 F-34094, France
| | | | - Emmanuelle Leray
- Univ Rennes, EHESP, CNRS, Inserm, Arènes - UMR 6051, RSMS (Recherche sur les Services et Management en Santé) - U 1309, Rennes F-35000, France
| | - Olivier Dejardin
- UNICAEN, CHU de Caen, INSERM U1086 ANTICIPE, Pôle de Recherche, Normandy University, Caen 14000, France
| | - Gilles Defer
- Department of Neurology, UNICAEN, Normandy University, MS Expert Center, CHU de Caen Normandy, Caen 14000, France
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Ciron J, Gueguen A, Al Khedr A, Bourre B, Clavelou P, Defer G, Durand-Dubief F, Labauge P, Ouallet JC, Pittion Vouyovitch S, Tourbah A, Vermersch P. Secondary progressive multiple sclerosis: A national consensus paper on diagnostic criteria. Rev Neurol (Paris) 2022; 178:1098-1104. [PMID: 36180289 DOI: 10.1016/j.neurol.2022.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 06/15/2022] [Accepted: 07/04/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND In clinical practice, the diagnosis of secondary progressive multiple sclerosis (SPMS) is often delayed, retrospective and non-reproducible, as there are no consensus criteria that define the advent of SPMS. Early identification of SPMS is essential to improve patient care. METHODS Eight regional board meetings in France involving 56 multiple sclerosis (MS) experts (neurologists) were convened to discuss diagnostic criteria for SPMS. Subsequently, a national board meeting of 13 neurologists (with an expert representing each geographical region) was held to review points of convergence or divergence between regions and to develop a national consensus document. RESULTS Based on the discussions from the regional boards, the MS experts at the national board retained the worsening of the EDSS score, with compatible clinical features, as the only consensus criterion for the diagnosis of SPMS in clinical practice. The patient should have experienced during at least the previous 6 months and in the absence of any relapse, a worsening in the EDSS score of +1.0 point (if the previous EDSS was≤5.0) or of +0.5 point (if the previous EDSS was≥5.5), with a pyramidal or cerebellar functional system score≥2 and without setting a minimum EDSS score; or, in case of a stable EDSS score≥4.0, a worsening of a functional score. This worsening should be confirmed within 3 to 6 months. According to the MS experts, the patient's age, duration of illness and a minimal threshold EDSS score are only risk factors for transition to SPMS. Patient reports during consultation and cognitive impairment are important warning signs, which should trigger an objective assessment with specific tests or closer monitoring. Clinical relapse and/or MRI activities are non-discriminatory for making the diagnosis of SPMS. CONCLUSIONS The experts defined precise diagnostic criteria adapted to clinical practice for earlier identification of SPMS, paving the way for better management of this stage of the disease.
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Affiliation(s)
- J Ciron
- Département de neurologie, CRC-SEP, CHU de Toulouse, place du Dr-Baylac, 31059 Toulouse cedex 9, France.
| | - A Gueguen
- Fondation ophtalmologique Adolphe de Rothschild, 29, rue Manin, Paris, France
| | - A Al Khedr
- CHU d'Amiens, 2, place Victor-Pauchet, Amiens, France
| | - B Bourre
- CHU de Rouen, 76000 Rouen, France
| | - P Clavelou
- CHU de Clermont-Ferrand, 58, rue Montalembert, Clermont-Ferrand, France
| | - G Defer
- CRC-SEP, service de neurologie, CHU de Caen, avenue de la Côte-de-Nacre, 14033 Caen, France
| | - F Durand-Dubief
- Service de sclérose en plaques, pathologies de la myéline et neuro-inflammation, hôpital neurologique, GHE, 59, boulevard Pinel, 69677 Bron Lyon cedex, France
| | - P Labauge
- CRC-SEP, département de neurologie, CHU de Montpellier, 80, avenue G.-Fliche, 34295 Montpellier cedex 5, France
| | - J-C Ouallet
- Service de neurologie et maladies inflammatoires du système nerveux central, CHU de Bordeaux, place Amélie-Raba-Léon, 33000 Bordeaux, France
| | | | - A Tourbah
- UFR Simone Veil, UVSQ, Inserm U 1195, service de neurologie, hôpital Raymond Poincaré, université Paris Saclay, AP-HP, Garches, France
| | - P Vermersch
- Inserm U1172 - Lille neuroscience et cognition, FHU Imminent, université de Lille, CHU Lille, 59000 Lille, France
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17
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Foley J, Defer G, Ryerson LZ, Cohen J, Arnold D, Butzkueven H, Cutter G, Giovannoni G, Killestein J. 136 NOVA primary results randomised controlled study of natalizumab Q6W versus continued Q4W treatment for MS. J Neurol Psychiatry 2022. [DOI: 10.1136/jnnp-2022-abn2.180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundNatalizumab every-6-week (Q6W) dosing is associated with lower progressive multifocal leukoencephalopathy risk than every-4-week dosing (Q4W) in retrospective analyses. NOVA is the first randomised trial to assess Q6W efficacy.ObjectiveEvaluate natalizumab Q6W efficacy in patients previously treated with natalizumab Q4W for≥12 months compared with continuation of Q4W over 72 weeks.MethodsNOVA is a randomised, controlled, open-label, rater-blinded phase 3b trial. Included patients were treated with natalizumab Q4W without relapse for ≥12 months. Patients were randomised 1:1 to Q4W (n=248) or Q6W (n=251). The primary endpoint was new/newly enlarging T2 (N/NET2) lesions. Secondary endpoints included clinical and safety outcomes.ResultsProportions of patients with N/NET2 lesions were low in both arms (Q4W:4.1%; Q6W:4.3%). Differ- ences in mean N/NET2 lesions for Q4W and Q6W (primary estimand: 0.05 vs 0.20 [P=0.0755]; secondary estimand: 0.06 vs 0.31 [P=0.0437]) were driven by two Q6W patients with extreme (≥25) values. Secondary outcomes were similar for Q4W and Q6W.ConclusionsOverall, NOVA data suggest most patients stable on natalizumab Q4W can switch to Q6W without clinically meaningful loss of efficacy. Support: Biogen. Disclosures on poster.
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Nguyen S, Bastien E, Chretien B, Sassier M, Defer G, Nehme A, Lelong-Boulouard V, Alexandre J, Fedrizzi S, Morice PM. Transverse myelitis following SARS-CoV-2 vaccination: a pharmacoepidemiological study in the World Health Organization's database. Ann Neurol 2022; 92:1080-1089. [PMID: 36054163 PMCID: PMC9538824 DOI: 10.1002/ana.26494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 08/26/2022] [Accepted: 08/29/2022] [Indexed: 11/28/2022]
Abstract
Background Transverse myelitis (TM) has recently been associated by health authorities with Ad26.COV2.S (Janssen/Johnson & Johnson), one of the 5 US Food and Drug Administration (FDA) or European Medicines Agency (EMA) labeled severe acute respiratory syndrome‐coronavirus 2 (SARS‐CoV‐2) vaccines. It is unknown whether a similar association exists for the other FDA or EMA labeled SARS‐CoV‐2 vaccines (BNT162b2 [Pfizer/BioNTech], mRNA‐1273 [Moderna], ChAdOx1nCov‐19 [Oxford–AstraZeneca], and NVX‐CoV2373 [Novavax]). This study aimed to evaluate the association between SARS‐CoV‐2 vaccine class and TM. Methods This observational, cross‐sectional, pharmacovigilance cohort study examined individual case safety reports from VigiBase, the World Health Organization's pharmacovigilance database. We first conducted a disproportionality analysis with the information component (IC) using the reports of TM that occurred within 28 days following exposure to the FDA or EMA labeled SARS‐CoV‐2 vaccines, from December 1, 2020 (first adverse event related to a SARS‐CoV‐2 vaccine) to March 27, 2022. Second, we analyzed the clinical features of SARS‐CoV‐2 vaccine‐associated TM cases reported in VigiBase. Results TM was significantly associated both with the messenger ribonucleic acid (mRNA)‐based (n = 364; IC025 = 0.62) and vector‐based (n = 136; IC025 = 0.52) SARS‐CoV‐2 vaccines that are authorized by the FDA or the EMA. Conclusions Findings from this observational, cross‐sectional pharmacovigilance study showed that mRNA‐based and vector‐based FDA/EMA labeled SARS‐CoV‐2 vaccines can be associated with TM. However, because TM remains a rare event, with a previously reported rate of 0.28 cases per 1 million vaccine doses, the risk–benefit ratio in favor of vaccination against SARS‐CoV‐2 virus remains unchallenged. Rather, this study suggests that clinicians should consider the diagnosis of TM in patients presenting with early signs of spinal cord dysfunction after SARS‐CoV‐2 vaccination. ANN NEUROL 2022
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Affiliation(s)
- Sophie Nguyen
- Department of Pharmacology, University Teaching Hospital of Caen-Normandie, France.,Department of Neurology, MS Expert Centre, University Teaching Hospital of Caen-Normandie, France
| | - Etienne Bastien
- Department of Pharmacology, University Teaching Hospital of Caen-Normandie, France
| | - Basile Chretien
- Department of Pharmacology, University Teaching Hospital of Caen-Normandie, France
| | - Marion Sassier
- Department of Pharmacology, University Teaching Hospital of Caen-Normandie, France
| | - Gilles Defer
- Department of Neurology, MS Expert Centre, University Teaching Hospital of Caen-Normandie, France
| | - Ahmad Nehme
- Normandie Univ, UNICAEN, INSERM U1086 'Interdisciplinary Research Unit for Cancers Prevention and Treatment' (ANTICIPE), Caen, France
| | | | - Joachim Alexandre
- Department of Pharmacology, University Teaching Hospital of Caen-Normandie, France.,Normandie Univ, UNICAEN, INSERM U1086 'Interdisciplinary Research Unit for Cancers Prevention and Treatment' (ANTICIPE), Caen, France
| | - Sophie Fedrizzi
- Department of Pharmacology, University Teaching Hospital of Caen-Normandie, France
| | - Pierre-Marie Morice
- Department of Pharmacology, University Teaching Hospital of Caen-Normandie, France.,Normandie Univ, UNICAEN, INSERM U1086 'Interdisciplinary Research Unit for Cancers Prevention and Treatment' (ANTICIPE), Caen, France
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Foley JF, Defer G, Ryerson LZ, Cohen JA, Arnold DL, Butzkueven H, Cutter G, Giovannoni G, Killestein J, Wiendl H, Smirnakis K, Xiao S, Kong G, Kuhelj R, Campbell N, Dwyer C, Buzzard K, Spies J, Parratt J, van Pesch V, Willekens B, Perrotta G, Bartholomé E, Grand'Maison F, Jacques F, Giacomini P, Vosoughi R, Girard JM, de Seze J, Lebrun Frenay C, Ruet A, Laplaud DA, Reifschneider G, Wagner B, Rauer S, Pul R, Seipelt M, Berthele A, Klotz L, Kallmann BA, Paul F, Achiron A, Lus G, Centonze D, Patti F, Grimaldi L, Hupperts R, Frequin S, Fermont J, Madueno SE, Alonso Torres AM, Costa-Frossard França L, Meca-Lallana JE, Ruiz LB, Pearson O, Rog D, Evangelou N, Ismail A, Lathi E, Fox E, Leist T, Sloane J, Wu G, Khatri B, Steingo B, Thrower B, Gudesblatt M, Calkwood J, Bandari D, Scagnelli J, Laganke C, Robertson D, Kipp L, Belkin M, Cohan S, Goldstick L, Courtney A, Vargas W, Sylvester A, Srinivasan J, Kannan M, Picone M, English J, Napoli S, Balabanov R, Zaydan I, Nicholas J, Kaplan J, Lublin F, Riser E, Miller T, Alvarez E, Wray S, Gross J, Pawate S, Hersh C, McCarthy L, Crayton H, Graves J. Comparison of switching to 6-week dosing of natalizumab versus continuing with 4-week dosing in patients with relapsing-remitting multiple sclerosis (NOVA): a randomised, controlled, open-label, phase 3b trial. Lancet Neurol 2022; 21:608-619. [PMID: 35483387 DOI: 10.1016/s1474-4422(22)00143-0] [Citation(s) in RCA: 43] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 02/28/2022] [Accepted: 03/31/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND Treatment with natalizumab once every 4 weeks is approved for patients with relapsing-remitting multiple sclerosis, but is associated with a risk of progressive multifocal leukoencephalopathy. Switching to extended-interval dosing is associated with lower progressive multifocal leukoencephalopathy risk, but the efficacy of this approach is unclear. We aimed to assess the safety and efficacy of natalizumab once every 6 weeks compared with once every 4 weeks in patients with relapsing-remitting multiple sclerosis. METHODS We did a randomised, controlled, open-label, phase 3b trial (NOVA) at 89 multiple sclerosis centres across 11 countries in the Americas, Europe, and Western Pacific. Included participants were aged 18-60 years with relapsing-remitting multiple sclerosis and had been treated with intravenous natalizumab 300 mg once every 4 weeks with no relapses for at least 12 months before randomisation, with no missed doses in the previous 3 months. Participants were randomly assigned (1:1), using a randomisation sequence generated by the study funder and contract personnel with interactive response technology, to switch to natalizumab once every 6 weeks or continue with once every 4 weeks. The centralised MRI reader, independent neurology evaluation committee, site examining neurologists, site backup examining neurologists, and site examining technicians were masked to study group assignments. The primary endpoint was the number of new or newly enlarging T2 hyperintense lesions at week 72, assessed in all participants who received at least one dose of assigned treatment and had at least one postbaseline MRI, relapse, or neurological examination or efficacy assessment. Missing primary endpoint data were handled under prespecified primary and secondary estimands: the primary estimand included all data, regardless of whether participants remained on the assigned treatment; the secondary estimand classed all data obtained after treatment discontinuation or study withdrawal as missing. Safety was assessed in all participants who received at least one dose of study treatment. Study enrolment is closed and an open-label extension study is ongoing. This study is registered with EudraCT, 2018-002145-11, and ClinicalTrials.gov, NCT03689972. FINDINGS Between Dec 26, 2018, and Aug 30, 2019, 605 patients were assessed for eligibility and 499 were enrolled and assigned to receive natalizumab once every 6 weeks (n=251) or once every 4 weeks (n=248). After prespecified adjustments for missing data, mean numbers of new or newly enlarging T2 hyperintense lesions at week 72 were 0·20 (95% CI 0·07-0·63) in the once every 6 weeks group and 0·05 (0·01-0·22) in the once every 4 weeks group (mean lesion ratio 4·24 [95% CI 0·86-20·85]; p=0·076) under the primary estimand, and 0·31 (95% CI 0·12-0·82) and 0·06 (0·01-0·31; mean lesion ratio 4·93 [95% CI 1·05-23·20]; p=0·044) under the secondary estimand. Two participants in the once every 6 weeks group with extreme new or newly enlarging T2 hyperintense lesion numbers (≥25) contributed most of the excess lesions. Adverse events occurred in 194 (78%) of 250 participants in the once every 6 weeks group and 190 (77%) of 247 in the once every 4 weeks group, and serious adverse events occurred in 17 (7%) and 17 (7%), respectively. No deaths were reported. There was one case of asymptomatic progressive multifocal leukoencephalopathy (without clinical signs) in the once every 6 weeks group, and no cases in the once every 4 weeks group; 6 months after diagnosis, the participant was without increased disability and remained classified as asymptomatic. INTERPRETATION We found a numerical difference in the mean number of new or newly enlarging T2 hyperintense lesions at week 72 between the once every 6 weeks and once every 4 weeks groups, which reached significance under the secondary estimand, but interpretation of statistical differences (or absence thereof) is limited because disease activity in the once every 4 weeks group was lower than expected. The safety profiles of natalizumab once every 6 weeks and once every 4 weeks were similar. Although this trial was not powered to assess differences in risk of progressive multifocal leukoencephalopathy, the occurrence of the (asymptomatic) case underscores the importance of monitoring and risk factor consideration in all patients receiving natalizumab. FUNDING Biogen.
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Affiliation(s)
- John F Foley
- Rocky Mountain MS Clinic, Salt Lake City, UT, USA.
| | - Gilles Defer
- Department of Neurology, Centre Hospitalier Universitaire de Caen, Caen, France
| | | | - Jeffrey A Cohen
- Mellen MS Center, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Douglas L Arnold
- Montreal Neurological Institute, McGill University, Montréal, QC, Canada; NeuroRx Research, Montréal, QC, Canada
| | - Helmut Butzkueven
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC, Australia
| | - Gary Cutter
- University of Alabama at Birmingham, School of Public Health, Birmingham, AL, USA
| | - Gavin Giovannoni
- Blizard Institute, Barts and The London School of Medicine and Dentistry, London, UK; Queen Mary University of London, London, UK
| | - Joep Killestein
- Department of Neurology, Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam, Netherlands
| | - Heinz Wiendl
- Department of Neurology with Institute of Translational Neurology, University of Münster, Münster, Germany
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20
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Lefort M, Sharmin S, Andersen JB, Vukusic S, Casey R, Debouverie M, Edan G, Ciron J, Ruet A, De Sèze J, Maillart E, Zephir H, Labauge P, Defer G, Lebrun-Frenay C, Moreau T, Berger E, Clavelou P, Pelletier J, Stankoff B, Gout O, Thouvenot E, Heinzlef O, Al-Khedr A, Bourre B, Casez O, Cabre P, Montcuquet A, Wahab A, Camdessanché JP, Maurousset A, Ben Nasr H, Hankiewicz K, Pottier C, Maubeuge N, Dimitri-Boulos D, Nifle C, Laplaud DA, Horakova D, Havrdova EK, Alroughani R, Izquierdo G, Eichau S, Ozakbas S, Patti F, Onofrj M, Lugaresi A, Terzi M, Grammond P, Grand'Maison F, Yamout B, Prat A, Girard M, Duquette P, Boz C, Trojano M, McCombe P, Slee M, Lechner-Scott J, Turkoglu R, Sola P, Ferraro D, Granella F, Shaygannejad V, Prevost J, Maimone D, Skibina O, Buzzard K, Van der Walt A, Karabudak R, Van Wijmeersch B, Csepany T, Spitaleri D, Vucic S, Koch-Henriksen N, Sellebjerg F, Soerensen PS, Hilt Christensen CC, Rasmussen PV, Jensen MB, Frederiksen JL, Bramow S, Mathiesen HK, Schreiber KI, Butzkueven H, Magyari M, Kalincik T, Leray E. Impact of methodological choices in comparative effectiveness studies: application in natalizumab versus fingolimod comparison among patients with multiple sclerosis. BMC Med Res Methodol 2022; 22:155. [PMID: 35637426 PMCID: PMC9150358 DOI: 10.1186/s12874-022-01623-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 04/25/2022] [Indexed: 11/18/2022] Open
Abstract
Background Natalizumab and fingolimod are used as high-efficacy treatments in relapsing–remitting multiple sclerosis. Several observational studies comparing these two drugs have shown variable results, using different methods to control treatment indication bias and manage censoring. The objective of this empirical study was to elucidate the impact of methods of causal inference on the results of comparative effectiveness studies. Methods Data from three observational multiple sclerosis registries (MSBase, the Danish MS Registry and French OFSEP registry) were combined. Four clinical outcomes were studied. Propensity scores were used to match or weigh the compared groups, allowing for estimating average treatment effect for treated or average treatment effect for the entire population. Analyses were conducted both in intention-to-treat and per-protocol frameworks. The impact of the positivity assumption was also assessed. Results Overall, 5,148 relapsing–remitting multiple sclerosis patients were included. In this well-powered sample, the 95% confidence intervals of the estimates overlapped widely. Propensity scores weighting and propensity scores matching procedures led to consistent results. Some differences were observed between average treatment effect for the entire population and average treatment effect for treated estimates. Intention-to-treat analyses were more conservative than per-protocol analyses. The most pronounced irregularities in outcomes and propensity scores were introduced by violation of the positivity assumption. Conclusions This applied study elucidates the influence of methodological decisions on the results of comparative effectiveness studies of treatments for multiple sclerosis. According to our results, there are no material differences between conclusions obtained with propensity scores matching or propensity scores weighting given that a study is sufficiently powered, models are correctly specified and positivity assumption is fulfilled. Supplementary Information The online version contains supplementary material available at 10.1186/s12874-022-01623-8.
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Affiliation(s)
- M Lefort
- Arènes - UMR 6051, RSMS (Recherche sur les Services et Management en Santé) - U 1309, Univ Rennes, EHESP, CNRS, Inserm, Rennes, France.,Univ Rennes, CHU Rennes, Investigation Clinique de Rennes)], CIC 1414 [(Centre d, 35000, InsermRennes, France
| | - S Sharmin
- Department of Medicine, University of Melbourne, Melbourne, Australia.,Melbourne MS Centre, Department of Neurology, Royal Melbourne Hospital, Melbourne, Australia
| | - J B Andersen
- Department of Neurology, The Danish Multiple Sclerosis Registry, Copenhagen University Hospital, Rigshospitalet Glostrup, Denmark
| | - S Vukusic
- Service de Neurologie, Sclérose en Plaques, Pathologies de La Myéline Et Neuro-Inflammation, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, 69677, Lyon/Bron, France.,Centre Des Neurosciences de Lyon, UMR5292, Observatoire Français de La Sclérose en Plaques, INSERM, 1028 et CNRS, 69003, Lyon, France.,Université, Claude Bernard Lyon 1, Faculté de médecine Lyon Est, 69000, Lyon, France
| | - R Casey
- Service de Neurologie, Sclérose en Plaques, Pathologies de La Myéline Et Neuro-Inflammation, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, 69677, Lyon/Bron, France.,Centre Des Neurosciences de Lyon, UMR5292, Observatoire Français de La Sclérose en Plaques, INSERM, 1028 et CNRS, 69003, Lyon, France.,Université, Claude Bernard Lyon 1, Faculté de médecine Lyon Est, 69000, Lyon, France.,Eugene Devic EDMUS Foundation, 69677, Lyon/Bron, France
| | - M Debouverie
- Centre Hospitalier Régional Universitaire de Nancy, Hôpital Central, Service de neurologie, Nancy, France
| | - G Edan
- Centre Hospitalier Universitaire de Rennes, Hôpital Pontchaillou, Service de neurologie, Rennes, France
| | - J Ciron
- Centre Hospitalier Universitaire de Toulouse, Hôpital Purpan, CRC-SEP, Département de neurologie, Toulouse, France
| | - A Ruet
- Centre Hospitalier Universitaire de Bordeaux, Hôpital Pellegrin, Service de neurologie, Bordeaux, France
| | - J De Sèze
- Service des maladies inflammatoires du système nerveux - neurologie, centre d'investigation clinique de Strasbourg, Hôpitaux Universitaire de Strasbourg, Hôpital de Hautepierre, INSERM 1434, Strasbourg, France
| | - E Maillart
- Assistance Publique Des Hôpitaux de Paris, Hôpital de La Pitié-Salpêtrière, Service de neurologie, Paris, France
| | - H Zephir
- Centre Hospitalier Universitaire de Lille, Hôpital Salengro, Service de neurologie D, Lille, France
| | - P Labauge
- Centre Hospitalier Universitaire de Montpellier, Hôpital Gui de Chauliac, Service de neurologie, Montpellier, France
| | - G Defer
- Centre Hospitalier Universitaire de Caen Normandie, Hôpital Côte de Nacre, Service de neurologie, Caen, France
| | - C Lebrun-Frenay
- Centre Hospitalier Universitaire de Nice, UR2CA-URRIS,, Université Nice Côte d'Azur, Hôpital, Pasteur 2, Service de neurologie, Nice, France
| | - T Moreau
- Centre Hospitalier Universitaire Dijon Bourgogne, Hôpital François Mitterrand, Maladies Inflammatoires du Système Nerveux Et Neurologie Générale, Service de neurologie, Dijon, France
| | - E Berger
- Centre Hospitalier Régional Universitaire de Besançon, Hôpital Jean Minjoz, Service de neurologie, Besançon, France
| | - P Clavelou
- Centre Hospitalier Universitaire de Clermont-Ferrand, Hôpital Gabriel-Montpied, Service de neurologie, Clermont-Ferrand, France
| | - J Pelletier
- Service de Neurologie, Aix Marseille Univ, APHM, Hôpital de La Timone, Pôle de Neurosciences Cliniques, 13005, Marseille, France
| | - B Stankoff
- Assistance Publique Des Hôpitaux de Paris, Hôpital Saint-Antoine, Service de neurologie, Paris, France
| | - O Gout
- Fondation Adolphe de Rothschild de L'œil Et du Cerveau, Service de neurologie, Paris, France
| | - E Thouvenot
- Centre Hospitalier Universitaire de Nîmes, Hôpital Carémeau, Service de neurologie, Nîmes, France
| | - O Heinzlef
- Centre Hospitalier Intercommunal de Poissy Saint-Germain-en-Laye, Service de neurologie, Poissy, France
| | - A Al-Khedr
- Centre Hospitalier Universitaire d'Amiens Picardie, Site sud, Service de neurologie, Amiens, France
| | - B Bourre
- Rouen University Hospital, 76000, Rouen, France
| | - O Casez
- Centre Hospitalier Universitaire Grenoble-Alpes, Site nord, Service de neurologie, Grenoble/La Tronche, France
| | - P Cabre
- Centre Hospitalier Universitaire de Martinique, Hôpital Pierre Zobda-Quitman, Service de neurologie, Fort-de-France, France
| | - A Montcuquet
- Centre Hospitalier Universitaire Limoges, Hôpital Dupuytren, Service de neurologie, Limoges, France
| | - A Wahab
- Assistance Publique Des Hôpitaux de Paris, Hôpital Henri Mondor, Service de neurologie, Créteil, France
| | - J P Camdessanché
- Centre Hospitalier Universitaire de Saint-Étienne, Hôpital Nord, Service de neurologie, Saint-Étienne, France
| | - A Maurousset
- Centre Hospitalier Régional Universitaire de Tours, Hôpital Bretonneau, Service de neurologie, Tours, France
| | - H Ben Nasr
- Centre Hospitalier Sud Francilien, Service de neurologie, Corbeil-Essonnes, France
| | - K Hankiewicz
- Centre Hospitalier de Saint-Denis, Hôpital Casanova, Service de neurologie, Saint-Denis, France
| | - C Pottier
- Centre Hospitalier de Pontoise, Service de neurologie, Pontoise, France
| | - N Maubeuge
- Centre Hospitalier Universitaire de Poitiers, Site de La Milétrie, Service de neurologie, Poitiers, France
| | - D Dimitri-Boulos
- Assistance Publique Des Hôpitaux de Paris, Hôpital Bicêtre, Service de neurologie, Le Kremlin-Bicêtre, France
| | - C Nifle
- Centre Hospitalier de Versailles, Hôpital André-Mignot, Service de neurologie, Le Chesnay, France
| | - D A Laplaud
- CHU de Nantes, Service de Neurologie & CIC015 INSERM, 44093, Nantes, France.,INSERM CR1064, 44000, Nantes, France
| | - D Horakova
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University in Prague and General University Hospital, Prague, Czech Republic
| | - E K Havrdova
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University in Prague and General University Hospital, Prague, Czech Republic
| | - R Alroughani
- Division of Neurology, Department of Medicine, Amiri Hospital, Sharq, Kuwait
| | - G Izquierdo
- Hospital Universitario Virgen Macarena, Seville, Spain
| | - S Eichau
- Hospital Universitario Virgen Macarena, Seville, Spain
| | - S Ozakbas
- Dokuz Eylul University, Konak/Izmir, Turkey
| | - F Patti
- GF Ingrassia Department, University of Catania, Catania, Italy.,Policlinico G Rodolico, Catania, Italy
| | - M Onofrj
- Department of Neuroscience, Imaging, and Clinical Sciences, University G. d'Annunzio, Chieti, Italy
| | - A Lugaresi
- Dipartimento Di Scienze Biomediche E Neuromotorie, Università Di Bologna, Bologna, Italy.,IRCCS Istituto Delle Scienze Neurologiche Di Bologna, Bologna, Italy
| | - M Terzi
- Medical Faculty, 19 Mayis University, Samsun, Turkey
| | - P Grammond
- CISSS Chaudiere-Appalache, Levis, Canada
| | | | - B Yamout
- Nehme and Therese Tohme Multiple Sclerosis Center, American University of Beirut Medical Center, Beirut, Lebanon
| | - A Prat
- Hopital Notre Dame, Montreal, Canada.,CHUM and Universite de Montreal, Montreal, Canada
| | - M Girard
- Hopital Notre Dame, Montreal, Canada.,CHUM and Universite de Montreal, Montreal, Canada
| | - P Duquette
- Hopital Notre Dame, Montreal, Canada.,CHUM and Universite de Montreal, Montreal, Canada
| | - C Boz
- KTU Medical Faculty Farabi Hospital, Trabzon, Turkey
| | - M Trojano
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari, Bari, Italy
| | - P McCombe
- University of Queensland, Brisbane, Australia.,Royal Brisbane and Women's Hospital, Herston, Australia
| | - M Slee
- Flinders University, Adelaide, Australia
| | - J Lechner-Scott
- School of Medicine and Public Health, University Newcastle, Newcastle, Australia.,Department of Neurology, John Hunter Hospital, Hunter New England Health, Newcastle, Australia
| | - R Turkoglu
- Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
| | - P Sola
- Department of Neuroscience, Azienda Ospedaliera Universitaria, Modena, Italy
| | - D Ferraro
- Department of Neuroscience, Azienda Ospedaliera Universitaria, Modena, Italy
| | - F Granella
- Department of Medicine and Surgery, University of Parma, Parma, Italy.,Department of Emergency and General Medicine, Parma University Hospital, Parma, Italy
| | | | - J Prevost
- CSSS Saint-Jérôme, Saint-Jerome, Canada
| | | | - O Skibina
- Monash University, Melbourne, Australia
| | - K Buzzard
- Monash University, Melbourne, Australia
| | | | | | - B Van Wijmeersch
- Rehabilitation and MS-Centre Overpelt and Hasselt University, Hasselt, Belgium
| | - T Csepany
- Department of Neurology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - D Spitaleri
- Azienda Ospedaliera Di Rilievo Nazionale San Giuseppe Moscati Avellino, Avellino, Italy
| | - S Vucic
- Westmead Hospital, Sydney, Australia
| | - N Koch-Henriksen
- Department of Clinical Epidemiology, Aarhus University Hospital Aarhus, Aarhus, Denmark
| | - F Sellebjerg
- Danish Multiple Sclerosis Centre, Department of Neurology, Copenhagen University Hospital, Rigshospitalet Glostrup, 2600, Glostrup, Denmark
| | - P S Soerensen
- Danish Multiple Sclerosis Centre, Department of Neurology, Copenhagen University Hospital, Rigshospitalet Glostrup, 2600, Glostrup, Denmark
| | - C C Hilt Christensen
- Department of Neurology, Aalborg University Hospital, Multiple Sclerosis Unit, Aalborg, Denmark
| | - P V Rasmussen
- Aarhus University Hospital, Neurology, PJJ Boulevard, DK-8200, Aarhus N, Denmark
| | - M B Jensen
- Department of Neurology, University Hospital of Northern Sealand, Copenhagen, Denmark
| | - J L Frederiksen
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - S Bramow
- Danish Multiple Sclerosis Centre, Department of Neurology, Copenhagen University Hospital, Rigshospitalet Glostrup, 2600, Glostrup, Denmark
| | - H K Mathiesen
- Department of Neurology, Copenhagen University Hospital Herlev, Copenhagen, Denmark
| | - K I Schreiber
- Danish Multiple Sclerosis Centre, Department of Neurology, Copenhagen University Hospital, Rigshospitalet Glostrup, 2600, Glostrup, Denmark
| | - H Butzkueven
- Central Clinical School, Monash University, Melbourne, Australia.,Department of Neurology, The Alfred Hospital, Melbourne, Australia.,Department of Neurology, Box Hill Hospital, Monash University, Melbourne, Australia
| | - M Magyari
- Melbourne MS Centre, Department of Neurology, Royal Melbourne Hospital, Melbourne, Australia.,Danish Multiple Sclerosis Centre, Department of Neurology, Copenhagen University Hospital, Rigshospitalet Glostrup, 2600, Glostrup, Denmark
| | - T Kalincik
- Department of Medicine, University of Melbourne, Melbourne, Australia.
| | - E Leray
- Arènes - UMR 6051, RSMS (Recherche sur les Services et Management en Santé) - U 1309, Univ Rennes, EHESP, CNRS, Inserm, Rennes, France. .,Univ Rennes, CHU Rennes, Investigation Clinique de Rennes)], CIC 1414 [(Centre d, 35000, InsermRennes, France.
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21
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Defer G, Derache N, Branger P, Arnaud C. Télémédecine et e-santé dans le parcours de soins des patients SEP. Rev Neurol (Paris) 2022. [DOI: 10.1016/j.neurol.2022.02.104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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22
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Lajoye AL, Defer G, Briant A. Élévation des gamma-GT sous fingolimod : prévalence, facteurs de risque et conséquences. Rev Neurol (Paris) 2022. [DOI: 10.1016/j.neurol.2022.02.421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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23
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Rollot F, Couturier J, Casey R, Wiertlewski S, Debouverie M, Pelletier J, De Sèze J, Labauge P, Ruet A, Thouvenot E, Ciron J, Berger E, Gout O, Clavelou P, Stankoff B, Casez O, Bourre B, Zephir H, Moreau T, Lebrun-Frenay C, Maillart E, Edan G, Neau JP, Montcuquet A, Cabre P, Camdessanché JP, Defer G, Nasr HB, Maurousset A, Hankiewicz K, Pottier C, Leray E, Vukusic S, Laplaud DA. Comparative Effectiveness of Natalizumab Versus Anti-CD20 in Highly Active Relapsing-Remitting Multiple Sclerosis After Fingolimod Withdrawal. Neurotherapeutics 2022; 19:476-490. [PMID: 35217934 PMCID: PMC9226262 DOI: 10.1007/s13311-022-01202-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/07/2022] [Indexed: 10/19/2022] Open
Abstract
In France, two therapeutic strategies can be offered after fingolimod (FNG) withdrawal to highly active relapsing-remitting multiple sclerosis (RRMS) patients: natalizumab (NTZ) or anti-CD20. We compared the effectiveness of these two strategies as a switch for FNG within the OFSEP database. The primary endpoint was the time to first relapse. Other outcomes were the relapse rates over 3-month periods, time to worsening the EDSS score, proportion of patients with worsened 24-month MRI, time to treatment discontinuation, and incidence rates of serious adverse events. The dynamics of event rates over time were modeled using multidimensional penalized splines, allowing the possibility to model the effects of covariates in a flexible way, considering non-linearity and interactions. A total of 740 patients were included (337 under anti-CD20 and 403 under NTZ). There was no difference between the two treatments regarding the dynamic of the first occurrence of relapse, with a monthly probability of 5.0% at initiation and 1.0% after 6 months. The rate of EDSS worsening increased in both groups until 6 months and then decreased. No difference in the proportion of patients with new T2 lesions at 24 months was observed. After 18 months of follow-up, a greater risk of NTZ discontinuation was found compared to anti-CD20. This study showed no difference between NTZ and anti-CD20 after the FNG switch regarding the clinical and radiological activity. The effect of these treatments was optimal after 6 months and there was more frequent discontinuation of NTZ after 18 months, probably mainly related to JC virus seroconversions.
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Affiliation(s)
- Fabien Rollot
- Université de Lyon, Université Claude Bernard, Lyon 1, Lyon, France.
- Service de Neurologie, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, sclérose en plaques, pathologies de la myéline et neuro-inflammation, Bron, France.
- Centre de Recherche en Neurosciences de Lyon, Observatoire Français de La Sclérose en Plaques, INSERM 1028 et CNRS UMR 5292, Lyon, France.
- EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis, State-Approved Foundation, Bron, France.
| | | | - Romain Casey
- Université de Lyon, Université Claude Bernard, Lyon 1, Lyon, France
- Service de Neurologie, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, sclérose en plaques, pathologies de la myéline et neuro-inflammation, Bron, France
- Centre de Recherche en Neurosciences de Lyon, Observatoire Français de La Sclérose en Plaques, INSERM 1028 et CNRS UMR 5292, Lyon, France
- EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis, State-Approved Foundation, Bron, France
| | - Sandrine Wiertlewski
- Service de Neurologie, CHU Nantes, Nantes, France
- INSERM, CIC 0004, CRTI-INSERM UMR U1064, Nantes, France
| | - Marc Debouverie
- Service de Neurologie, Centre Hospitalier Régional Et Universitaire de Nancy, Université de Lorraine, 4360 APEMAC, Vandoeuvre-Lès-Nancy, EA, France
| | - Jean Pelletier
- Aix Marseille University, APHM, Hôpital de La Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, CEMEREM, 13005, Marseille, France
| | - Jérôme De Sèze
- Service de Neurologie Et Centre d'Investigation Clinique, CHU de Strasbourg, INSERM 1434, Strasbourg, France
| | - Pierre Labauge
- Service de Neurologie, CHU de Montpellier, Montpellier, France
| | - Aurélie Ruet
- Service de Neurologie, CHU de Bordeaux, Bordeaux, France
- Université de Bordeaux, INSERM, Neurocentre Magendie, U1215, Bordeaux, France
| | - Eric Thouvenot
- Service de Neurologie, CHU de Nîmes, Nîmes, France
- Institut de Génomique Fonctionnelle, Université de Montpellier, CNRS, INSERM, Montpellier, France
| | - Jonathan Ciron
- Service de Neurologie, CHU de Toulouse, Hôpital Pierre-Paul Riquet, CRC-SEP, Toulouse, France
- Institut Toulousain Des Maladies Infectieuses Et Inflammatoires (Infinity), INSERM UMR 1291, CNRS UMR 5051, Université Toulouse III, Toulouse, France
| | - Eric Berger
- Service de Neurologie, CHU de Besançon, Besançon, France
| | - Olivier Gout
- Service de Neurologie, Hôpital Fondation A de Rothschild, Paris, France
| | - Pierre Clavelou
- Service de Neurologie, CHU de Clermont-Ferrand, Clermont-Ferrand, France
| | | | - Olivier Casez
- Service de Neurologie, CHU de Grenoble, Grenoble, France
| | | | - Hélène Zephir
- Pôle Des Neurosciences Et de L'appareil Locomoteur, CRC-SEP, Hôpital Roger Salengro, Université de Lille, Inserm U1172, Lille, France
| | | | - Christine Lebrun-Frenay
- Service de Neurologie, Neurologie Pasteur 2, CHU de Nice, Université Nice Cote d'Azur UR2CA-URRIS, Nice, France
| | - Elisabeth Maillart
- Département de Neurologie, APHP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Gilles Edan
- Service de Neurologie, CHU Pontchaillou, Rennes, France
| | | | | | - Philippe Cabre
- Service de Neurologie, CHU de Fort de France, Fort de France, France
| | | | - Gilles Defer
- Service de Neurologie, Centre Expert SEP, CHU de Caen, Université Normandie, Caen, France
| | - Haifa Ben Nasr
- Service de Neurologie, Hôpital Sud Francilien, Corbeil Essonnes, France
| | | | | | | | - Emmanuelle Leray
- Université de Rennes/EHESP, REPERES - EA, 7449, Rennes, France
- CHU Rennes, CIC-P 1414, Rennes, France
| | - Sandra Vukusic
- Université de Lyon, Université Claude Bernard, Lyon 1, Lyon, France
- Service de Neurologie, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, sclérose en plaques, pathologies de la myéline et neuro-inflammation, Bron, France
- Centre de Recherche en Neurosciences de Lyon, Observatoire Français de La Sclérose en Plaques, INSERM 1028 et CNRS UMR 5292, Lyon, France
- EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis, State-Approved Foundation, Bron, France
| | - David-Axel Laplaud
- Service de Neurologie, CHU Nantes, Nantes, France.
- INSERM, CIC 0004, CRTI-INSERM UMR U1064, Nantes, France.
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Foley J, Defer G, Ryerson LZ, Cohen JA, Arnold DL, Butzkueven H, Cutter G, Giovannoni G, Killestein J, Wiendl H, Smirnakis K, Xiao S, Kong G, Kuhelj R, Campbell N. Primary Results of NOVA: A Randomized Controlled Study of the Efficacy of 6 Week Dosing of Natalizumab Versus Continued 4-Week Treatment for Multiple Sclerosis. Mult Scler Relat Disord 2022. [DOI: 10.1016/j.msard.2022.103626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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25
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Brochet B, Clavelou P, Defer G, De Seze J, Louapre C, Magnin E, Ruet A, Thomas-Anterion C, Vermersch P. Cognitive Impairment in Secondary Progressive Multiple Sclerosis: Effect of Disease Duration, Age, and Progressive Phenotype. Brain Sci 2022; 12:brainsci12020183. [PMID: 35203948 PMCID: PMC8870031 DOI: 10.3390/brainsci12020183] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 01/21/2022] [Accepted: 01/24/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Cognitive deficits are common in multiple sclerosis (MS) and affect patients at all stages of the disease, regardless of phenotype. Aims: This literature review focuses the cognitive deficits observed in secondary progressive MS (SPMS). It is mainly based on studies that compared the frequency and main characteristics of cognitive deficits in SPMS with other phenotypes. Methods: A bibliographic search was carried out using the PubMed database with the following keywords: multiple sclerosis, secondary-progressive, cognition. Results: Thirteen studies were initially selected that were published in English, reporting the neuropsychological data of a sample of at least 30 patients with SPMS, comparing them with patients with other phenotypes. Studies suggest that there is an association between the duration of the disease and the frequency and extent of the cognitive disorders. Studies also showed that the SP form is associated with an increased frequency of cognitive impairment and with an increased severity as compared to relapsing-remitting MS (RRMS). Compared to RRMS, progressive forms of MS are associated with more severe impairment in certain cognitive areas, such as episodic verbal memory, information processing speed, working memory, or verbal fluency. Two studies showed that cognitive performances decline overtime in SPMS. Conclusion: Cognitive disorders are more frequent and more severe in the SP form than in relapsing course of MS. The profile of cognitive impairment encountered in the SP form also appears to be different from those found in the other phenotypes.
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Affiliation(s)
- Bruno Brochet
- Neurocentre Magendie Inserm U 1215, Université de Bordeaux, 146 rue de Léo Saignat, 33077 Bordeaux, France
- Correspondence:
| | - Pierre Clavelou
- CRC-SEP, Hôpital Gabriel Montpied, CHU de Clermont-Ferrand, 58 Rue Montalembert, 63003 Clermont-Ferrand, France;
| | - Gilles Defer
- CRC-SEP, Service de Neurologie, CHU de Caen, Avenue de la côte de Nacre, 14033 Caen, France;
| | - Jérôme De Seze
- CRC-SEP, CHU Strasbourg, Hôpital Hautepierre, 1 Avenue Molière, 67098 Strasbourg, France;
| | - Céline Louapre
- Sorbonne University, Paris Brain Institute—ICM, Assistance Publique Hôpitaux de Paris, Inserm, CNRS, Hôpital de la Pitié Salpêtrière, CIC Neurosciences, 75013, Paris, France;
| | - Eloi Magnin
- Service de Neurologie, Hôpital Jean Minoz, 1-3 Boulevard Alexandre Fleming, 25000 Besançon, France;
| | - Aurélie Ruet
- Neurocentre Magendie, INSERM U 1215, Université de Bordeaux, Service de Neurologie, CHU de Bordeaux, Hôpital Pellegrin, Place Amélie Raba Léon, 33076 Bordeaux, France;
| | | | - Patrick Vermersch
- Inserm U1172—Lille Neuroscience et Cognition, Université de Lille, CRCR SEP, CHU Lille, FHU Precise, 59000 Lille, France;
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26
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Sharmin S, Lefort M, Andersen JB, Leray E, Horakova D, Havrdova EK, Alroughani R, Izquierdo G, Ozakbas S, Patti F, Onofrj M, Lugaresi A, Terzi M, Grammond P, Grand'Maison F, Yamout B, Prat A, Girard M, Duquette P, Boz C, Trojano M, McCombe P, Slee M, Lechner-Scott J, Turkoglu R, Sola P, Ferraro D, Granella F, Prevost J, Maimone D, Skibina O, Buzzard K, Van der Walt A, Van Wijmeersch B, Csepany T, Spitaleri D, Vucic S, Casey R, Debouverie M, Edan G, Ciron J, Ruet A, De Sèze J, Maillart E, Zephir H, Labauge P, Defer G, Lebrun-Frénay C, Moreau T, Berger E, Clavelou P, Pelletier J, Stankoff B, Gout O, Thouvenot E, Heinzlef O, Al-Khedr A, Bourre B, Casez O, Cabre P, Montcuquet A, Wahab A, Camdessanché JP, Maurousset A, Patry I, Hankiewicz K, Pottier C, Maubeuge N, Labeyrie C, Nifle C, Laplaud D, Koch-Henriksen N, Sellebjerg FT, Soerensen PS, Pfleger CC, Rasmussen PV, Jensen MB, Frederiksen JL, Bramow S, Mathiesen HK, Schreiber KI, Magyari M, Vukusic S, Butzkueven H, Kalincik T. Natalizumab Versus Fingolimod in Patients with Relapsing-Remitting Multiple Sclerosis: A Subgroup Analysis From Three International Cohorts. CNS Drugs 2021; 35:1217-1232. [PMID: 34536228 DOI: 10.1007/s40263-021-00860-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/16/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Natalizumab has proved to be more effective than fingolimod in reducing disease activity in relapsing-remitting multiple sclerosis (RRMS). Whether this association is universal for all patient groups remains to be determined. OBJECTIVE The aim of this study was to compare the relative effectiveness of natalizumab and fingolimod in RRMS subgroups defined by the baseline demographic and clinical characteristics of interest. METHODS Patients with RRMS who were given natalizumab or fingolimod were identified in a merged cohort from three international registries. Efficacy outcomes were compared across subgroups based on patients' sex, age, disease duration, Expanded Disability Status Scale (EDSS) score, and disease and magnetic resonance imaging (MRI) activity 12 months prior to treatment initiation. Study endpoints were number of relapses (analyzed with weighted negative binomial generalized linear model) and 6-month confirmed disability worsening and improvement events (weighted Cox proportional hazards model), recorded during study therapy. Each patient was weighted using inverse probability of treatment weighting based on propensity score. RESULTS A total of 5148 patients (natalizumab 1989; fingolimod 3159) were included, with a mean ± standard deviation age at baseline of 38 ± 10 years, and the majority (72%) were women. The median on-treatment follow-up was 25 (quartiles 15-41) months. Natalizumab was associated with fewer relapses than fingolimod (incidence rate ratio [IRR]; 95% confidence interval [CI]) in women (0.76; 0.65-0.88); in those aged ≤ 38 years (0.64; 0.54-0.76); in those with disease duration ≤ 7 years (0.63; 0.53-0.76); in those with EDSS score < 4 (0.75; 0.64-0.88), < 6 (0.80; 0.70-0.91), and ≥ 6 (0.52; 0.31-0.86); and in patients with pre-baseline relapses (0.74; 0.64-0.86). A higher probability of confirmed disability improvement on natalizumab versus fingolimod (hazard ratio [HR]; 95% CI) was observed among women (1.36; 1.10-1.66); those aged > 38 years (1.34; 1.04-1.73); those with disease duration > 7 years (1.33; 1.01-1.74); those with EDSS score < 6 (1.21; 1.01-1.46) and ≥ 6 (1.93; 1.11-3.34); and patients with no new MRI lesion (1.73; 1.19-2.51). CONCLUSIONS Overall, in women, younger patients, those with shorter disease durations, and patients with pre-treatment relapses, natalizumab was associated with a lower frequency of multiple sclerosis relapses than fingolimod. It was also associated with an increased chance of recovery from disability among most patients, particularly women and those with no recent MRI activity.
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Affiliation(s)
- Sifat Sharmin
- CORe, Department of Medicine, University of Melbourne, L4 East, Grattan St, Melbourne, VIC, 3050, Australia
| | - Mathilde Lefort
- Rennes University, EHESP, REPERES, EA, 7449, Rennes, France.,Univ Rennes, CHU Rennes, Inserm, CIC 1414 (Centre d'Investigation Clinique de Rennes), Rennes, France
| | - Johanna Balslev Andersen
- The Danish Multiple Sclerosis Registry, Department of Neurology, University of Copenhagen, Rigshospitalet, Copenhagen, Denmark
| | - Emmanuelle Leray
- Rennes University, EHESP, REPERES, EA, 7449, Rennes, France.,Univ Rennes, CHU Rennes, Inserm, CIC 1414 (Centre d'Investigation Clinique de Rennes), Rennes, France
| | - Dana Horakova
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University in Prague and General University Hospital, Prague, Czech Republic
| | - Eva Kubala Havrdova
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University in Prague and General University Hospital, Prague, Czech Republic
| | - Raed Alroughani
- Division of Neurology, Department of Medicine, Amiri Hospital, Sharq, Kuwait
| | | | | | - Francesco Patti
- Department of Medical and Surgical Sciences and Advanced Technologies, GF Ingrassia, Catania, Italy.,Multiple Sclerosis Center, University of Catania, Catania, Italy
| | - Marco Onofrj
- Department of Neuroscience, Imaging, and Clinical Sciences, University G. d'Annunzio, Chieti, Italy
| | - Alessandra Lugaresi
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy.,Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna, Bologna, Italia
| | - Murat Terzi
- Medical Faculty, 19 Mayis University, Samsun, Turkey
| | | | | | - Bassem Yamout
- Nehme and Therese Tohme Multiple Sclerosis Center, American University of Beirut Medical Center, Beirut, Lebanon
| | - Alexandre Prat
- CHUM MS Center and Universite de Montreal, Montreal, Canada
| | - Marc Girard
- CHUM MS Center and Universite de Montreal, Montreal, Canada
| | | | - Cavit Boz
- KTU Medical Faculty Farabi Hospital, Trabzon, Turkey
| | - Maria Trojano
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari, Bari, Italy
| | - Pamela McCombe
- University of Queensland, Brisbane, Australia.,Royal Brisbane and Women's Hospital, Brisbane, Australia
| | - Mark Slee
- College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Jeannette Lechner-Scott
- School of Medicine and Public Health, University Newcastle, Newcastle, Australia.,Department of Neurology, John Hunter Hospital, Hunter New England Health, Newcastle, Australia
| | - Recai Turkoglu
- Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
| | - Patrizia Sola
- Department of Neuroscience, Azienda Ospedaliera Universitaria, Modena, Italy
| | - Diana Ferraro
- Department of Neuroscience, Azienda Ospedaliera Universitaria, Modena, Italy
| | - Franco Granella
- Department of Medicine and Surgery, University of Parma, Parma, Italy.,Department of Emergency and General Medicine, Parma University Hospital, Parma, Italy
| | | | | | - Olga Skibina
- Department of Neuroscience, Monash University, Melbourne, Australia.,Department of Neurology, The Alfred Hospital, Melbourne, Australia
| | - Katherine Buzzard
- Department of Neurology, The Alfred Hospital, Melbourne, Australia.,Central Clinical School, Monash University, Melbourne, Australia
| | - Anneke Van der Walt
- Department of Neurology, The Alfred Hospital, Melbourne, Australia.,Central Clinical School, Monash University, Melbourne, Australia
| | - Bart Van Wijmeersch
- Rehabilitation and MS-Centre Overpelt and Hasselt University, Hasselt, Belgium
| | - Tunde Csepany
- Department of Neurology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Daniele Spitaleri
- Azienda Ospedaliera di Rilievo Nazionale San Giuseppe Moscati Avellino, Avellino, Italy
| | - Steve Vucic
- Neurophysiology Department, Westmead Hospital, Sydney, Australia
| | - Romain Casey
- Université de Lyon, Université, Claude Bernard Lyon 1, F-69000, Lyon, France.,Service de neurologie, sclérose en plaques, pathologies de la myéline et neuro-inflammation, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron, Lyon, France.,Observatoire Français de la Sclérose en Plaques, Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR 5292, 69003, Lyon, France.,EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis, State-Approved Foundation, 69677, Bron, France
| | - Marc Debouverie
- Department of Neurology, Nancy University Hospital, Nancy, France.,Université de Lorraine, APEMAC, 54000, Nancy, France
| | - Gilles Edan
- CHU Pontchaillou, CIC1414 INSERM, 35000, Rennes, France
| | - Jonathan Ciron
- Department of Neurology, CHU de Toulouse, Hôpital Pierre-Paul Riquet, CRC-SEP, 31059, Toulouse Cedex 9, France
| | - Aurélie Ruet
- Neurocentre Magendie, Université de Bordeaux, 33000, Bordeaux, France.,INSERM U1215, Neurocentre Magendie, 33000, Bordeaux, France.,Department of Neurology, CHU de Bordeaux, CIC Bordeaux CIC1401, 33000, Bordeaux, France
| | - Jérôme De Sèze
- Department of Neurology and Clinical Investigation Center, CHU de Strasbourg, CIC 1434, INSERM 1434, 67000, Strasbourg, France
| | - Elisabeth Maillart
- Département de neurologie, Hôpital Pitié-Salpêtrière, APHP, Paris, France.,Centre de Ressources et de Compétences SEP, Paris, France
| | - Hélène Zephir
- CHU Lille, CRCSEP Lille, Univ Lille, U1172, 59000, Lille, France
| | - Pierre Labauge
- MS Unit, CHU de Montpellier, 34295, Montpellier Cedex 5, France.,University of Montpellier (MUSE), 34000, Montpellier, France
| | - Gilles Defer
- Department of Neurology, CHU de Caen, MS Expert Centre, Normandy University, avenue de la Côte-de-Nacre, 14033, Caen, France
| | | | - Thibault Moreau
- Department of Neurology, CHU de Dijon, EA4184, 21000, Dijon, France
| | - Eric Berger
- CHU de Besançon, Service de Neurologie 25 030, Besançon, France
| | - Pierre Clavelou
- Department of Neurology, CHU Clermont-Ferrand, 63000, Clermont-Ferrand, France.,Université Clermont Auvergne, Inserm, Neuro-Dol, 63000, Clermont-Ferrand, France
| | - Jean Pelletier
- Aix Marseille Univ, APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, 13005, Marseille, France
| | - Bruno Stankoff
- Sorbonne Universités, UPMC Paris 06, Brain and Spine Institute, ICM, Hôpital de la Pitié Salpêtrière, Inserm UMR S 1127, CNRS UMR 7225, Paris, France.,Department of Neurology, AP-HP, Saint-Antoine Hospital, 75000, Paris, France
| | - Olivier Gout
- Department of Neurology, Fondation Rotschild, 75000, Paris, France
| | - Eric Thouvenot
- Department of Neurology, Nimes University Hospital, 30029, Nimes Cedex 9, France.,Institut de Génomique Fonctionnelle, UMR5203, INSERM 1191, Univ. Montpellier, 34094, Montpellier Cedex 5, France
| | - Olivier Heinzlef
- Department of Neurology, Hôpital de Poissy, 78300, Poissy, France
| | | | | | - Olivier Casez
- Department of Neurology, CHU Grenoble Alpes, La Tronche, 38700, Grenoble, France
| | - Philippe Cabre
- Department of Neurology, CHU de la Martinique, 97200, Fort-de-France, France
| | - Alexis Montcuquet
- Department of Neurology, CHU de Limoges, Hôpital Dupuytren, 87000, Limoges, France
| | - Abir Wahab
- Department of Neurology, APHP, Hôpital Henri Mondor, 94000, Créteil, France
| | | | - Aude Maurousset
- CRC SEP and Department of Neurology, CHU de Tours, Hôpital Bretonneau, 37000, Tours, France
| | - Ivania Patry
- Department of Neurology, Hôpital Sud Francilien, 91160, Corbeil Essonnes, France
| | - Karolina Hankiewicz
- Department of Neurology, Hôpital Pierre Delafontaine, Centre Hospitalier de Saint-Denis, 93200, Saint-Denis, France
| | - Corinne Pottier
- Department of Neurology, CH de Pontoise, Hôpital René Dubos, 95300, Pontoise, France
| | - Nicolas Maubeuge
- Department of Neurology, CHU La Milétrie, Hôpital Jean Bernard, 86000, Poitiers, France
| | - Céline Labeyrie
- Department of Neurology, CHU Bicêtre, 94275, Le Kremlin Bicêtre, France
| | - Chantal Nifle
- Department of Neurology, Centre Hospitalier de Versailles, 78150, Le Chesnay, France
| | - David Laplaud
- CHU de Nantes, Service de Neurologie & CIC015 INSERM, 44093, Nantes, France.,CRTI-Inserm U1064, 44000, Nantes, France
| | - Niels Koch-Henriksen
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
| | - Finn Thorup Sellebjerg
- Department of Neurology, The Danish Multiple Sclerosis Center, University of Copenhagen, Rigshospitalet, Copenhagen, Denmark
| | - Per Soelberg Soerensen
- Department of Neurology, The Danish Multiple Sclerosis Center, University of Copenhagen, Rigshospitalet, Copenhagen, Denmark
| | | | | | | | - Jette Lautrup Frederiksen
- Department of Neurology, Rigshospitalet Glostrup, Copenhagen, Denmark.,Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Stephan Bramow
- Department of Neurology, Danish Multiple Sclerosis Centre, Copenhagen University Hospital, Rigshospitalet in Glostrup, 2600, Glostrup, Denmark
| | | | - Karen Ingrid Schreiber
- Department of Neurology, The Danish Multiple Sclerosis Center, University of Copenhagen, Rigshospitalet, Copenhagen, Denmark
| | - Melinda Magyari
- The Danish Multiple Sclerosis Registry, Department of Neurology, University of Copenhagen, Rigshospitalet, Copenhagen, Denmark.,Department of Neurology, The Danish Multiple Sclerosis Center, University of Copenhagen, Rigshospitalet, Copenhagen, Denmark
| | - Sandra Vukusic
- Service de neurologie, sclérose en plaques, pathologies de la myéline et neuro-inflammation, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron, Lyon, France.,Centre des Neurosciences de Lyon, Observatoire Français de la Sclérose en Plaques, INSERM 1028 et CNRS UMR5292, 69003, Lyon, France.,Université Claude Bernard Lyon 1, Faculté de médecine Lyon Est, F-69000, Lyon, France
| | - Helmut Butzkueven
- Department of Neurology, The Alfred Hospital, Melbourne, Australia.,Central Clinical School, Monash University, Melbourne, Australia.,Department of Neurology, Box Hill Hospital, Monash University, Melbourne, Australia
| | - Tomas Kalincik
- CORe, Department of Medicine, University of Melbourne, L4 East, Grattan St, Melbourne, VIC, 3050, Australia. .,MS Centre, Department of Neurology, Royal Melbourne Hospital, Melbourne, Australia.
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Dolladille C, Chrétien B, Peyro-Saint-Paul L, Alexandre J, Dejardin O, Fedrizzi S, Defer G. Association Between Disease-Modifying Therapies Prescribed to Persons with Multiple Sclerosis and Cancer: a WHO Pharmacovigilance Database Analysis. Neurotherapeutics 2021; 18:1657-1664. [PMID: 34231126 PMCID: PMC8608969 DOI: 10.1007/s13311-021-01073-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/09/2021] [Indexed: 02/04/2023] Open
Abstract
The risk of cancer associated with persons with multiple sclerosis (pwMS) prescribed with disease modifying therapies (DMTs) is not well established. This observational, cross-sectional, pharmacovigilance cohort study examined individual case safety reports from the World Health Organization database: VigiBase®. All consecutive reports of DMTs prescribed to pwMS (alemtuzumab, dimethyl fumarate, fingolimod, glatiramer acetate, interferon-β, natalizumab, ocrelizumab, and teriflunomide), and their serious adverse event cases were eligible, excluding those reporting immunosuppressant DMTs used as anticancer therapies. The primary outcome was the multivariate odds ratio of cancer reporting (r-OR) for DMTs prescribed to pwMS after imputation of missing data. There were 5966 cancer cases from 240,993 reports of DMTs prescribed to pwMS. After adjustments on age, sex, and geographical region, natalizumab (r-OR 1.74, 95% CI 1.63-1.87), interferon-β (r-OR 1.39, 95% CI 1.30-1.49), dimethyl fumarate (r-OR 1.35, 95% CI 1.25-1.46), and fingolimod (r-OR 1.15, 95% CI 1.06-1.24) were significantly associated with a greater cancer reporting, whereas alemtuzumab, glatiramer acetate, ocrelizumab, and teriflunomide were not, in the disproportionality analysis. As exploratory analyses, upper aerodigestive tract, breast, urinary including the male genitourinary tract, and nervous system cancers were associated with natalizumab, interferon-β, and dimethyl fumarate. Fingolimod was only associated with skin cancer types. Cancer cases reporting these four DMTs prescribed to pwMS were younger in age than for non-pwMS drugs in the VigiBase® (p < 0.0001). A close and regular cancer screening in pwMS treated with natalizumab, interferon-β, dimethyl fumarate, and fingolimod may be warranted, even for persons at a younger age. Trial Registration NCT04237337.
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Affiliation(s)
- Charles Dolladille
- Department of Pharmacology, CHU de Caen, 14000, Caen, France.
- Medical School, Electrophysiologie Et Imagerie Des Lesions D Ischemie Reperfusion Myocardique, Université Caen Normandie, EA 4650, Signalisation, 14000, Caen, France.
| | - Basile Chrétien
- Department of Pharmacology, CHU de Caen, 14000, Caen, France
| | | | - Joachim Alexandre
- Department of Pharmacology, CHU de Caen, 14000, Caen, France
- Medical School, Electrophysiologie Et Imagerie Des Lesions D Ischemie Reperfusion Myocardique, Université Caen Normandie, EA 4650, Signalisation, 14000, Caen, France
| | - Olivier Dejardin
- ANTICIPE U1086, Ligue Contre Le Cancer Team, Centre François Baclesse, INSERM-University of Caen Normandy, Caen, France
| | - Sophie Fedrizzi
- Department of Pharmacology, CHU de Caen, 14000, Caen, France
| | - Gilles Defer
- MS Expert Centre Department of Neurology, CHU de Caen, 14000, Caen, France
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28
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Andersen JB, Sharmin S, Lefort M, Koch-Henriksen N, Sellebjerg F, Sørensen PS, Hilt Christensen CC, Rasmussen PV, Jensen MB, Frederiksen JL, Bramow S, Mathiesen HK, Schreiber KI, Horakova D, Havrdova EK, Alroughani R, Izquierdo G, Eichau S, Ozakbas S, Patti F, Onofrj M, Lugaresi A, Terzi M, Grammond P, Grand Maison F, Yamout B, Prat A, Girard M, Duquette P, Boz C, Trojano M, McCombe P, Slee M, Lechner-Scott J, Turkoglu R, Sola P, Ferraro D, Granella F, Shaygannejad V, Prevost J, Skibina O, Solaro C, Karabudak R, Wijmeersch BV, Csepany T, Spitaleri D, Vucic S, Casey R, Debouverie M, Edan G, Ciron J, Ruet A, Sèze JD, Maillart E, Zephir H, Labauge P, Defer G, Lebrun C, Moreau T, Berger E, Clavelou P, Pelletier J, Stankoff B, Gout O, Thouvenot E, Heinzlef O, Al-Khedr A, Bourre B, Casez O, Cabre P, Montcuquet A, Wahab A, Camdessanché JP, Marousset A, Patry I, Hankiewicz K, Pottier C, Maubeuge N, Labeyrie C, Nifle C, Leray E, Laplaud DA, Butzkueven H, Kalincik T, Vukusic S, Magyari M. The effectiveness of natalizumab vs fingolimod-A comparison of international registry studies. Mult Scler Relat Disord 2021; 53:103012. [PMID: 34116480 DOI: 10.1016/j.msard.2021.103012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 04/21/2021] [Accepted: 04/29/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Natalizumab and fingolimod were the first preparations recommended for disease breakthrough in priorly treated relapsing-remitting multiple sclerosis. Of three published head-to-head studies two showed that natalizumab is the more effective to prevent relapses and EDSS worsening. METHODS By re-analyzing original published results from MSBase, France, and Denmark using uniform methodologies, we aimed at identifying the effects of differences in methodology, in the MS-populations, and at re-evaluating the differences in effectiveness between the two drugs. We gained access to copies of the individual amended databases and pooled all data. We used uniform inclusion/exclusion criteria and statistical methods with Inverse Probability Treatment Weighting. RESULTS The pooled analyses comprised 968 natalizumab- and 1479 fingolimod treated patients. The on-treatment natalizumab/fingolimod relapse rate ratio was 0.77 (p=0.004). The hazard ratio (HR) for a first relapse was 0.82 (p=0.030), and the HR for sustained EDSS improvement was 1.4 (p=0.009). There were modest differences between each of the original published studies and the replication study, but the conclusions of the three original studies remained unchanged: in two of them natalizumab was more effective, but in the third there was no difference between natalizumab and fingolimod. CONCLUSION The results were largely invariant to the epidemiological and statistical methods but differed between the MS populations. Generally, the advantage of natalizumab was confirmed.
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Affiliation(s)
- Johanna B Andersen
- The Danish Multiple Sclerosis Registry, Department of Neurology, University of Copenhagen, Rigshospitalet, Copenhagen, Denmark.
| | - Sifat Sharmin
- CORe, Department of Medicine, University of Melbourne, Melbourne, Australia; Department of Neurology, Royal Melbourne Hospital, Melbourne, Australia
| | - Mathilde Lefort
- Rennes University, EHESP, REPERES - EA 7449, F-35000 Rennes, France; Univ Rennes, CHU Rennes, Inserm, CIC 1414 (Centre d'Investigation Clinique de Rennes), F-35000 Rennes, France
| | - Nils Koch-Henriksen
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
| | - Finn Sellebjerg
- The Danish Multiple Sclerosis Center, Department of Neurology, Copenhagen University Hospital, Rigshospitalet Glostrup, Denmark
| | - Per Soelberg Sørensen
- The Danish Multiple Sclerosis Center, Department of Neurology, University of Copenhagen, Rigshospitalet, Copenhagen, Denmark
| | | | - Peter V Rasmussen
- Aarhus University Hospital, Neurology, PPJ Boulevard, DK-8200 Aarhus N
| | - Michael B Jensen
- Department of Neurology, University Hospital of Northern Sealand
| | - Jette L Frederiksen
- Danish Multiple Sclerosis Centre, Dept. of Neurology, Copenhagen University Hospital, Rigshospitalet in Glostrup, 2600 Glostrup, Denmark
| | - Stephan Bramow
- The Danish Multiple Sclerosis Center, Department of Neurology, Copenhagen University Hospital, Rigshospitalet Glostrup, Denmark
| | - Henrik K Mathiesen
- The Danish Multiple Sclerosis Center, Department of Neurology, University of Copenhagen, Rigshospitalet, Copenhagen, Denmark
| | - Karen I Schreiber
- The Danish Multiple Sclerosis Center, Department of Neurology, Copenhagen University Hospital, Rigshospitalet Glostrup, Denmark
| | - Dana Horakova
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University in Prague and General University Hospital, Prague, Czech Republic
| | - Eva K Havrdova
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University in Prague and General University Hospital, Prague, Czech Republic
| | - Raed Alroughani
- Division of Neurology, Department of Medicine, Amiri Hospital, Sharq, Kuwait
| | | | - Sara Eichau
- Hospital Universitario Virgen Macarena, Sevilla, Spain
| | | | - Francesco Patti
- GF Ingrassia Department, University of Catania, Catania, Policlinico G Rodolico, Italy
| | - Marco Onofrj
- Department of Neuroscience, Imaging, and Clinical Sciences, University G. d'Annunzio, Chieti, Italy
| | - Alessandra Lugaresi
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy, IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Murat Terzi
- Medical Faculty, 19 Mayis University, Samsun, Turkey
| | | | | | - Bassem Yamout
- Nehme and Therese Tohme Multiple Sclerosis Center, American University of Beirut Medical Center, Beirut, Lebanon
| | - Alexandre Prat
- Hopital Notre Dame, Montreal, Canada, CHUM and Universite de Montreal, Montreal, Canada
| | - Marc Girard
- Hopital Notre Dame, Montreal, Canada, CHUM and Universite de Montreal, Montreal, Canada
| | - Pierre Duquette
- Hopital Notre Dame, Montreal, Canada, CHUM and Universite de Montreal, Montreal, Canada
| | - Cavit Boz
- KTU Medical Faculty Farabi Hospital, Trabzon, Turkey
| | - Maria Trojano
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari, Bari, Italy
| | - Pamela McCombe
- University of Queensland, Brisbane, Australia, Royal Brisbane and Women's Hospital
| | - Mark Slee
- Flinders University, Adelaide, Australia
| | - Jeannette Lechner-Scott
- School of Medicine and Public Health, University Newcastle, Newcastle, Australia; Department of Neurology, John Hunter Hospital, Hunter New England Health, Newcastle, Australia
| | - Recai Turkoglu
- Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
| | - Patrizia Sola
- Department of Neuroscience, Azienda Ospedaliera Universitaria, Modena, Italy
| | - Diana Ferraro
- Department of Neuroscience, Azienda Ospedaliera Universitaria, Modena, Italy
| | - Franco Granella
- Department of Medicine and Surgery, University of Parma, Parma, Italy; Department of Emergency and General Medicine, Parma University Hospital, Parma, Italy
| | | | | | | | - Claudio Solaro
- Department of Neurology, ASL3 Genovese, Genova, Italy; Department of Rehabilitaiton, ML Novarese Hospital Moncrivello
| | | | - Bart V Wijmeersch
- Rehabilitation and MS-Centre Overpelt and Hasselt University, Hasselt, Belgium
| | - Tunde Csepany
- Department of Neurology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Daniele Spitaleri
- Azienda Ospedaliera di Rilievo Nazionale San Giuseppe Moscati Avellino, Avellino, Italy
| | | | - Romain Casey
- Service de neurologie, sclérose en plaques, pathologies de la myéline et neuro-inflammation, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, 69677 Lyon/Bron, France; Centre des Neurosciences de Lyon, Observatoire Français de la Sclérose en Plaques, INSERM 1028 et CNRS UMR5292, 69003 Lyon, France ; Université Claude Bernard Lyon 1, Faculté de médecine Lyon Est, F-69000 Lyon, France, Eugene Devic EDMUS Foundation, 69677 Lyon/Bron, France
| | - Marc Debouverie
- Centre hospitalier régional universitaire de Nancy, Hôpital central, Service de neurologie, Nancy, France
| | - Gilles Edan
- Centre hospitalier universitaire de Rennes, Hôpital Pontchaillou, Service de neurologie, Rennes, France
| | - Jonathan Ciron
- Centre hospitalier universitaire de Toulouse, Hôpital Purpan, Service de neurologie inflammatoire et neuro-oncologie, Toulouse, France
| | - Aurélie Ruet
- Centre hospitalier universitaire de Bordeaux, Hôpital Pellegrin, Service de neurologie, Bordeaux, France
| | - Jérôme D Sèze
- Hôpitaux universitaire de Strasbourg, Hôpital de Hautepierre, Service des maladies inflammatoires du système nerveux - neurologie, Strasbourg, France
| | - Elisabeth Maillart
- Assistance publique des hôpitaux de Paris, Hôpital de la Pitié-Salpêtrière, Service de neurologie, Paris, France
| | - Hélène Zephir
- Centre hospitalier universitaire de Lille, Hôpital Salengro, Service de neurologie D, Lille, France
| | - Pierre Labauge
- Centre hospitalier universitaire de Montpellier, Hôpital Gui de Chauliac, Service de neurologie, Montpellier, France
| | - Gilles Defer
- Centre hospitalier universitaire de Caen Normandie, Service de neurologie, Hôpital Côte de Nacre, Caen, France
| | - Christine Lebrun
- Centre hospitalier universitaire de Nice, Université Nice Côte d'Azur, Hôpital Pasteur, Service de neurologie, Nice, France
| | - Thibault Moreau
- Centre hospitalier universitaire Dijon Bourgogne, Hôpital François Mitterrand, Service de neurologie, maladies inflammatoires du système nerveux et neurologie générale, Dijon, France
| | - Eric Berger
- Centre hospitalier régional universitaire de Besançon, Hôpital Jean Minjoz, Service de neurologie, Besançon, France
| | - Pierre Clavelou
- Centre hospitalier universitaire de Clermont-Ferrand, Hôpital Gabriel-Montpied, Service de neurologie, Clermont-Ferrand, France
| | - Jean Pelletier
- Assistance publique des hôpitaux de Marseille, Centre hospitalier de la Timone, Service de neurologie et unité neuro-vasculaire, Marseille, France
| | - Bruno Stankoff
- Assistance publique des hôpitaux de Paris, Hôpital Saint-Antoine, Service de neurologie, Paris, France
| | - Olivier Gout
- Fondation Adolphe de Rothschild de l'œil et du cerveau, Service de neurologie, Paris, France
| | - Eric Thouvenot
- Centre hospitalier universitaire de Nîmes, Hôpital Carémeau, Service de neurologie, Nîmes, France
| | - Olivier Heinzlef
- Centre hospitalier intercommunal de Poissy Saint-Germain-en-Laye, Service de neurologie, Poissy, France
| | - Abdullatif Al-Khedr
- Centre hospitalier universitaire d'Amiens Picardie, Site sud, Service de neurologie, Amiens, France
| | - Bertrand Bourre
- Centre hospitalier universitaire Rouen Normandie, Hôpital Charles-Nicolle, Service de neurologie, Rouen, France
| | - Olivier Casez
- Centre hospitalier universitaire Grenoble-Alpes, Site nord, Service de neurologie, Grenoble/La Tronche, France
| | - Philippe Cabre
- Centre hospitalier universitaire de Martinique, Hôpital Pierre Zobda-Quitman, Service de Neurologie, Fort-de-France, France
| | - Alexis Montcuquet
- Centre hospitalier universitaire Limoges, Hôpital Dupuytren, Service de neurologie, Limoges, France
| | - Abir Wahab
- Hôpital Henri Mondor, Department of Neurology, F-94000 Créteil, France
| | - Jean-Philippe Camdessanché
- Centre hospitalier universitaire de Saint-Étienne, Hôpital Nord, Service de neurologie, Saint-Étienne, France
| | - Aude Marousset
- Centre hospitalier régional universitaire de Tours, Hôpital Bretonneau, Service de neurologie, Tours, France
| | - Ivania Patry
- Centre hospitalier sud francilien, Service de neurologie, Corbeil-Essonnes, France
| | - Karolina Hankiewicz
- Centre hospitalier de Saint-Denis, Hôpital Casanova, Service de neurologie, Saint-Denis, France
| | - Corinne Pottier
- Centre hospitalier de Pontoise, Service de neurologie, Pontoise, France
| | - Nicolas Maubeuge
- Centre hospitalier universitaire de Poitiers, Site de la Milétrie, Service de neurologie, Poitiers, France
| | - Céline Labeyrie
- Assistance publique des hôpitaux de Paris, Hôpital Bicêtre, Service de neurologie, Le Kremlin-Bicêtre, France
| | - Chantal Nifle
- Centre hospitalier de Versailles, Hôpital André-Mignot, Service de neurologie, Le Chesnay, France
| | - Emmanuelle Leray
- Rennes University, EHESP, REPERES - EA 7449, F-35000 Rennes, France; Univ Rennes, CHU Rennes, Inserm, CIC 1414 (Centre d'Investigation Clinique de Rennes), F-35000 Rennes, France
| | - David A Laplaud
- CHU de Nantes, Service de Neurologie & CIC015 INSERM, F-44093 Nantes, France; INSERM CR1064, F-44000 Nantes, France
| | - Helmut Butzkueven
- Central Clinical School, Monash University, Melbourne, Australia; Department of Neurology, The Alfred Hospital, Melbourne, Australia; Department of Neurology, Box Hill Hospital, Monash University, Melbourne, Australia
| | - Tomas Kalincik
- CORe, Department of Medicine, University of Melbourne, Melbourne, Australia; Melbourne MS Centre, Department of Neurology, Royal Melbourne Hospital, Melbourne, Australia
| | - Sandra Vukusic
- The Danish Multiple Sclerosis Registry, Department of Neurology, University of Copenhagen, Rigshospitalet, Copenhagen, Denmark; The Danish Multiple Sclerosis Center, Department of Neurology, University of Copenhagen, Rigshospitalet, Copenhagen, Denmark
| | - Melinda Magyari
- The Danish Multiple Sclerosis Registry, Department of Neurology, University of Copenhagen, Rigshospitalet, Copenhagen, Denmark; The Danish Multiple Sclerosis Center, Department of Neurology, Copenhagen University Hospital, Rigshospitalet Glostrup, Denmark
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29
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Fissolo N, Pignolet B, Rio J, Vermersch P, Ruet A, deSèze J, Labauge P, Vukusic S, Papeix C, Martinez-Almoyna L, Tourbah A, Clavelou P, Moreau T, Pelletier J, Lebrun-Frenay C, Bourre B, Defer G, Montalban X, Brassat D, Comabella M. Serum Neurofilament Levels and PML Risk in Patients With Multiple Sclerosis Treated With Natalizumab. Neurol Neuroimmunol Neuroinflamm 2021; 8:8/4/e1003. [PMID: 33903203 PMCID: PMC8105883 DOI: 10.1212/nxi.0000000000001003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 03/03/2021] [Indexed: 12/22/2022]
Abstract
Objectives The study aimed to assess the potential for serum neurofilament light chain (NFL) levels to predict the risk of progressive multifocal leukoencephalopathy (PML) in natalizumab (NTZ)-treated patients with multiple sclerosis (MS) and to discriminate PML from MS relapses. Methods NFL levels were measured with single molecule array (Simoa) in 4 cohorts: (1) a prospective cohort of patients with MS who developed PML under NTZ therapy (pre-PML) and non-PML NTZ-treated patients (NTZ-ctr); (2) a cohort of patients whose blood was collected during PML; (3) an independent cohort of non-PML NTZ-treated patients with serum NFL determinations at 2 years (replication cohort); and (4) a cohort of patients whose blood was collected during exacerbations. Results Serum NFL levels were significantly increased after 2 years of NTZ treatment in pre-PML patients compared with NTZ-ctr. The prognostic performance of serum NFL levels to predict PML development at 2 years was similar in the NTZ-ctr group and replication cohort. Serum NFL levels also distinguished PML from MS relapses and were 8-fold higher during PML compared with relapses. Conclusions These results support the use of serum NFL levels in clinical practice to identify patients with relapsing-remitting MS at higher PML risk and to differentiate PML from clinical relapses in NTZ-treated patients. Classification of Evidence This study provides Class I evidence that serum NFL levels can identify NTZ-treated patients with MS who will develop PML with a sensitivity of 67% and specificity of 80%.
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Affiliation(s)
- Nicolás Fissolo
- From the Servei de Neurologia-Neuroimmunologia (N.F., M.C.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Institut de Recerca Vall d'Hebron (VHIR), Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Spain; CRC-SEP Neurosciences Centre Hospitalier Universitaire Toulouse (B.P., D.B.), CPTP INSERM UMR 1043 CNRS UMR 5282 et Université de Toulouse III, UPS, France; Servei de Neurologia-Neuroimmunologia (J.R., X.M.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Hospital Universitari Vall d'Hebron, Barcelona, Spain; Univ. Lille (P.V.), Inserm U1172, CHU Lille, FHU Imminent, France; Université (A.R.), Bordeaux; CHU de Bordeaux (A.R.), INSERM-CHU CIC-P 0005, & Services de Neurologie; Neurocentre Magendie (A.R.), INSERM U1215; Department of Neurology (J.dS), Hôpital Civil, Strasbourg; Department of Neurology (P.L.), CHU Montpellier; Department of Neurology CHU Lyon (S.V.); Department of Neurology (C.P.), Hôpital de la Salpétrière, Paris; Chi Aix en Provence (L.M.-A.); Department of Neurology and Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; LPN EA2027 Université Paris VIII (A.T.), Saint-Denis; Department of Neurology (P.C.), CHRU Clermont Ferrand; Department of Neurology (T.M.), CHU Dijon; Aix-Marseille Univ (J.P.), APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, CNRS, CRMBM UMR 7339, Marseille; Service de Neurology (C.L.-F.), CHU de Nice Pasteur2, Université Nice Cote d'Azur UR2CA URRIS, Nice; Neurologie (B.B.), CHU Rouen; and Neurologie (G.D.), CHU Caen, France
| | - Beatrice Pignolet
- From the Servei de Neurologia-Neuroimmunologia (N.F., M.C.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Institut de Recerca Vall d'Hebron (VHIR), Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Spain; CRC-SEP Neurosciences Centre Hospitalier Universitaire Toulouse (B.P., D.B.), CPTP INSERM UMR 1043 CNRS UMR 5282 et Université de Toulouse III, UPS, France; Servei de Neurologia-Neuroimmunologia (J.R., X.M.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Hospital Universitari Vall d'Hebron, Barcelona, Spain; Univ. Lille (P.V.), Inserm U1172, CHU Lille, FHU Imminent, France; Université (A.R.), Bordeaux; CHU de Bordeaux (A.R.), INSERM-CHU CIC-P 0005, & Services de Neurologie; Neurocentre Magendie (A.R.), INSERM U1215; Department of Neurology (J.dS), Hôpital Civil, Strasbourg; Department of Neurology (P.L.), CHU Montpellier; Department of Neurology CHU Lyon (S.V.); Department of Neurology (C.P.), Hôpital de la Salpétrière, Paris; Chi Aix en Provence (L.M.-A.); Department of Neurology and Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; LPN EA2027 Université Paris VIII (A.T.), Saint-Denis; Department of Neurology (P.C.), CHRU Clermont Ferrand; Department of Neurology (T.M.), CHU Dijon; Aix-Marseille Univ (J.P.), APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, CNRS, CRMBM UMR 7339, Marseille; Service de Neurology (C.L.-F.), CHU de Nice Pasteur2, Université Nice Cote d'Azur UR2CA URRIS, Nice; Neurologie (B.B.), CHU Rouen; and Neurologie (G.D.), CHU Caen, France
| | - Jordi Rio
- From the Servei de Neurologia-Neuroimmunologia (N.F., M.C.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Institut de Recerca Vall d'Hebron (VHIR), Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Spain; CRC-SEP Neurosciences Centre Hospitalier Universitaire Toulouse (B.P., D.B.), CPTP INSERM UMR 1043 CNRS UMR 5282 et Université de Toulouse III, UPS, France; Servei de Neurologia-Neuroimmunologia (J.R., X.M.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Hospital Universitari Vall d'Hebron, Barcelona, Spain; Univ. Lille (P.V.), Inserm U1172, CHU Lille, FHU Imminent, France; Université (A.R.), Bordeaux; CHU de Bordeaux (A.R.), INSERM-CHU CIC-P 0005, & Services de Neurologie; Neurocentre Magendie (A.R.), INSERM U1215; Department of Neurology (J.dS), Hôpital Civil, Strasbourg; Department of Neurology (P.L.), CHU Montpellier; Department of Neurology CHU Lyon (S.V.); Department of Neurology (C.P.), Hôpital de la Salpétrière, Paris; Chi Aix en Provence (L.M.-A.); Department of Neurology and Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; LPN EA2027 Université Paris VIII (A.T.), Saint-Denis; Department of Neurology (P.C.), CHRU Clermont Ferrand; Department of Neurology (T.M.), CHU Dijon; Aix-Marseille Univ (J.P.), APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, CNRS, CRMBM UMR 7339, Marseille; Service de Neurology (C.L.-F.), CHU de Nice Pasteur2, Université Nice Cote d'Azur UR2CA URRIS, Nice; Neurologie (B.B.), CHU Rouen; and Neurologie (G.D.), CHU Caen, France
| | - Patrick Vermersch
- From the Servei de Neurologia-Neuroimmunologia (N.F., M.C.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Institut de Recerca Vall d'Hebron (VHIR), Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Spain; CRC-SEP Neurosciences Centre Hospitalier Universitaire Toulouse (B.P., D.B.), CPTP INSERM UMR 1043 CNRS UMR 5282 et Université de Toulouse III, UPS, France; Servei de Neurologia-Neuroimmunologia (J.R., X.M.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Hospital Universitari Vall d'Hebron, Barcelona, Spain; Univ. Lille (P.V.), Inserm U1172, CHU Lille, FHU Imminent, France; Université (A.R.), Bordeaux; CHU de Bordeaux (A.R.), INSERM-CHU CIC-P 0005, & Services de Neurologie; Neurocentre Magendie (A.R.), INSERM U1215; Department of Neurology (J.dS), Hôpital Civil, Strasbourg; Department of Neurology (P.L.), CHU Montpellier; Department of Neurology CHU Lyon (S.V.); Department of Neurology (C.P.), Hôpital de la Salpétrière, Paris; Chi Aix en Provence (L.M.-A.); Department of Neurology and Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; LPN EA2027 Université Paris VIII (A.T.), Saint-Denis; Department of Neurology (P.C.), CHRU Clermont Ferrand; Department of Neurology (T.M.), CHU Dijon; Aix-Marseille Univ (J.P.), APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, CNRS, CRMBM UMR 7339, Marseille; Service de Neurology (C.L.-F.), CHU de Nice Pasteur2, Université Nice Cote d'Azur UR2CA URRIS, Nice; Neurologie (B.B.), CHU Rouen; and Neurologie (G.D.), CHU Caen, France
| | - Aurélie Ruet
- From the Servei de Neurologia-Neuroimmunologia (N.F., M.C.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Institut de Recerca Vall d'Hebron (VHIR), Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Spain; CRC-SEP Neurosciences Centre Hospitalier Universitaire Toulouse (B.P., D.B.), CPTP INSERM UMR 1043 CNRS UMR 5282 et Université de Toulouse III, UPS, France; Servei de Neurologia-Neuroimmunologia (J.R., X.M.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Hospital Universitari Vall d'Hebron, Barcelona, Spain; Univ. Lille (P.V.), Inserm U1172, CHU Lille, FHU Imminent, France; Université (A.R.), Bordeaux; CHU de Bordeaux (A.R.), INSERM-CHU CIC-P 0005, & Services de Neurologie; Neurocentre Magendie (A.R.), INSERM U1215; Department of Neurology (J.dS), Hôpital Civil, Strasbourg; Department of Neurology (P.L.), CHU Montpellier; Department of Neurology CHU Lyon (S.V.); Department of Neurology (C.P.), Hôpital de la Salpétrière, Paris; Chi Aix en Provence (L.M.-A.); Department of Neurology and Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; LPN EA2027 Université Paris VIII (A.T.), Saint-Denis; Department of Neurology (P.C.), CHRU Clermont Ferrand; Department of Neurology (T.M.), CHU Dijon; Aix-Marseille Univ (J.P.), APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, CNRS, CRMBM UMR 7339, Marseille; Service de Neurology (C.L.-F.), CHU de Nice Pasteur2, Université Nice Cote d'Azur UR2CA URRIS, Nice; Neurologie (B.B.), CHU Rouen; and Neurologie (G.D.), CHU Caen, France
| | - Jerome deSèze
- From the Servei de Neurologia-Neuroimmunologia (N.F., M.C.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Institut de Recerca Vall d'Hebron (VHIR), Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Spain; CRC-SEP Neurosciences Centre Hospitalier Universitaire Toulouse (B.P., D.B.), CPTP INSERM UMR 1043 CNRS UMR 5282 et Université de Toulouse III, UPS, France; Servei de Neurologia-Neuroimmunologia (J.R., X.M.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Hospital Universitari Vall d'Hebron, Barcelona, Spain; Univ. Lille (P.V.), Inserm U1172, CHU Lille, FHU Imminent, France; Université (A.R.), Bordeaux; CHU de Bordeaux (A.R.), INSERM-CHU CIC-P 0005, & Services de Neurologie; Neurocentre Magendie (A.R.), INSERM U1215; Department of Neurology (J.dS), Hôpital Civil, Strasbourg; Department of Neurology (P.L.), CHU Montpellier; Department of Neurology CHU Lyon (S.V.); Department of Neurology (C.P.), Hôpital de la Salpétrière, Paris; Chi Aix en Provence (L.M.-A.); Department of Neurology and Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; LPN EA2027 Université Paris VIII (A.T.), Saint-Denis; Department of Neurology (P.C.), CHRU Clermont Ferrand; Department of Neurology (T.M.), CHU Dijon; Aix-Marseille Univ (J.P.), APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, CNRS, CRMBM UMR 7339, Marseille; Service de Neurology (C.L.-F.), CHU de Nice Pasteur2, Université Nice Cote d'Azur UR2CA URRIS, Nice; Neurologie (B.B.), CHU Rouen; and Neurologie (G.D.), CHU Caen, France
| | - Pierre Labauge
- From the Servei de Neurologia-Neuroimmunologia (N.F., M.C.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Institut de Recerca Vall d'Hebron (VHIR), Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Spain; CRC-SEP Neurosciences Centre Hospitalier Universitaire Toulouse (B.P., D.B.), CPTP INSERM UMR 1043 CNRS UMR 5282 et Université de Toulouse III, UPS, France; Servei de Neurologia-Neuroimmunologia (J.R., X.M.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Hospital Universitari Vall d'Hebron, Barcelona, Spain; Univ. Lille (P.V.), Inserm U1172, CHU Lille, FHU Imminent, France; Université (A.R.), Bordeaux; CHU de Bordeaux (A.R.), INSERM-CHU CIC-P 0005, & Services de Neurologie; Neurocentre Magendie (A.R.), INSERM U1215; Department of Neurology (J.dS), Hôpital Civil, Strasbourg; Department of Neurology (P.L.), CHU Montpellier; Department of Neurology CHU Lyon (S.V.); Department of Neurology (C.P.), Hôpital de la Salpétrière, Paris; Chi Aix en Provence (L.M.-A.); Department of Neurology and Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; LPN EA2027 Université Paris VIII (A.T.), Saint-Denis; Department of Neurology (P.C.), CHRU Clermont Ferrand; Department of Neurology (T.M.), CHU Dijon; Aix-Marseille Univ (J.P.), APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, CNRS, CRMBM UMR 7339, Marseille; Service de Neurology (C.L.-F.), CHU de Nice Pasteur2, Université Nice Cote d'Azur UR2CA URRIS, Nice; Neurologie (B.B.), CHU Rouen; and Neurologie (G.D.), CHU Caen, France
| | - Sandra Vukusic
- From the Servei de Neurologia-Neuroimmunologia (N.F., M.C.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Institut de Recerca Vall d'Hebron (VHIR), Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Spain; CRC-SEP Neurosciences Centre Hospitalier Universitaire Toulouse (B.P., D.B.), CPTP INSERM UMR 1043 CNRS UMR 5282 et Université de Toulouse III, UPS, France; Servei de Neurologia-Neuroimmunologia (J.R., X.M.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Hospital Universitari Vall d'Hebron, Barcelona, Spain; Univ. Lille (P.V.), Inserm U1172, CHU Lille, FHU Imminent, France; Université (A.R.), Bordeaux; CHU de Bordeaux (A.R.), INSERM-CHU CIC-P 0005, & Services de Neurologie; Neurocentre Magendie (A.R.), INSERM U1215; Department of Neurology (J.dS), Hôpital Civil, Strasbourg; Department of Neurology (P.L.), CHU Montpellier; Department of Neurology CHU Lyon (S.V.); Department of Neurology (C.P.), Hôpital de la Salpétrière, Paris; Chi Aix en Provence (L.M.-A.); Department of Neurology and Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; LPN EA2027 Université Paris VIII (A.T.), Saint-Denis; Department of Neurology (P.C.), CHRU Clermont Ferrand; Department of Neurology (T.M.), CHU Dijon; Aix-Marseille Univ (J.P.), APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, CNRS, CRMBM UMR 7339, Marseille; Service de Neurology (C.L.-F.), CHU de Nice Pasteur2, Université Nice Cote d'Azur UR2CA URRIS, Nice; Neurologie (B.B.), CHU Rouen; and Neurologie (G.D.), CHU Caen, France
| | - Caroline Papeix
- From the Servei de Neurologia-Neuroimmunologia (N.F., M.C.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Institut de Recerca Vall d'Hebron (VHIR), Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Spain; CRC-SEP Neurosciences Centre Hospitalier Universitaire Toulouse (B.P., D.B.), CPTP INSERM UMR 1043 CNRS UMR 5282 et Université de Toulouse III, UPS, France; Servei de Neurologia-Neuroimmunologia (J.R., X.M.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Hospital Universitari Vall d'Hebron, Barcelona, Spain; Univ. Lille (P.V.), Inserm U1172, CHU Lille, FHU Imminent, France; Université (A.R.), Bordeaux; CHU de Bordeaux (A.R.), INSERM-CHU CIC-P 0005, & Services de Neurologie; Neurocentre Magendie (A.R.), INSERM U1215; Department of Neurology (J.dS), Hôpital Civil, Strasbourg; Department of Neurology (P.L.), CHU Montpellier; Department of Neurology CHU Lyon (S.V.); Department of Neurology (C.P.), Hôpital de la Salpétrière, Paris; Chi Aix en Provence (L.M.-A.); Department of Neurology and Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; LPN EA2027 Université Paris VIII (A.T.), Saint-Denis; Department of Neurology (P.C.), CHRU Clermont Ferrand; Department of Neurology (T.M.), CHU Dijon; Aix-Marseille Univ (J.P.), APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, CNRS, CRMBM UMR 7339, Marseille; Service de Neurology (C.L.-F.), CHU de Nice Pasteur2, Université Nice Cote d'Azur UR2CA URRIS, Nice; Neurologie (B.B.), CHU Rouen; and Neurologie (G.D.), CHU Caen, France
| | - Laurent Martinez-Almoyna
- From the Servei de Neurologia-Neuroimmunologia (N.F., M.C.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Institut de Recerca Vall d'Hebron (VHIR), Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Spain; CRC-SEP Neurosciences Centre Hospitalier Universitaire Toulouse (B.P., D.B.), CPTP INSERM UMR 1043 CNRS UMR 5282 et Université de Toulouse III, UPS, France; Servei de Neurologia-Neuroimmunologia (J.R., X.M.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Hospital Universitari Vall d'Hebron, Barcelona, Spain; Univ. Lille (P.V.), Inserm U1172, CHU Lille, FHU Imminent, France; Université (A.R.), Bordeaux; CHU de Bordeaux (A.R.), INSERM-CHU CIC-P 0005, & Services de Neurologie; Neurocentre Magendie (A.R.), INSERM U1215; Department of Neurology (J.dS), Hôpital Civil, Strasbourg; Department of Neurology (P.L.), CHU Montpellier; Department of Neurology CHU Lyon (S.V.); Department of Neurology (C.P.), Hôpital de la Salpétrière, Paris; Chi Aix en Provence (L.M.-A.); Department of Neurology and Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; LPN EA2027 Université Paris VIII (A.T.), Saint-Denis; Department of Neurology (P.C.), CHRU Clermont Ferrand; Department of Neurology (T.M.), CHU Dijon; Aix-Marseille Univ (J.P.), APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, CNRS, CRMBM UMR 7339, Marseille; Service de Neurology (C.L.-F.), CHU de Nice Pasteur2, Université Nice Cote d'Azur UR2CA URRIS, Nice; Neurologie (B.B.), CHU Rouen; and Neurologie (G.D.), CHU Caen, France
| | - Ayman Tourbah
- From the Servei de Neurologia-Neuroimmunologia (N.F., M.C.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Institut de Recerca Vall d'Hebron (VHIR), Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Spain; CRC-SEP Neurosciences Centre Hospitalier Universitaire Toulouse (B.P., D.B.), CPTP INSERM UMR 1043 CNRS UMR 5282 et Université de Toulouse III, UPS, France; Servei de Neurologia-Neuroimmunologia (J.R., X.M.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Hospital Universitari Vall d'Hebron, Barcelona, Spain; Univ. Lille (P.V.), Inserm U1172, CHU Lille, FHU Imminent, France; Université (A.R.), Bordeaux; CHU de Bordeaux (A.R.), INSERM-CHU CIC-P 0005, & Services de Neurologie; Neurocentre Magendie (A.R.), INSERM U1215; Department of Neurology (J.dS), Hôpital Civil, Strasbourg; Department of Neurology (P.L.), CHU Montpellier; Department of Neurology CHU Lyon (S.V.); Department of Neurology (C.P.), Hôpital de la Salpétrière, Paris; Chi Aix en Provence (L.M.-A.); Department of Neurology and Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; LPN EA2027 Université Paris VIII (A.T.), Saint-Denis; Department of Neurology (P.C.), CHRU Clermont Ferrand; Department of Neurology (T.M.), CHU Dijon; Aix-Marseille Univ (J.P.), APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, CNRS, CRMBM UMR 7339, Marseille; Service de Neurology (C.L.-F.), CHU de Nice Pasteur2, Université Nice Cote d'Azur UR2CA URRIS, Nice; Neurologie (B.B.), CHU Rouen; and Neurologie (G.D.), CHU Caen, France
| | - Pierre Clavelou
- From the Servei de Neurologia-Neuroimmunologia (N.F., M.C.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Institut de Recerca Vall d'Hebron (VHIR), Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Spain; CRC-SEP Neurosciences Centre Hospitalier Universitaire Toulouse (B.P., D.B.), CPTP INSERM UMR 1043 CNRS UMR 5282 et Université de Toulouse III, UPS, France; Servei de Neurologia-Neuroimmunologia (J.R., X.M.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Hospital Universitari Vall d'Hebron, Barcelona, Spain; Univ. Lille (P.V.), Inserm U1172, CHU Lille, FHU Imminent, France; Université (A.R.), Bordeaux; CHU de Bordeaux (A.R.), INSERM-CHU CIC-P 0005, & Services de Neurologie; Neurocentre Magendie (A.R.), INSERM U1215; Department of Neurology (J.dS), Hôpital Civil, Strasbourg; Department of Neurology (P.L.), CHU Montpellier; Department of Neurology CHU Lyon (S.V.); Department of Neurology (C.P.), Hôpital de la Salpétrière, Paris; Chi Aix en Provence (L.M.-A.); Department of Neurology and Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; LPN EA2027 Université Paris VIII (A.T.), Saint-Denis; Department of Neurology (P.C.), CHRU Clermont Ferrand; Department of Neurology (T.M.), CHU Dijon; Aix-Marseille Univ (J.P.), APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, CNRS, CRMBM UMR 7339, Marseille; Service de Neurology (C.L.-F.), CHU de Nice Pasteur2, Université Nice Cote d'Azur UR2CA URRIS, Nice; Neurologie (B.B.), CHU Rouen; and Neurologie (G.D.), CHU Caen, France
| | - Thibault Moreau
- From the Servei de Neurologia-Neuroimmunologia (N.F., M.C.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Institut de Recerca Vall d'Hebron (VHIR), Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Spain; CRC-SEP Neurosciences Centre Hospitalier Universitaire Toulouse (B.P., D.B.), CPTP INSERM UMR 1043 CNRS UMR 5282 et Université de Toulouse III, UPS, France; Servei de Neurologia-Neuroimmunologia (J.R., X.M.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Hospital Universitari Vall d'Hebron, Barcelona, Spain; Univ. Lille (P.V.), Inserm U1172, CHU Lille, FHU Imminent, France; Université (A.R.), Bordeaux; CHU de Bordeaux (A.R.), INSERM-CHU CIC-P 0005, & Services de Neurologie; Neurocentre Magendie (A.R.), INSERM U1215; Department of Neurology (J.dS), Hôpital Civil, Strasbourg; Department of Neurology (P.L.), CHU Montpellier; Department of Neurology CHU Lyon (S.V.); Department of Neurology (C.P.), Hôpital de la Salpétrière, Paris; Chi Aix en Provence (L.M.-A.); Department of Neurology and Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; LPN EA2027 Université Paris VIII (A.T.), Saint-Denis; Department of Neurology (P.C.), CHRU Clermont Ferrand; Department of Neurology (T.M.), CHU Dijon; Aix-Marseille Univ (J.P.), APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, CNRS, CRMBM UMR 7339, Marseille; Service de Neurology (C.L.-F.), CHU de Nice Pasteur2, Université Nice Cote d'Azur UR2CA URRIS, Nice; Neurologie (B.B.), CHU Rouen; and Neurologie (G.D.), CHU Caen, France
| | - Jean Pelletier
- From the Servei de Neurologia-Neuroimmunologia (N.F., M.C.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Institut de Recerca Vall d'Hebron (VHIR), Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Spain; CRC-SEP Neurosciences Centre Hospitalier Universitaire Toulouse (B.P., D.B.), CPTP INSERM UMR 1043 CNRS UMR 5282 et Université de Toulouse III, UPS, France; Servei de Neurologia-Neuroimmunologia (J.R., X.M.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Hospital Universitari Vall d'Hebron, Barcelona, Spain; Univ. Lille (P.V.), Inserm U1172, CHU Lille, FHU Imminent, France; Université (A.R.), Bordeaux; CHU de Bordeaux (A.R.), INSERM-CHU CIC-P 0005, & Services de Neurologie; Neurocentre Magendie (A.R.), INSERM U1215; Department of Neurology (J.dS), Hôpital Civil, Strasbourg; Department of Neurology (P.L.), CHU Montpellier; Department of Neurology CHU Lyon (S.V.); Department of Neurology (C.P.), Hôpital de la Salpétrière, Paris; Chi Aix en Provence (L.M.-A.); Department of Neurology and Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; LPN EA2027 Université Paris VIII (A.T.), Saint-Denis; Department of Neurology (P.C.), CHRU Clermont Ferrand; Department of Neurology (T.M.), CHU Dijon; Aix-Marseille Univ (J.P.), APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, CNRS, CRMBM UMR 7339, Marseille; Service de Neurology (C.L.-F.), CHU de Nice Pasteur2, Université Nice Cote d'Azur UR2CA URRIS, Nice; Neurologie (B.B.), CHU Rouen; and Neurologie (G.D.), CHU Caen, France
| | - Christine Lebrun-Frenay
- From the Servei de Neurologia-Neuroimmunologia (N.F., M.C.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Institut de Recerca Vall d'Hebron (VHIR), Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Spain; CRC-SEP Neurosciences Centre Hospitalier Universitaire Toulouse (B.P., D.B.), CPTP INSERM UMR 1043 CNRS UMR 5282 et Université de Toulouse III, UPS, France; Servei de Neurologia-Neuroimmunologia (J.R., X.M.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Hospital Universitari Vall d'Hebron, Barcelona, Spain; Univ. Lille (P.V.), Inserm U1172, CHU Lille, FHU Imminent, France; Université (A.R.), Bordeaux; CHU de Bordeaux (A.R.), INSERM-CHU CIC-P 0005, & Services de Neurologie; Neurocentre Magendie (A.R.), INSERM U1215; Department of Neurology (J.dS), Hôpital Civil, Strasbourg; Department of Neurology (P.L.), CHU Montpellier; Department of Neurology CHU Lyon (S.V.); Department of Neurology (C.P.), Hôpital de la Salpétrière, Paris; Chi Aix en Provence (L.M.-A.); Department of Neurology and Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; LPN EA2027 Université Paris VIII (A.T.), Saint-Denis; Department of Neurology (P.C.), CHRU Clermont Ferrand; Department of Neurology (T.M.), CHU Dijon; Aix-Marseille Univ (J.P.), APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, CNRS, CRMBM UMR 7339, Marseille; Service de Neurology (C.L.-F.), CHU de Nice Pasteur2, Université Nice Cote d'Azur UR2CA URRIS, Nice; Neurologie (B.B.), CHU Rouen; and Neurologie (G.D.), CHU Caen, France
| | - Bertrand Bourre
- From the Servei de Neurologia-Neuroimmunologia (N.F., M.C.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Institut de Recerca Vall d'Hebron (VHIR), Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Spain; CRC-SEP Neurosciences Centre Hospitalier Universitaire Toulouse (B.P., D.B.), CPTP INSERM UMR 1043 CNRS UMR 5282 et Université de Toulouse III, UPS, France; Servei de Neurologia-Neuroimmunologia (J.R., X.M.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Hospital Universitari Vall d'Hebron, Barcelona, Spain; Univ. Lille (P.V.), Inserm U1172, CHU Lille, FHU Imminent, France; Université (A.R.), Bordeaux; CHU de Bordeaux (A.R.), INSERM-CHU CIC-P 0005, & Services de Neurologie; Neurocentre Magendie (A.R.), INSERM U1215; Department of Neurology (J.dS), Hôpital Civil, Strasbourg; Department of Neurology (P.L.), CHU Montpellier; Department of Neurology CHU Lyon (S.V.); Department of Neurology (C.P.), Hôpital de la Salpétrière, Paris; Chi Aix en Provence (L.M.-A.); Department of Neurology and Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; LPN EA2027 Université Paris VIII (A.T.), Saint-Denis; Department of Neurology (P.C.), CHRU Clermont Ferrand; Department of Neurology (T.M.), CHU Dijon; Aix-Marseille Univ (J.P.), APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, CNRS, CRMBM UMR 7339, Marseille; Service de Neurology (C.L.-F.), CHU de Nice Pasteur2, Université Nice Cote d'Azur UR2CA URRIS, Nice; Neurologie (B.B.), CHU Rouen; and Neurologie (G.D.), CHU Caen, France
| | - Gilles Defer
- From the Servei de Neurologia-Neuroimmunologia (N.F., M.C.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Institut de Recerca Vall d'Hebron (VHIR), Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Spain; CRC-SEP Neurosciences Centre Hospitalier Universitaire Toulouse (B.P., D.B.), CPTP INSERM UMR 1043 CNRS UMR 5282 et Université de Toulouse III, UPS, France; Servei de Neurologia-Neuroimmunologia (J.R., X.M.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Hospital Universitari Vall d'Hebron, Barcelona, Spain; Univ. Lille (P.V.), Inserm U1172, CHU Lille, FHU Imminent, France; Université (A.R.), Bordeaux; CHU de Bordeaux (A.R.), INSERM-CHU CIC-P 0005, & Services de Neurologie; Neurocentre Magendie (A.R.), INSERM U1215; Department of Neurology (J.dS), Hôpital Civil, Strasbourg; Department of Neurology (P.L.), CHU Montpellier; Department of Neurology CHU Lyon (S.V.); Department of Neurology (C.P.), Hôpital de la Salpétrière, Paris; Chi Aix en Provence (L.M.-A.); Department of Neurology and Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; LPN EA2027 Université Paris VIII (A.T.), Saint-Denis; Department of Neurology (P.C.), CHRU Clermont Ferrand; Department of Neurology (T.M.), CHU Dijon; Aix-Marseille Univ (J.P.), APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, CNRS, CRMBM UMR 7339, Marseille; Service de Neurology (C.L.-F.), CHU de Nice Pasteur2, Université Nice Cote d'Azur UR2CA URRIS, Nice; Neurologie (B.B.), CHU Rouen; and Neurologie (G.D.), CHU Caen, France
| | - Xavier Montalban
- From the Servei de Neurologia-Neuroimmunologia (N.F., M.C.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Institut de Recerca Vall d'Hebron (VHIR), Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Spain; CRC-SEP Neurosciences Centre Hospitalier Universitaire Toulouse (B.P., D.B.), CPTP INSERM UMR 1043 CNRS UMR 5282 et Université de Toulouse III, UPS, France; Servei de Neurologia-Neuroimmunologia (J.R., X.M.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Hospital Universitari Vall d'Hebron, Barcelona, Spain; Univ. Lille (P.V.), Inserm U1172, CHU Lille, FHU Imminent, France; Université (A.R.), Bordeaux; CHU de Bordeaux (A.R.), INSERM-CHU CIC-P 0005, & Services de Neurologie; Neurocentre Magendie (A.R.), INSERM U1215; Department of Neurology (J.dS), Hôpital Civil, Strasbourg; Department of Neurology (P.L.), CHU Montpellier; Department of Neurology CHU Lyon (S.V.); Department of Neurology (C.P.), Hôpital de la Salpétrière, Paris; Chi Aix en Provence (L.M.-A.); Department of Neurology and Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; LPN EA2027 Université Paris VIII (A.T.), Saint-Denis; Department of Neurology (P.C.), CHRU Clermont Ferrand; Department of Neurology (T.M.), CHU Dijon; Aix-Marseille Univ (J.P.), APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, CNRS, CRMBM UMR 7339, Marseille; Service de Neurology (C.L.-F.), CHU de Nice Pasteur2, Université Nice Cote d'Azur UR2CA URRIS, Nice; Neurologie (B.B.), CHU Rouen; and Neurologie (G.D.), CHU Caen, France
| | - David Brassat
- From the Servei de Neurologia-Neuroimmunologia (N.F., M.C.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Institut de Recerca Vall d'Hebron (VHIR), Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Spain; CRC-SEP Neurosciences Centre Hospitalier Universitaire Toulouse (B.P., D.B.), CPTP INSERM UMR 1043 CNRS UMR 5282 et Université de Toulouse III, UPS, France; Servei de Neurologia-Neuroimmunologia (J.R., X.M.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Hospital Universitari Vall d'Hebron, Barcelona, Spain; Univ. Lille (P.V.), Inserm U1172, CHU Lille, FHU Imminent, France; Université (A.R.), Bordeaux; CHU de Bordeaux (A.R.), INSERM-CHU CIC-P 0005, & Services de Neurologie; Neurocentre Magendie (A.R.), INSERM U1215; Department of Neurology (J.dS), Hôpital Civil, Strasbourg; Department of Neurology (P.L.), CHU Montpellier; Department of Neurology CHU Lyon (S.V.); Department of Neurology (C.P.), Hôpital de la Salpétrière, Paris; Chi Aix en Provence (L.M.-A.); Department of Neurology and Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; LPN EA2027 Université Paris VIII (A.T.), Saint-Denis; Department of Neurology (P.C.), CHRU Clermont Ferrand; Department of Neurology (T.M.), CHU Dijon; Aix-Marseille Univ (J.P.), APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, CNRS, CRMBM UMR 7339, Marseille; Service de Neurology (C.L.-F.), CHU de Nice Pasteur2, Université Nice Cote d'Azur UR2CA URRIS, Nice; Neurologie (B.B.), CHU Rouen; and Neurologie (G.D.), CHU Caen, France
| | - Manuel Comabella
- From the Servei de Neurologia-Neuroimmunologia (N.F., M.C.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Institut de Recerca Vall d'Hebron (VHIR), Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Spain; CRC-SEP Neurosciences Centre Hospitalier Universitaire Toulouse (B.P., D.B.), CPTP INSERM UMR 1043 CNRS UMR 5282 et Université de Toulouse III, UPS, France; Servei de Neurologia-Neuroimmunologia (J.R., X.M.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Hospital Universitari Vall d'Hebron, Barcelona, Spain; Univ. Lille (P.V.), Inserm U1172, CHU Lille, FHU Imminent, France; Université (A.R.), Bordeaux; CHU de Bordeaux (A.R.), INSERM-CHU CIC-P 0005, & Services de Neurologie; Neurocentre Magendie (A.R.), INSERM U1215; Department of Neurology (J.dS), Hôpital Civil, Strasbourg; Department of Neurology (P.L.), CHU Montpellier; Department of Neurology CHU Lyon (S.V.); Department of Neurology (C.P.), Hôpital de la Salpétrière, Paris; Chi Aix en Provence (L.M.-A.); Department of Neurology and Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; LPN EA2027 Université Paris VIII (A.T.), Saint-Denis; Department of Neurology (P.C.), CHRU Clermont Ferrand; Department of Neurology (T.M.), CHU Dijon; Aix-Marseille Univ (J.P.), APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, CNRS, CRMBM UMR 7339, Marseille; Service de Neurology (C.L.-F.), CHU de Nice Pasteur2, Université Nice Cote d'Azur UR2CA URRIS, Nice; Neurologie (B.B.), CHU Rouen; and Neurologie (G.D.), CHU Caen, France.
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Donzé C, Olivier D, Defer G, Lecoz P, Vermersch P, Abdullatif A, Hautecoeur P. NUTRISEP : évaluation de l’état nutritionnel des patients atteints de sclérose en plaques et lien avec la fatigue. Rev Neurol (Paris) 2021. [DOI: 10.1016/j.neurol.2021.02.341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Peyro-Saint-Paul L, Fedrizzi S, Defer G. Drug safety in multiple sclerosis: From reporting to signal detection and benefit-risk management. Rev Neurol (Paris) 2021; 177:582-588. [PMID: 33812676 DOI: 10.1016/j.neurol.2021.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 01/28/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Pharmacovigilance (PV) rules emerged in the late 60s-early 70s. Since that time, the World Health Organization Center for International Drug Monitoring carries out the corresponding tasks. Multiple sclerosis (MS) is a chronic inflammatory demyelinating disease of the central nervous system that generally starts in young adults between 20 and 40 years of age. Over the last 25 years, MS patients have benefited from the development of a plethora of disease modifying drugs (DMD). These changes in the therapeutic armamentarium have been associated with some serious adverse reactions challenging health authorities and neurologists involved in treatment and care for MS patients. METHODS The present review aims to describe, for MS DMDs, how adverse drug reactions are reported during clinical trials and the post-marketing period and how important signal detection and benefit-risk management have been in this disease until now. Several examples are reported to illustrate the different steps of PV processes. CONCLUSION Improvement of the PV system procedures has led to significant progress in the detection of signals, allowing better assessment of the benefit-risk balance and the implementation of risk management plans for MS treatments. The involvement of neurologists is essential to improve knowledge on the benefit-risk balance of these drugs. In addition, adverse drug reactions reporting by persons with MS should be encouraged.
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Affiliation(s)
- L Peyro-Saint-Paul
- Direction de la Recherche et de l'Enseignement, CHU de Caen Normandie, Caen, France
| | - S Fedrizzi
- Centre Régional de Pharmacovigilance, Pharmacologie, CHU de Caen Normandie, Caen, France
| | - G Defer
- Centre de Ressources et Compétences (CRC-SEP), Service de Neurologie, CHU de Caen, Normandie-Université, Caen, France; Réseau Normand pour la prise en charge de la SEP, Caen, France.
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Moisset X, Fouchard AA, Pereira B, Taithe F, Mathey G, Edan G, Ciron J, Brochet B, De Sèze J, Papeix C, Vermersch P, Labauge P, Defer G, Lebrun-Frenay C, Moreau T, Laplaud D, Berger E, Pelletier J, Stankoff B, Gout O, Thouvenot E, Heinzlef O, Al-Khedr A, Bourre B, Casez O, Cabre P, Montcuquet A, Créange A, Camdessanché JP, Bakchine S, Maurousset A, Hankiewicz K, Pottier C, Maubeuge N, Dimitri Boulos D, Nifle C, Vukusic S, Clavelou P. Untreated patients with multiple sclerosis: A study of French expert centers. Eur J Neurol 2021; 28:2026-2036. [PMID: 33650261 DOI: 10.1111/ene.14790] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 02/11/2021] [Accepted: 02/25/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND PURPOSE Disease-modifying therapies (DMTs) have an impact on relapses and disease progression. Nonetheless, many patients with multiple sclerosis (MS) remain untreated. The objectives of the present study were to determine the proportion of untreated patients with MS followed in expert centers in France and to determine the predictive factors of nontreatment. METHODS We conducted a retrospective cohort study. Data were extracted from the 38 centers participating in the European Database for Multiple Sclerosis (EDMUS) on December 15, 2018, and patients with MS seen at least once during the study period (from June 15, 2016 to June 14, 2017) were included. RESULTS Of the 21,189 patients with MS (age 47.1 ± 13.1 years; Expanded Disability Status Scale (EDSS) score 3.4 ± 2.4), 6,631 (31.3%; 95% confidence interval [CI] 30.7-31.9) were not receiving any DMT. Although patients with a relapsing-remitting course (n = 11,693) were the most likely to receive DMT, 14.8% (95% CI 14.2-15.4) were still untreated (6.8% never treated). After multivariate analysis among patients with relapsing-remitting MS, the main factors explaining never having been treated were: not having ≥9 lesions on brain magnetic resonance imaging (odds ratio [OR] 0.52 [95% CI 0.44-0.61]) and lower EDSS score (OR 0.78 [95% CI 0.74-0.82]). Most patients with progressive MS (50.4% for secondary and 64.2% for primary progressive MS) did not receive any DMT during the study period, while 11.6% of patients with secondary and 34.0% of patients with primary progressive MS had never received any DMT. CONCLUSION A significant proportion of patients with MS did not receive any DMT, even though such treatments are reimbursed by the healthcare system for French patients. This result highlights the unmet need for current DMTs for a large subgroup of patients with MS.
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Affiliation(s)
- Xavier Moisset
- Neuro-Dol, Université Clermont Auvergne, CHU de Clermont-Ferrand, Inserm, Clermont-Ferrand, France
| | - Audrey-Anne Fouchard
- Neuro-Dol, Université Clermont Auvergne, CHU de Clermont-Ferrand, Inserm, Clermont-Ferrand, France
| | - Bruno Pereira
- Neuro-Dol, Université Clermont Auvergne, CHU de Clermont-Ferrand, Inserm, Clermont-Ferrand, France
| | - Frédéric Taithe
- Neuro-Dol, Université Clermont Auvergne, CHU de Clermont-Ferrand, Inserm, Clermont-Ferrand, France
| | - Guillaume Mathey
- Department of Neurology, Nancy University Hospital, Nancy, France.,EA 4360 APEMAC, Université de Lorraine, Vandoeuvre-Lès-Nancy, France
| | - Gilles Edan
- CIC1414 INSERM, CHU Pontchaillou, Rennes, France
| | - Jonathan Ciron
- Department of Neurology, CHU de Toulouse, CRC-SEP, Toulouse, France
| | - Bruno Brochet
- University of Bordeaux, Bordeaux, France.,INSERM U1215, Neurocentre Magendie, Bordeaux, France.,CHU de Bordeaux, CIC Bordeaux CIC1401, Bordeaux, France
| | - Jérôme De Sèze
- Department of Neurology and Clinical Investigation Center, CHU de Strasbourg, INSERM 1434, Strasbourg, France
| | - Caroline Papeix
- Department of Neurology, APHP, Pitié-Salpêtrière Hospital, Paris, France
| | - Patrick Vermersch
- University of Lille, INSERM UMR-S1172, CHU Lille, FHU Imminent, Lille, France
| | - Pierre Labauge
- MS Unit, CHU de Montpellier, Montpellier Cedex 5, France.,University of Montpellier (MUSE), Montpellier, France
| | - Gilles Defer
- Department of Neurology, CHU de la Côte de Nacre, Caen, France
| | - Christine Lebrun-Frenay
- CHU de Nice; UR2CA, Nice Cote d'Azur University, CRCSEP Nice, Pasteur2 Hospital, Nice, France
| | - Thibault Moreau
- Department of Neurology, CHU de Dijon, EA4184, Dijon, France
| | - David Laplaud
- Service de Neurologie & CIC015 INSERM, CHU de Nantes, Nantes, France.,INSERM CR1064, Nantes, France
| | - Eric Berger
- Service de Neurologie, CHU de Besançon, Besançon, France
| | - Jean Pelletier
- Service de Neurologie, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Aix Marseille University, APHM, Marseille, France
| | - Bruno Stankoff
- Service de Neurologie, Assistance publique des hôpitaux de Paris, Hôpital Saint-Antoine, Paris, France
| | - Olivier Gout
- Department of Neurology, Fondation Rotschild, Paris, France
| | - Eric Thouvenot
- Department of Neurology, Nîmes University Hospital, Nîmes, France.,Institut de Génomique Fonctionnelle, Université de Montpellier, CNRS, INSERM, Montpellier, France
| | - Olivier Heinzlef
- Department of Neurology, Poissy Hôpital de Poissy, Poissy, France
| | - Abdullatif Al-Khedr
- Service de Neurologie, Centre Hospitalier Universitaire d'Amiens Picardie, Site Sud, Amiens, France
| | - Bertrand Bourre
- CHU de Rouen, Rouen, France.,Rouen University Hospital, Rouen, France
| | - Olivier Casez
- Service de Neurologie, Centre Hospitalier Universitaire Grenoble-Alpes, Site Nord, Grenoble/La Tronche, France
| | - Philippe Cabre
- Service de Neurologie, Hôpital Pierre Zobda-Quitman, Centre Hospitalier Universitaire de Martinique, Fort-de-France, France
| | - Alexis Montcuquet
- Department of Neurology, CHU de Limoges, Hôpital Dupuytren, Limoges, France
| | - Alain Créange
- Service de Neurologie, Assistance Publique des Hôpitaux de Paris, Hôpital Henri Mondor, Créteil, France
| | | | - Serge Bakchine
- Service de Neurologie, Hôpital Maison-Blanche, Centre Hospitalier Universitaire de Reims, Reims, France
| | - Aude Maurousset
- CRC SEP and Department of Neurology, Hôpital Bretonneau, CHU de Tours, Tours, France
| | - Karolina Hankiewicz
- Service de Neurologie, Centre Hospitalier de Saint-Denis, Saint-Denis, France
| | - Corinne Pottier
- Service de Neurologie, Centre Hospitalier de Pontoise, Pontoise, France
| | - Nicolas Maubeuge
- Site de la Milétrie, Service de Neurologie, Centre Hospitalier Universitaire de Poitiers, Poitiers, France
| | - Dalia Dimitri Boulos
- Service de Neurologie, Assistance publique des hôpitaux de Paris, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Chantal Nifle
- Service de Neurologie, Centre Hospitalier de Versailles, Hôpital André-Mignot, Le Chesnay, France
| | - Sandra Vukusic
- Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-Inflammation, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon/Bron, France.,Centre des Neurosciences de Lyon, Observatoire Français de la Sclérose en Plaques, INSERM 1028 et CNRS UMR5292, Lyon, France.,Faculté de Médecine Lyon Est, Université Claude Bernard Lyon 1, Lyon, France
| | - Pierre Clavelou
- Neuro-Dol, Université Clermont Auvergne, CHU de Clermont-Ferrand, Inserm, Clermont-Ferrand, France
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Roos I, Leray E, Frascoli F, Casey R, Brown JWL, Horakova D, Havrdova EK, Debouverie M, Trojano M, Patti F, Izquierdo G, Eichau S, Edan G, Prat A, Girard M, Duquette P, Onofrj M, Lugaresi A, Grammond P, Ciron J, Ruet A, Ozakbas S, De Seze J, Louapre C, Zephir H, Sá MJ, Sola P, Ferraro D, Labauge P, Defer G, Bergamaschi R, Lebrun-Frenay C, Boz C, Cartechini E, Moreau T, Laplaud D, Lechner-Scott J, Grand'Maison F, Gerlach O, Terzi M, Granella F, Alroughani R, Iuliano G, Van Pesch V, Van Wijmeersch B, Spitaleri DLA, Soysal A, Berger E, Prevost J, Aguera-Morales E, McCombe P, Castillo Triviño T, Clavelou P, Pelletier J, Turkoglu R, Stankoff B, Gout O, Thouvenot E, Heinzlef O, Sidhom Y, Gouider R, Csepany T, Bourre B, Al Khedr A, Casez O, Cabre P, Montcuquet A, Wahab A, Camdessanche JP, Maurousset A, Patry I, Hankiewicz K, Pottier C, Maubeuge N, Labeyrie C, Nifle C, Coles A, Malpas CB, Vukusic S, Butzkueven H, Kalincik T. Determinants of therapeutic lag in multiple sclerosis. Mult Scler 2021; 27:1838-1851. [PMID: 33423618 DOI: 10.1177/1352458520981300] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND A delayed onset of treatment effect, termed therapeutic lag, may influence the assessment of treatment response in some patient subgroups. OBJECTIVES The objective of this study is to explore the associations of patient and disease characteristics with therapeutic lag on relapses and disability accumulation. METHODS Data from MSBase, a multinational multiple sclerosis (MS) registry, and OFSEP, the French MS registry, were used. Patients diagnosed with MS, minimum 1 year of exposure to MS treatment and 3 years of pre-treatment follow-up, were included in the analysis. Studied outcomes were incidence of relapses and disability accumulation. Therapeutic lag was calculated using an objective, validated method in subgroups stratified by patient and disease characteristics. Therapeutic lag under specific circumstances was then estimated in subgroups defined by combinations of clinical and demographic determinants. RESULTS High baseline disability scores, annualised relapse rate (ARR) ⩾ 1 and male sex were associated with longer therapeutic lag on disability progression in sufficiently populated groups: females with expanded disability status scale (EDSS) < 6 and ARR < 1 had mean lag of 26.6 weeks (95% CI = 18.2-34.9), males with EDSS < 6 and ARR < 1 31.0 weeks (95% CI = 25.3-36.8), females with EDSS < 6 and ARR ⩾ 1 44.8 weeks (95% CI = 24.5-65.1), and females with EDSS ⩾ 6 and ARR < 1 54.3 weeks (95% CI = 47.2-61.5). CONCLUSIONS Pre-treatment EDSS and ARR are the most important determinants of therapeutic lag.
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Affiliation(s)
- Izanne Roos
- CORe, Department of Medicine, University of Melbourne, Melbourne, VIC, Australia/Melbourne MS Centre, Department of Neurology, Royal Melbourne Hospital, Melbourne, VIC, Australia
| | - Emmanuelle Leray
- Rennes University, EHESP, REPERES - EA 7449, Rennes, France/Rennes University, CHU Rennes, Inserm, CIC 1414 [(Centre d'Investigation Clinique de Rennes)], Rennes, France
| | - Federico Frascoli
- Faculty of Science, Engineering and Technology, School of Science, Department of Mathematics, Swinburne University of Technology, Melbourne, VIC, Australia
| | - Romain Casey
- Université de Lyon, Université Claude Bernard Lyon 1, Lyon, France/Hospices Civils de Lyon, Service de Neurologie, sclérose en plaques, pathologies de la myéline et neuro-inflammation, Bron, France/Observatoire Français de la Sclérose en Plaques, Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR 5292, Lyon, France/EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis, State-Approved Foundation, Bron, France
| | - J William L Brown
- CORe, Department of Medicine, University of Melbourne, Melbourne, VIC, Australia/Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Dana Horakova
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University in Prague and General University Hospital, Prague, Czech Republic
| | - Eva Kubala Havrdova
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University in Prague and General University Hospital, Prague, Czech Republic
| | - Marc Debouverie
- Department of Neurology, Nancy University Hospital, Nancy, France/Université de Lorraine, APEMAC, Nancy, France
| | - Maria Trojano
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari, Bari, Italy
| | - Francesco Patti
- GF Ingrassia Department, University of Catania, Catania, Italy/Policlinico G Rodolico, Catania, Italy
| | | | - Sara Eichau
- Hospital Universitario Virgen Macarena, Sevilla, Spain
| | - Gilles Edan
- Centre hospitalier universitaire de Rennes, Hôpital Pontchaillou, Service de neurologie, CIC1414 INSERM, Rennes, France
| | - Alexandre Prat
- CHUM MS Center and Universite de Montreal, Montreal, QC, Canada
| | - Marc Girard
- CHUM MS Center and Universite de Montreal, Montreal, QC, Canada
| | - Pierre Duquette
- CHUM MS Center and Universite de Montreal, Montreal, QC, Canada
| | - Marco Onofrj
- Department of Neuroscience, Imaging, and Clinical Sciences, University G. d'Annunzio, Chieti, Italy
| | - Alessandra Lugaresi
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italia/Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna, Bologna, Italia
| | | | - Jonathan Ciron
- Hôpital Pierre-Paul Riquet, Department of Neurology, CHU de Toulouse, CRC-SEP, Toulouse, France
| | - Aurélie Ruet
- University Bordeaux, Bordeaux, France/INSERM U1215, Neurocentre Magendie, Bordeaux, France/Department of Neurology, CHU de Bordeaux, CIC Bordeaux CIC1401, Bordeaux, France
| | | | - Jérôme De Seze
- CHU de Strasbourg, Department of Neurology and Clinical Investigation Center, CIC (centre d'investigation clinique) INSERM 1434, Strasbourg, France
| | - Céline Louapre
- Sorbonne Université, Institut du Cerveau, ICM, Assistance Publique Hôpitaux de Paris APHP, Département de neurologie, Hôpital de la Pitié Salpêtrière, Paris, France
| | - Hélène Zephir
- CHU Lille, CRCSEP Lille, Univ Lille, U1172, Lille, France
| | - Maria José Sá
- Centro Hospitalar Universitário de São João and Universidade Fernando Pessoa, Porto, Portugal
| | - Patrizia Sola
- Department of Neuroscience, Azienda Ospedaliera Universitaria, Modena, Italy
| | - Diana Ferraro
- Department of Biomedical, Metabolic and Neurosciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Pierre Labauge
- CHU de Montpellier, MS Unit, Montpellier, France/University of Montpellier (MUSE), Montpellier, France
| | - Gilles Defer
- CHU de Caen, MS Expert Centre, Department of Neurology, avenue de la Côte-de-Nacre, Normandy University, Caen, France
| | | | - Christine Lebrun-Frenay
- CRCSEP Nice, UR2CA, Université Nice Cote d'Azur, Centre hospitalier universitaire de Nice, Hopital Pasteur 2, Nice, France
| | - Cavit Boz
- KTU Medical Faculty Farabi Hospital, Trabzon, Turkey
| | | | - Thibault Moreau
- CHU de Dijon, Department of Neurology, EA4184, Dijon, France
| | - David Laplaud
- CHU de Nantes, Service de Neurologie & CIC015 INSERM, Nantes, France/CRTI-Inserm U1064, Nantes, France
| | - Jeannette Lechner-Scott
- School of Medicine and Public Health, University Newcastle, Newcastle, NSW, Australia/Department of Neurology, John Hunter Hospital, Hunter New England Health, Newcastle, NSW, Australia
| | | | - Oliver Gerlach
- Department of Neurology, Zuyderland Medical Center, Sittard-Geleen, The Netherlands
| | - Murat Terzi
- Medical Faculty, 19 Mayis University, Samsun, Turkey
| | - Franco Granella
- Department of Medicine and Surgery, University of Parma, Parma, Italy/Department of General Medicine, Parma University Hospital, Parma, Italy
| | - Raed Alroughani
- Division of Neurology, Department of Medicine, Amiri Hospital, Sharq, Kuwait
| | | | | | - Bart Van Wijmeersch
- Rehabilitation and MS-Centre Overpelt and Hasselt University, Hasselt, Belgium
| | | | - Aysun Soysal
- Bakirkoy Education and Research Hospital for Psychiatric and Neurological Diseases, Istanbul, Turkey
| | - Eric Berger
- CHU de Besançon, Department of Neurology, Besançon, France
| | | | | | - Pamela McCombe
- University of Queensland, Brisbane, QLD, Australia/Royal Brisbane and Women's Hospital, Herston, QLD, Australia
| | - Tamara Castillo Triviño
- Instituto de Investigación Sanitaria Biodonostia, Hospital Universitario Donostia, San Sebastian, Spain
| | - Pierre Clavelou
- CHU Clermont-Ferrand, Department of Neurology, Clermont-Ferrand, France/Université Clermont Auvergne, Inserm, Neuro-Dol, Clermont-Ferrand, France
| | - Jean Pelletier
- Aix Marseille Univ, APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, Marseille, France
| | - Recai Turkoglu
- Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
| | - Bruno Stankoff
- Sorbonne Universités, UPMC Paris 06, Brain and Spine Institute, ICM, Hôpital de la Pitié Salpêtrière, Inserm UMR S 1127, CNRS UMR 7225, Pars, France/Department of Neurology, AP-HP, Saint-Antoine Hospital, Paris, France
| | - Olivier Gout
- Fondation Adolphe de Rothschild de l'œil et du cerveau, Department of Neurology, Paris, France
| | - Eric Thouvenot
- CHU de Nîmes, Department of Neurology, Nîmes, France/Institut de Génomique Fonctionnelle, UMR5203, INSERM 1191, Université de Montpellier, Montpellier, France
| | - Olivier Heinzlef
- Centre hospitalier intercommunal de Poissy Saint-Germain-en-Laye, Departement of Neurology, Poissy, France
| | - Youssef Sidhom
- Department of Neurology - LR 18 SP03 - CIC Neurosciences, Razi Hospital, La Manouba, Tunisia
| | - Riadh Gouider
- Department of Neurology - LR 18 SP03 - CIC Neurosciences, Razi Hospital, La Manouba, Tunisia/Faculty of Medicine, UTM, Tunis, Tunisia
| | - Tunde Csepany
- Department of Neurology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Bertrand Bourre
- Centre hospitalier universitaire Rouen Normandie, Hôpital Charles-Nicolle, Departement of Neurology, Rouen, France
| | - Abdullatif Al Khedr
- Amiens University Hospital, Department of Neurology, place Victor Pauchet, Amiens, France
| | - Olivier Casez
- Department of Neurology, Centre hospitalier universitaire Grenoble-Alpes, La Tronche/Grenoble, France
| | - Philippe Cabre
- Centre hospitalier universitaire de Martinique, Department of Neurology, Hôpital Pierre Zobda-Quitman, Fort-de-France, France
| | - Alexis Montcuquet
- Centre hospitalier universitaire Limoges, Department of Neurology, Hôpital Dupuytren, Limoges, France
| | - Abir Wahab
- Assistance publique des hôpitaux de Paris, Department of Neurology, Hôpital Henri Mondor, Créteil, France
| | - Jean-Philippe Camdessanche
- Centre hospitalier universitaire de Saint-Étienne, Department of Neurology, Hôpital Nord, Saint-Étienne, France
| | - Aude Maurousset
- Centre hospitalier régional universitaire de Tours, Department of Neurology, Hôpital Bretonneau, CRCSEP, Tours, France
| | - Ivania Patry
- Department of Neurology, Centre Hospitalier Sud Francilien, Corbeil Essonnes, France
| | - Karolina Hankiewicz
- Department of Neurology, Hôpital Pierre Delafontaine, Centre Hospitalier de Saint-Denis, Saint-Denis, France
| | - Corinne Pottier
- Department of Neurology, Centre hospitalier de Pontoise, Hôpital René Dubos, Pontoise, France
| | - Nicolas Maubeuge
- CHU La Milétrie, Hôpital Jean Bernard, Department of Neurology, Poitiers, France
| | - Céline Labeyrie
- Assistance publique des hôpitaux de Paris, Hôpital Bicêtre, Department of Neurology, Le Kremlin Bicêtre, France
| | - Chantal Nifle
- Hopital Andre Mignot, Department of Neurology, 177 Rue de Versailles, Le Chesnay, France
| | - Alasdair Coles
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Charles B Malpas
- CORe, Department of Medicine, University of Melbourne, Melbourne, VIC, Australia/Melbourne MS Centre, Department of Neurology, Royal Melbourne Hospital, Melbourne, VIC, Australia
| | - Sandra Vukusic
- Service de neurologie, sclérose en plaques, pathologies de la myéline et neuro-inflammation, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon/Bron, France/Centre des Neurosciences de Lyon, Observatoire Français de la Sclérose en Plaques, INSERM 1028 et CNRS UMR5292, Lyon, France/Université Claude Bernard Lyon 1, Faculté de médecine Lyon Est, Lyon, France
| | - Helmut Butzkueven
- Central Clinical School, Monash University, Melbourne, Australia/Department of Neurology, The Alfred Hospital, Melbourne, VIC, Australia/Department of Neurology, Box Hill Hospital, Monash University, Melbourne, VIC, Australia
| | - Tomas Kalincik
- CORe, Department of Medicine, University of Melbourne, Melbourne, VIC, Australia/Melbourne MS Centre, Department of Neurology, Royal Melbourne Hospital, Melbourne, VIC, Australia
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Mathais S, Moisset X, Pereira B, Taithe F, Ciron J, Labauge P, Dulau C, Laplaud D, De Seze J, Pelletier J, Berger E, Lebrun-Frenay C, Castelnovo G, Edan G, Defer G, Vermersch P, Bourre B, Camdessanche JP, Magy L, Guennoc AM, Mathey G, Moreau T, Gout O, Heinzlef O, Maillart E, Vukusic S, Clavelou P. Relapses in Patients Treated with High-Dose Biotin for Progressive Multiple Sclerosis. Neurotherapeutics 2021; 18:378-386. [PMID: 32964402 PMCID: PMC8116391 DOI: 10.1007/s13311-020-00926-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/31/2020] [Indexed: 12/26/2022] Open
Abstract
High-dose biotin (HDB) is a therapy used in non-active progressive multiple sclerosis (PMS). Several reports have suggested that HDB treatment may be associated with an increased risk of relapse. We aimed to determine whether HDB increases the risk of clinical relapse in PMS and describe the characteristics of the patients who experience it. We conducted a French, multicenter, retrospective study, comparing a group of PMS patients treated with HDB to a matched control group. Poisson regression was applied to model the specific statistical distribution of the annualized relapse rate (ARR). A propensity score (PS), based on the inverse probability of treatment weighting (IPTW), was used to adjust for indication bias and included the following variables: gender, primary PMS or not, age, EDSS, time since the last relapse, and co-prescription of a DMT. Two thousand six hundred twenty-eight patients treated with HDB and 654 controls were analyzed with a follow-up of 17 ± 8 months. Among them, 148 validated relapses were observed in the group treated with biotin and 38 in the control group (p = 0.62). After adjustment based on the PS, the ARR was 0.044 ± 0.23 for the biotin-treated group and 0.028 ± 0.16 for the control group (p = 0.18). The more relapses there were before biotin, the higher the risk of relapse during treatment, independently from the use of HDB. While the number of relapses reported for patients with no previous inflammatory activity receiving biotin has gradually increased, the present retrospective study is adequately powered to exclude an elevated risk of relapse for patients with PMS treated with HDB.
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Affiliation(s)
- Sophie Mathais
- CHU de Clermont-Ferrand, F-63000, Clermont-Ferrand, France
| | - Xavier Moisset
- CHU de Clermont-Ferrand, F-63000, Clermont-Ferrand, France.
- Université Clermont Auvergne, INSERM, Neuro-Dol, F-63000, Clermont-Ferrand, France.
| | - Bruno Pereira
- CHU de Clermont-Ferrand, F-63000, Clermont-Ferrand, France
| | | | - Jonathan Ciron
- Department of Neurology, CHU de Toulouse, CRC-SEP, F-31000, Toulouse, France
| | - Pierre Labauge
- CHU de Montpellier, MS Unit, F-34295, Montpellier Cedex 5, France
- University of Montpellier (MUSE), F-34000, Montpellier, France
| | - Cécile Dulau
- University Bordeaux, F-33000, Bordeaux, France
- INSERM U1215, Neurocentre Magendie, F-33000, Bordeaux, France
- CHU de Bordeaux, CIC Bordeaux CIC1401, F-33000, Bordeaux, France
| | - David Laplaud
- Service de Neurologie & CIC015 INSERM, CHU de Nantes, F-44093, Nantes, France
- INSERM CR1064, F-44000, Nantes, France
| | - Jérôme De Seze
- Department of Neurology and Clinical Investigation Center, CHU de Strasbourg, INSERM 1434, F-67000, Strasbourg, France
| | - Jean Pelletier
- APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, Marseille, France
| | - Eric Berger
- Department of Neurology, CHU de Besançon, F-25000, Besançon, France
| | - Christine Lebrun-Frenay
- CHU de Nice, F-06000, Nice, France
- CRCSEP Nice, Pasteur2 Hospital, UR2CA, Nice Cote d'Azur University, F-06000, Nice, France
| | | | - Gilles Edan
- CHU Pontchaillou, CIC1414 INSERM, F-35000, Rennes, France
| | - Gilles Defer
- Department of Neurology, CHU de la Côte de Nacre, F-14000, Caen, France
| | - Patrick Vermersch
- Univ. Lille, INSERM UMR-S1172, CHU Lille, FHU Imminent, F-59000, Lille, France
| | - Bertrand Bourre
- CHU de Rouen / Rouen University Hospital, F-76000, Rouen, France
| | - Jean-Philippe Camdessanche
- Department of Neurology, CHU de Saint-Étienne, Hôpital Nord, CHU de Saint-Étienne, Hôpital Nord, F-42055, Saint-Étienne Cedex 2, France
| | - Laurent Magy
- Department of Neurology, CHU de Limoges, Hôpital Dupuytren, F-87042, Limoges, France
| | - Anne-Marie Guennoc
- CRC SEP and Department of Neurology, CHU de Tours, Hôpital Bretonneau, F-37000, Tours, France
| | - Guillaume Mathey
- Department of Neurology, Nancy University Hospital, F-54035, Nancy, France
- Université de Lorraine, APEMAC, F-54500 Vandoeuvre-Lès-, 4360, Nancy, EA, France
| | - Thibault Moreau
- Department of Neurology, CHU de Dijon, EA4184, F-21000, Dijon, France
| | - Olivier Gout
- Department of Neurology, Fondation Rotschild, F-75000, Paris, France
| | - Olivier Heinzlef
- Departement of Neurology, Hôpital de Poissy, F-78300, Poissy, France
| | - Elisabeth Maillart
- Department of Neurology, APHP, Pitié-Salpêtrière Hospital, F-75013, Paris, France
| | - Sandra Vukusic
- Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-Inflammation, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, 69677, Lyon/Bron, France
- Centre des Neurosciences de Lyon, Observatoire Français de la Sclérose en Plaques, INSERM 1028 et CNRS UMR5292, 69003, Lyon, France
- Faculté de Médecine Lyon Est, Université Claude Bernard Lyon 1, F-69000, Lyon, France
| | - Pierre Clavelou
- CHU de Clermont-Ferrand, F-63000, Clermont-Ferrand, France
- Université Clermont Auvergne, INSERM, Neuro-Dol, F-63000, Clermont-Ferrand, France
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Derache N, Hauchard K, Seguin F, Ohannessian R, Defer G. Retrospective evaluation of regional telemedicine team meetings for multiple sclerosis (MS) patients: Experience from the Caen MS expert center in Normandy, France. Rev Neurol (Paris) 2020; 177:407-413. [PMID: 33272563 DOI: 10.1016/j.neurol.2020.06.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 05/01/2020] [Accepted: 06/09/2020] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Multiple sclerosis (MS) is a demyelinating disease requiring multidisciplinary care coordination. Recent development of diagnosis criteria and disease modifying treatments have encouraged the setup of regional team meetings by MS expert centers, known as CRC Sep, to improve the quality of care provided to patients with complex cases. The CRC Sep in Caen initiated regional telemedicine meetings named Télé-SEP, operating since 2016. The objective of this study was to evaluate the Télé-SEP used by neurologists, on MS patient care management in Normandy. METHODS An internal ex-itinere evaluation was conducted with a retrospective descriptive observational study from July 2016 to June 2018. The Télé-SEP meetings were organized with 41 neurologists using a regional telemedicine platform (Therap-e). Data were collected from online records and a declarative voluntary survey. Twenty indicators were classified in the categories: volume of activity, clinical profile, quality and impact. RESULTS Fifteen meetings were organized with a median of 13 senior neurologists. One hundred forty MS cases were discussed and there was a 33% increase in the second year of Télé-SEP. Median patient age was 44 years with a 72-month median length of disease. Most patient cases required second-line treatment. Relapsing remitting MS was diagnosed in 51.4% of cases. Télé-SEP satisfaction rate was 4.5/5 and 96% of neurologists applied the medical decisions and recommendations given in the meetings. CONCLUSION Without Télé-SEP, 54.5% of patients would have been referred to a physical expert consultation in the CRC Sep. This study showed the feasibility and relevance of regional telemedicine team meetings for MS cases in the Normandy region.
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Affiliation(s)
- N Derache
- Service de Neurologie, Réseau Bas-Normand Pour la Prise en Charge de la SEP, Centre de Ressources et de Compétences SEP France, Avenue de la Côte de Nacre, 14000 Caen, France
| | | | - F Seguin
- GCS Normand'e Santé, Caen, France
| | | | - G Defer
- Service de Neurologie, Réseau Bas-Normand Pour la Prise en Charge de la SEP, Centre de Ressources et de Compétences SEP France, Avenue de la Côte de Nacre, 14000 Caen, France
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36
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Cohen M, Mondot L, Bucciarelli F, Pignolet B, Laplaud DA, Wiertlewski S, Brochet B, Ruet A, Defer G, Derache N, Vermersch P, Zephir H, Debouverie M, Mathey G, Berger E, Cappé C, Labauge P, Carra C, De Seze J, Bigaut K, Brassat D, Lebrun-Frenay C. BEST-MS: A prospective head-to-head comparative study of natalizumab and fingolimod in active relapsing MS. Mult Scler 2020; 27:1556-1563. [PMID: 33124504 DOI: 10.1177/1352458520969145] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND There are few head-to-head studies to compare highly active treatments in multiple sclerosis (MS). OBJECTIVE The aim of this study was to compare the effectiveness between natalizumab (NTZ) and fingolimod (FTY) in active relapsing-remitting MS. METHOD Best Escalation STrategy in Multiple Sclerosis (BEST-MS) is a multicentric, prospective study with a 12-month follow-up including patients with active MS. Treatment choice was at the discretion of physician. Clinical and magnetic resonance imaging (MRI) data were collected at baseline and at 12 months. The primary outcome was the proportion of patients reaching no evidence of disease activity (NEDA) at 12 months. Secondary outcomes included annualized relapse rate and MRI activity. RESULTS A total of 223 patients were included (NTZ: 109 and FTY: 114). Treatment groups were well balanced at baseline. Proportion of NEDA patients was 47.8% in NTZ group versus 30.4% in FTY group (p = 0.015). This superiority was driven by annualized relapse rate and MRI activity. In the multivariate analysis, treatment group was the only factor associated with NEDA at 12 months with a lower probability in FTY group (odds ratio (OR) = 0.49, p = 0.029). CONCLUSION BEST-MS is a prospective study that compared head-to-head the effectiveness of NTZ and FTY in active relapsing-remitting MS. Our results suggest a superiority of NTZ over FTY.
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Affiliation(s)
- Mikael Cohen
- Service de Neurologie, CRCSEP, Unité de Recherche Clinique Cote d'Azur (UR2CA), Centre Hospitalier Universitaire Pasteur 2, Nice, France
| | - Lydiane Mondot
- Service de Radiologie, Unité de Recherche Clinique Cote d'Azur (UR2CA), Centre Hospitalier Universitaire Pasteur 2, Nice, France
| | - Florence Bucciarelli
- Neurosciences Department, CRCSEP, University Hospital of Toulouse, Toulouse, France/INSERM U1043-CNRS UMR 5282, Centre de Physiopathologie Toulouse, Toulouse, France
| | - Béatrice Pignolet
- Neurosciences Department, CRCSEP, University Hospital of Toulouse, Toulouse, France/INSERM U1043-CNRS UMR 5282, Centre de Physiopathologie Toulouse, Toulouse, France
| | - David-Axel Laplaud
- CRTI-INSERM U1064, CIC 1413, Service de Neurologie, CHU Nantes, Nantes, France
| | | | - Bruno Brochet
- Service de Neurologie, CRC SEP, Centre Hospitalier Universitaire (CHU) de Bordeaux, Bordeaux, France
| | - Aurélie Ruet
- Service de Neurologie, CRC SEP, Centre Hospitalier Universitaire (CHU) de Bordeaux, Bordeaux, France
| | - Gilles Defer
- Service de Neurologie, CHU de Caen, Avenue de la Côte de Nacre, Caen, France
| | - Nathalie Derache
- Service de Neurologie, CHU de Caen, Avenue de la Côte de Nacre, Caen, France
| | | | - Hélène Zephir
- Univ. Lille, INSERM U1172, CHU Lille, FHU Imminent, Lille, France
| | - Marc Debouverie
- CHRU-Nancy, INSERM, Université de Lorraine, CIC, Epidémiologie Clinique, Nancy, France
| | - Guillaume Mathey
- CHRU-Nancy, INSERM, Université de Lorraine, CIC, Epidémiologie Clinique, Nancy, France
| | - Eric Berger
- Service de Neurologie, CHU de Besançon, Besançon, France
| | - Chrystelle Cappé
- Centre d'investigation clinique, CHU de Besançon, Besançon, France
| | | | | | - Jérôme De Seze
- Clinical Investigation Center, Department of Neurology, CHU de Strasbourg, INSERM 1434, Strasbourg, France
| | - Kevin Bigaut
- Clinical Investigation Center, Department of Neurology, CHU de Strasbourg, INSERM 1434, Strasbourg, France
| | - David Brassat
- Neurosciences Department, CRCSEP, University Hospital of Toulouse, Toulouse, France/INSERM U1043-CNRS UMR 5282, Centre de Physiopathologie Toulouse, Toulouse, France
| | - Christine Lebrun-Frenay
- Service de Neurologie, CRCSEP, Unité de Recherche Clinique Cote d'Azur (UR2CA), Centre Hospitalier Universitaire Pasteur 2, Nice, France
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37
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Khoy K, Mariotte D, Defer G, Petit G, Toutirais O, Le Mauff B. Natalizumab in Multiple Sclerosis Treatment: From Biological Effects to Immune Monitoring. Front Immunol 2020; 11:549842. [PMID: 33072089 PMCID: PMC7541830 DOI: 10.3389/fimmu.2020.549842] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 09/04/2020] [Indexed: 12/13/2022] Open
Abstract
Multiple sclerosis is a chronic demyelinating disease of the central nervous system (CNS) with an autoimmune component. Among the recent disease-modifying treatments available, Natalizumab, a monoclonal antibody directed against the alpha chain of the VLA-4 integrin (CD49d), is a potent inhibitor of cell migration toward the tissues including CNS. It potently reduces relapses and active brain lesions in the relapsing remitting form of the disease. However, it has also been associated with a severe infectious complication, the progressive multifocal leukoencephalitis (PML). Using the standard protocol with an injection every 4 weeks it has been shown by a close monitoring of the drug that trough levels soon reach a plateau with an almost saturation of the target cell receptor as well as a down modulation of this receptor. In this review, mechanisms of action involved in therapeutic efficacy as well as in PML risk will be discussed. Furthermore the interest of a biological monitoring that may be helpful to rapidly adapt treatment is presented. Indeed, development of anti-NAT antibodies, although sometimes unapparent, can be detected indirectly by normalization of CD49d expression on circulating mononuclear cells and might require to switch to another drug. On the other hand a stable modulation of CD49d expression might be useful to follow the circulating NAT levels and apply an extended interval dose scheme that could contribute to limiting the risk of PML.
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Affiliation(s)
- Kathy Khoy
- Laboratory of Immunology, Department of Biology, CHU Caen Normandie, Caen, France
| | - Delphine Mariotte
- Laboratory of Immunology, Department of Biology, CHU Caen Normandie, Caen, France
| | - Gilles Defer
- Department of Neurology, MS Expert Centre, CHU Caen Normandie, Caen, France.,UMR-S1237, Physiopathology and Imaging of Neurological Disorders, INSERM, Caen, France.,Normandie Université, UNICAEN, Caen, France
| | - Gautier Petit
- Laboratory of Immunology, Department of Biology, CHU Caen Normandie, Caen, France
| | - Olivier Toutirais
- Laboratory of Immunology, Department of Biology, CHU Caen Normandie, Caen, France.,UMR-S1237, Physiopathology and Imaging of Neurological Disorders, INSERM, Caen, France.,Normandie Université, UNICAEN, Caen, France
| | - Brigitte Le Mauff
- Laboratory of Immunology, Department of Biology, CHU Caen Normandie, Caen, France.,UMR-S1237, Physiopathology and Imaging of Neurological Disorders, INSERM, Caen, France.,Normandie Université, UNICAEN, Caen, France
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Roos I, Leray E, Frascoli F, Casey R, Brown JWL, Horakova D, Havrdova EK, Trojano M, Patti F, Izquierdo G, Eichau S, Onofrj M, Lugaresi A, Prat A, Girard M, Grammond P, Sola P, Ferraro D, Ozakbas S, Bergamaschi R, Sá MJ, Cartechini E, Boz C, Granella F, Hupperts R, Terzi M, Lechner-Scott J, Spitaleri D, Van Pesch V, Soysal A, Olascoaga J, Prevost J, Aguera-Morales E, Slee M, Csepany T, Turkoglu R, Sidhom Y, Gouider R, Van Wijmeersch B, McCombe P, Macdonell R, Coles A, Malpas CB, Butzkueven H, Vukusic S, Kalincik T, Duquette P, Grand'Maison F, Iuliano G, Ramo-Tello C, Solaro C, Cabrera-Gomez JA, Rio ME, Bolaños RF, Shaygannejad V, Oreja-Guevara C, Sanchez-Menoyo JL, Petersen T, Altintas A, Barnett M, Flechter S, Fragoso Y, Amato MP, Moore F, Ampapa R, Verheul F, Hodgkinson S, Cristiano E, Yamout B, Laureys G, Dominguez JA, Zwanikken C, Deri N, Dobos E, Vrech C, Butler E, Rozsa C, Petkovska-Boskova T, Karabudak R, Rajda C, Alkhaboori J, Saladino ML, Shaw C, Shuey N, Vucic S, Sempere AP, Campbell J, Piroska I, Taylor B, van der Walt A, Kappos L, Roullet E, Gray O, Simo M, Sirbu CA, Brochet B, Cotton F, De Sèze J, Dion A, Douek P, Guillemin F, Laplaud D, Lebrun-Frenay C, Moreau T, Olaiz J, Pelletier J, Rigaud-Bully C, Stankoff B, Marignier R, Debouverie M, Edan G, Ciron J, Ruet A, Collongues N, Lubetzki C, Vermersch P, Labauge P, Defer G, Cohen M, Fromont A, Wiertlewsky S, Berger E, Clavelou P, Audoin B, Giannesini C, Gout O, Thouvenot E, Heinzlef O, Al-Khedr A, Bourre B, Casez O, Cabre P, Montcuquet A, Créange A, Camdessanché JP, Faure J, Maurousset A, Patry I, Hankiewicz K, Pottier C, Maubeuge N, Labeyrie C, Nifle C. Delay from treatment start to full effect of immunotherapies for multiple sclerosis. Brain 2020; 143:2742-2756. [DOI: 10.1093/brain/awaa231] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2020] [Revised: 04/30/2020] [Accepted: 06/01/2020] [Indexed: 01/21/2023] Open
Abstract
Abstract
In multiple sclerosis, treatment start or switch is prompted by evidence of disease activity. Whilst immunomodulatory therapies reduce disease activity, the time required to attain maximal effect is unclear. In this study we aimed to develop a method that allows identification of the time to manifest fully and clinically the effect of multiple sclerosis treatments (‘therapeutic lag’) on clinical disease activity represented by relapses and progression-of-disability events. Data from two multiple sclerosis registries, MSBase (multinational) and OFSEP (French), were used. Patients diagnosed with multiple sclerosis, minimum 1-year exposure to treatment, minimum 3-year pretreatment follow-up and yearly review were included in the analysis. For analysis of disability progression, all events in the subsequent 5-year period were included. Density curves, representing incidence of relapses and 6-month confirmed progression events, were separately constructed for each sufficiently represented therapy. Monte Carlo simulations were performed to identify the first local minimum of the first derivative after treatment start; this point represented the point of stabilization of treatment effect, after the maximum treatment effect was observed. The method was developed in a discovery cohort (MSBase), and externally validated in a separate, non-overlapping cohort (OFSEP). A merged MSBase-OFSEP cohort was used for all subsequent analyses. Annualized relapse rates were compared in the time before treatment start and after the stabilization of treatment effect following commencement of each therapy. We identified 11 180 eligible treatment epochs for analysis of relapses and 4088 treatment epochs for disability progression. External validation was performed in four therapies, with no significant difference in the bootstrapped mean differences in therapeutic lag duration between registries. The duration of therapeutic lag for relapses was calculated for 10 therapies and ranged between 12 and 30 weeks. The duration of therapeutic lag for disability progression was calculated for seven therapies and ranged between 30 and 70 weeks. Significant differences in the pre- versus post-treatment annualized relapse rate were present for all therapies apart from intramuscular interferon beta-1a. In conclusion we have developed, and externally validated, a method to objectively quantify the duration of therapeutic lag on relapses and disability progression in different therapies in patients more than 3 years from multiple sclerosis onset. Objectively defined periods of expected therapeutic lag allows insights into the evaluation of treatment response in randomized clinical trials and may guide clinical decision-making in patients who experience early on-treatment disease activity. This method will subsequently be applied in studies that evaluate the effect of patient and disease characteristics on therapeutic lag.
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Affiliation(s)
- Izanne Roos
- CORe, Department of Medicine, University of Melbourne, Melbourne, 3050, Australia
- Melbourne MS Centre, Department of Neurology, Royal Melbourne Hospital, Melbourne, 3050, Australia
| | - Emmanuelle Leray
- Rennes University, EHESP, REPERES (Pharmaco-epidemiology and Health services research) - EA 7449, Rennes, France
| | - Federico Frascoli
- Faculty of Science, Engineering and Technology, School of Science, Department of Mathematics, Swinburne University of Technology, Melbourne, 3122, Australia
| | - Romain Casey
- University of Lyon, Claude Bernard University Lyon 1, F-69000 Lyon, France
- Hospices Civils de Lyon, Service de Neurologie, sclérose en plaques, pathologies de la myéline et neuro-inflammation, F-69677 Bron, France
- Observatoire Français de la Sclérose en Plaques, Lyon Neuroscience Research Centre, INSERM 1028 et CNRS UMR 5292, F-69003 Lyon, France
- EUGENE DEVIC EDMUS Foundation against multiple sclerosis, state-approved foundation, F-69677 Bron, France
| | - J William L Brown
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, CB2 0QQ, UK
| | - Dana Horakova
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University in Prague and General University Hospital, Prague, 12808, Czech Republic
| | - Eva K Havrdova
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University in Prague and General University Hospital, Prague, 12808, Czech Republic
| | - Maria Trojano
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari, Bari, 70122, Italy
| | - Francesco Patti
- GF Ingrassia Department, University of Catania, Catania, 95123, Italy
- Policlinico G Rodolico, 95123, Catania, Italy
| | | | - Sara Eichau
- Hospital Universitario Virgen Macarena, Sevilla, 41009, Spain
| | - Marco Onofrj
- Department of Neuroscience, Imaging, and Clinical Sciences, University G. d’Annunzio, 66100 Chieti, Italy
| | - Alessandra Lugaresi
- IRCCS Istituto delle Scienze Neurologiche di Bologna, UOSI Riabilitazione Sclerosi Multipla, Bologna, 40139, Italy
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Alexandre Prat
- CHUM MS Center and Universite de Montreal, Montreal, H2L 4M1, Canada
| | - Marc Girard
- CHUM MS Center and Universite de Montreal, Montreal, H2L 4M1, Canada
| | | | - Patrizia Sola
- Department of Neuroscience, Azienda Ospedaliera Universitaria, Modena, 41100, Italy
| | - Diana Ferraro
- Department of Neuroscience, Azienda Ospedaliera Universitaria, Modena, 41100, Italy
| | | | | | - Maria José Sá
- Centro Hospitalar Universitário de São João and Universidade Fernando Pessoa, 4249-004 Porto, Portugal
| | - Elisabetta Cartechini
- UOC Neurologia, Azienda Sanitaria Unica Regionale Marche - AV3, Macerata, 62100, Italy
| | - Cavit Boz
- KTU Medical Faculty Farabi Hospital, Karadeniz Technical University, Trabzon, 61080, Turkey
| | - Franco Granella
- Department of Medicine and Surgery, University of Parma, Parma, 43126, Italy
- Department of General Medicine, Parma University Hospital, Parma, 43126, Italy
| | - Raymond Hupperts
- Zuyderland Ziekenhuis, Sittard, Sittard, 6131 BK, The Netherlands
| | - Murat Terzi
- Medical Faculty, 19 Mayis University, Kurupelit, Samsun, 55160, Turkey
| | - Jeannette Lechner-Scott
- School of Medicine and Public Health, University Newcastle, 2308, Australia
- Department of Neurology, John Hunter Hospital, Hunter New England Health, Newcastle, 2305, Australia
| | - Daniele Spitaleri
- Azienda Ospedaliera di Rilievo Nazionale San Giuseppe Moscati Avellino, Contrada Amoretta, Avellino, 83100, Italy
| | | | - Aysun Soysal
- Bakirkoy Education and Research Hospital for Psychiatric and Neurological Diseases, Istanbul, 34142, Turkey
| | - Javier Olascoaga
- Instituto de Investigación Sanitaria Biodonostia, Hospital Universitario Donostia, San San Sebastián, Spain, 20014, Spain
| | | | | | - Mark Slee
- Flinders University, Adelaide, 5042, Australia
| | - Tunde Csepany
- Department of Neurology, Faculty of Medicine, University of Debrecen, Debrecen, 4032, Hungary
| | - Recai Turkoglu
- Haydarpasa Numune Training and Research Hospital, Selimiye Mahallesi, Istanbul, 34668, Turkey
| | - Youssef Sidhom
- Department of Neurology, Razi Hospital, 2010, Tunis, Manouba, Tunisia
| | - Riadh Gouider
- Department of Neurology, Razi Hospital, 2010, Tunis, Manouba, Tunisia
| | - Bart Van Wijmeersch
- Rehabilitation and MS-Centre Overpelt and Hasselt University, Hasselt, 3900, Belgium
| | - Pamela McCombe
- University of Queensland, St Lucia, 4072, Australia
- Royal Brisbane and Women's Hospital, Herston, 4029, Australia
| | - Richard Macdonell
- Department of Neurology, Austin Health, Heidlberg, 3084, Australia
- Faculty of Medicine and Dental Health Sciences, University of Melbourne, Melbourne, 3050, Australia
| | - Alasdair Coles
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, CB2 0QQ, UK
| | - Charles B Malpas
- CORe, Department of Medicine, University of Melbourne, Melbourne, 3050, Australia
- Melbourne MS Centre, Department of Neurology, Royal Melbourne Hospital, Melbourne, 3050, Australia
| | - Helmut Butzkueven
- Central Clinical School, Monash University, Melbourne, 3004, Australia
- Department of Neurology, The Alfred Hospital, Melbourne, 3004, Australia
- Department of Neurology, Box Hill Hospital, Monash University, Melbourne, 3128, Australia
| | - Sandra Vukusic
- University of Lyon, Claude Bernard University Lyon 1, F-69000 Lyon, France
- Hospices Civils de Lyon, Service de Neurologie, sclérose en plaques, pathologies de la myéline et neuro-inflammation, F-69677 Bron, France
- Observatoire Français de la Sclérose en Plaques, Lyon Neuroscience Research Centre, INSERM 1028 et CNRS UMR 5292, F-69003 Lyon, France
| | - Tomas Kalincik
- CORe, Department of Medicine, University of Melbourne, Melbourne, 3050, Australia
- Melbourne MS Centre, Department of Neurology, Royal Melbourne Hospital, Melbourne, 3050, Australia
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Peyro-Saint-Paul L, Derache N, Ficheux M, Allouche S, Parienti JJ, Calocer F, Le Caignec F, Fedrizzi S, Defer G. Severe bone pain with teriflunomide: Five case reports and review of the French pharmacovigilance database. Therapie 2020; 75:503-506. [DOI: 10.1016/j.therap.2019.07.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 05/06/2019] [Accepted: 07/22/2019] [Indexed: 10/26/2022]
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Branger P, Parienti JJ, Derache N, Kassis N, Assouad R, Maillart E, Defer G. Relapses During High-Dose Biotin Treatment in Progressive Multiple Sclerosis: a Case-Crossover and Propensity Score-Adjusted Prospective Cohort. Neurotherapeutics 2020; 17:989-993. [PMID: 32557122 PMCID: PMC7641290 DOI: 10.1007/s13311-020-00880-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
High-dose biotin (HDB) is a therapy used in non-active progressive multiple sclerosis (PMS). Some reports have suggested that HDB treatment may be associated with an increased risk of relapse. We evaluate the relationship between exposure to HDB for treating PMS and the risk of relapse. We screened for PMS patients prospectively registered in a French regional cohort being part of the OFSEP national registry. In a case-crossover design among patients who received HDB, we first compared number of relapses before and after initiation of HDB. Second, time to the first clinical relapse was compared between patients who received HDB (biotin group) and a control group using a Cox survival analysis after a propensity score (PS) matching (1:1) and inverse probability of treatment weighting (IPTW) method. In the 42 PMS patients who received HDB, the number of relapses was statistically and clinically significant higher after biotin initiation than before biotin initiation (incident rate ratio [IRR] 7.4, 95% confidence interval [CI] 3.5-15.9, p < 0.0001). With the PS matching method, the risk of relapse was significantly higher in the biotin group compared to the control group (hazard ratio [HR] 4.3, 95% CI 1.4-13.3, p = 0.01). The IPTW method with 440 control patients revealed consistent results (HR 5.1, 95% CI 2.3-11.3, p < 0.0001). In our non-randomized study, HDB treatment for PMS was associated with an increased risk of relapse. The follow-up of PMS patients initiating HDB should include careful assessment of clinical and radiological activity to monitor the potential pro-inflammatory effect of biotin.
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Affiliation(s)
- Pierre Branger
- Department of Neurology, CHU de Caen, F-14000, Caen, France.
| | - Jean-Jacques Parienti
- Department of Clinical Research and Biostatistics, CHU de Caen, F-14000, Caen, France
| | | | - Nizam Kassis
- Department of Neurology, CHP du Cotentin, F-50102, Cherbourg-en-Cotentin, France
| | - Rana Assouad
- Department of Neurology, GH Pitié-Salpêtrière, F-75013, Paris VI, France
| | - Elisabeth Maillart
- Department of Neurology, GH Pitié-Salpêtrière, F-75013, Paris VI, France
| | - Gilles Defer
- Department of Neurology, CHU de Caen, F-14000, Caen, France
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Brisset JC, Kremer S, Hannoun S, Bonneville F, Durand-Dubief F, Tourdias T, Barillot C, Guttmann C, Vukusic S, Dousset V, Cotton F, Ameli R, Anxionnat R, Audoin B, Attye A, Bannier E, Barillot C, Ben Salem D, Boncoeur-Martel MP, Bonhomme G, Bonneville F, Boutet C, Brisset J, Cervenanski F, Claise B, Commowick O, Constans JM, Cotton F, Dardel P, Desal H, Dousset V, Durand-Dubief F, Ferre JC, Gaultier A, Gerardin E, Glattard T, Grand S, Grenier T, Guillevin R, Guttmann C, Krainik A, Kremer S, Lion S, Champfleur NMD, Mondot L, Outteryck O, Pyatigorskaya N, Pruvo JP, Rabaste S, Ranjeva JP, Roch JA, Sadik JC, Sappey-Marinier D, Savatovsky J, Stankoff B, Tanguy JY, Tourbah A, Tourdias T, Brochet B, Casey R, Cotton F, De Sèze J, Douek P, Guillemin F, Laplaud D, Lebrun-Frenay C, Mansuy L, Moreau T, Olaiz J, Pelletier J, Rigaud-Bully C, Stankoff B, Vukusic S, Debouverie M, Edan G, Ciron J, Lubetzki C, Vermersch P, Labauge P, Defer G, Berger E, Clavelou P, Gout O, Thouvenot E, Heinzlef O, Al-Khedr A, Bourre B, Casez O, Cabre P, Montcuquet A, Créange A, Camdessanché JP, Bakchine S, Maurousset A, Patry I, De Broucker T, Pottier C, Neau JP, Labeyrie C, Nifle C. New OFSEP recommendations for MRI assessment of multiple sclerosis patients: Special consideration for gadolinium deposition and frequent acquisitions. J Neuroradiol 2020; 47:250-258. [DOI: 10.1016/j.neurad.2020.01.083] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 01/22/2020] [Accepted: 01/22/2020] [Indexed: 01/04/2023]
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Calocer F, Dejardin O, Kwiatkowski A, Bourre B, Vermersch P, Hautecoeur P, Launoy G, Defer G. Socioeconomic deprivation increases the risk of disability in multiple sclerosis patients. Mult Scler Relat Disord 2020; 40:101930. [DOI: 10.1016/j.msard.2020.101930] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 11/25/2019] [Accepted: 01/02/2020] [Indexed: 11/16/2022]
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Harand C, Defer G. Psychological interventions in multiple sclerosis: Improving cognition and quality of life. Ann Phys Rehabil Med 2020. [DOI: 10.1016/j.rehab.2018.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Harand C, Daniel F, Mondou A, Chevanne D, Creveuil C, Defer G. Neuropsychological management of multiple sclerosis: evaluation of a supervised and customized cognitive rehabilitation program for self-used at home (SEPIA): protocol for a randomized controlled trial. Trials 2019; 20:614. [PMID: 31665039 PMCID: PMC6819362 DOI: 10.1186/s13063-019-3715-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Accepted: 09/10/2019] [Indexed: 11/22/2022] Open
Abstract
Background Cognitive and mood disorders negatively impact daily life in patients with multiple sclerosis (MS). Pharmacological treatments did not demonstrate any effect on cognition compared with cognitive rehabilitation (CR). However, if CR programs offer promising results on cognition, they are less consistent concerning mood and quality of life (QoL). In this context, we designed a randomized controlled trial to evaluate the efficacy of an innovative computerized CR program, conducted at home, on QoL. Secondary objectives will estimate the improvement, or the stabilization over time, of patients’ cognitive performances and their emotional affects. Methods Forty MS patients (relapsing-remitting or secondary progressive forms) who have cognitive impairment will be recruited for the trial (called SEPIA-NCT03471338) and randomly assigned to either the experimental group or the control group. Patients randomly assigned in the experimental group will perform a home-based CR program with psychological support during eight consecutive weeks. CR will be based on computerized cognitive exercises from the PRESCO® software developed by HAPPYneuron©. Training sessions (three sessions of 45 min per week) will consist of short exercises evaluating a broad range of cognitive domains and will be personalized for each patient (tracking tool and supervised guidance). The control group, designed to control for non-specific elements of the intervention, will receive only psychological support consisting of various issues related to MS, such as everyday cognitive-related difficulties or management of emotions. QoL, assessed by the MUSIQOL (Multiple Sclerosis International Quality Of Life) questionnaire, will be evaluated three times (at baseline and after 1 week and 25 weeks after home-based intervention) as well as secondary outcomes measuring self-esteem, cognition, depression, anxiety, metacognition, fatigue, and sleep quality. Given the expected MUSIQOL variation, the inclusion of 20 patients per group (alpha risk 5% and power 80%) will be required. Discussion Evidence suggests that computerized programs may be a practice option for CR for people with MS, but there is a paucity of studies evaluating QoL. We hope that this innovative program will highlight such benefits over time in patients’ daily life. In the future, such programs will allow a wider range of available therapeutic options for MS patients with cognitive impairment and for practitioners in charge of their care. Trial registration ClinicalTrials.gov identifier: NCT03471338. Retrospectively registered on 25 April 2018. https://clinicaltrials.gov/ct2/show/NCT03471338?term=NCT03471338&cond=Multiple+Sclerosis&draw=2&rank=1.
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Affiliation(s)
- Caroline Harand
- MS Expert Centre, Department of Neurology, Caen University Hospital Centre, Avenue de la Côte de Nacre CS 30001, 14033, Caen, Cedex 9, France
| | - France Daniel
- Réseau Bas-Normand de prise en charge des patients atteints de SEP, 29 rue du Général Moulin, 14000, Caen, France
| | - Audrey Mondou
- MS Expert Centre, Department of Neurology, Caen University Hospital Centre, Avenue de la Côte de Nacre CS 30001, 14033, Caen, Cedex 9, France
| | - Damien Chevanne
- MS Expert Centre, Department of Neurology, Caen University Hospital Centre, Avenue de la Côte de Nacre CS 30001, 14033, Caen, Cedex 9, France
| | - Christian Creveuil
- Biostatistics and Clinical Research Unit, Caen University Hospital Centre, Avenue de la Côte de Nacre CS 30001, 14033, Caen, cedex 9, France
| | - Gilles Defer
- MS Expert Centre, Department of Neurology, Caen University Hospital Centre, Avenue de la Côte de Nacre CS 30001, 14033, Caen, Cedex 9, France. .,Réseau Bas-Normand de prise en charge des patients atteints de SEP, 29 rue du Général Moulin, 14000, Caen, France.
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Laplaud DA, Casey R, Barbin L, Debouverie M, De Sèze J, Brassat D, Wiertlewski S, Brochet B, Pelletier J, Vermersch P, Edan G, Lebrun-Frenay C, Clavelou P, Thouvenot E, Camdessanché JP, Tourbah A, Stankoff B, Al Khedr A, Cabre P, Lubetzki C, Papeix C, Berger E, Heinzlef O, Debroucker T, Moreau T, Gout O, Bourre B, Wahab A, Labauge P, Magy L, Defer G, Guennoc AM, Maubeuge N, Labeyrie C, Patry I, Nifle C, Casez O, Michel L, Rollot F, Leray E, Vukusic S, Foucher Y. Comparative effectiveness of teriflunomide vs dimethyl fumarate in multiple sclerosis. Neurology 2019; 93:e635-e646. [PMID: 31300547 PMCID: PMC6715507 DOI: 10.1212/wnl.0000000000007938] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2018] [Accepted: 04/10/2019] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVE In this study, we compared the effectiveness of teriflunomide (TRF) and dimethyl fumarate (DMF) on both clinical and MRI outcomes in patients followed prospectively in the Observatoire Français de la Sclérose en Plaques. METHODS A total of 1,770 patients with relapsing-remitting multiple sclerosis (RRMS) (713 on TRF and 1,057 on DMF) with an available baseline brain MRI were included in intention to treat. The 1- and 2-year postinitiation outcomes were relapses, increase of T2 lesions, increase in Expanded Disability Status Scale score, and reason for treatment discontinuation. Propensity scores (inverse probability weighting) and logistic regressions were estimated. RESULTS The confounder-adjusted proportions of patients were similar in TRF- compared to DMF-treated patients for relapses and disability progression after 1 and 2 years. However, the adjusted proportion of patients with at least one new T2 lesion after 2 years was lower in DMF compared to TRF (60.8% vs 72.2%, odds ratio [OR] 0.60, p < 0.001). Analyses of reasons for treatment withdrawal showed that lack of effectiveness was reported for 8.5% of DMF-treated patients vs 14.5% of TRF-treated patients (OR 0.54, p < 0.001), while adverse events accounted for 16% of TRF-treated patients and 21% of DMF-treated patients after 2 years (OR 1.39, p < 0.001). CONCLUSIONS After 2 years of treatment, we found similar effectiveness of DMF and TRF in terms of clinical outcomes, but with better MRI-based outcomes for DMF-treated patients, resulting in a lower rate of treatment discontinuation due to lack of effectiveness. CLASSIFICATION OF EVIDENCE This study provides Class III evidence that for patients with RRMS, TRF and DMF have similar clinical effectiveness after 2 years of treatment.
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Affiliation(s)
- David-Axel Laplaud
- From INSERM (D.-A.L., L.B.), CIC 0004, Nantes; CRTI-INSERM UMR U1064 (D.-A.L.), Université de Nantes; Service de Neurologie (D.-A.L., S.W., L. Michel), CHU Nantes; Centre des Neurosciences de Lyon (R.C., F.R., S.V.), Observatoire Français de la Sclérose en Plaques, INSERM 1028 and CNRS UMR5292, Lyon; Université Claude Bernard Lyon 1 (R.C., F.R., S.V.), Université de Lyon; Department of Neurology (M.D.), Nancy University Hospital; Université de Lorraine (M.D.), EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology and Clinical Investigation Center (J.D.S.), CHU de Strasbourg, INSERM 1434; Department of Neurology (D.B.), CHU de Toulouse; Service de Neurologie (B. Brochet), CHU de Bordeaux; Service de Neurologie (J.P.), Hôpital de la Timone, CRMBM, CNRS, APHM, Aix Marseille Univ, Marseille; Univ Lille (P.V.), CHU Lille, LIRIC (Lille Inflammation Research International Center), INSERM UMR995; Service de Neurologie (G.E., L. Michel), CHU de Rennes; CRCSEP Nice (C.L.-F.), Neurologie Pasteur 2, Université Nice Cote d'Azur, Nice; Service de Neurologie (P. Clavelou), CHU de Clermont-Ferrand; Service de Neurologie (E.T.), CHU de Nîmes; Department of Neurology (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; Service de Neurologie et Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; Service de Neurologie (B.S.), CHU Saint-Antoine; Service de Neurologie (A.A.K.), CHU d'Amiens; Service de Neurologie (P. Cabre), CHU de Fort de France; Service de Neurologie (C. Lubetzki, C.P.), CHU Pitié-Salpêtrière; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (T.D.), CH de Saint-Denis; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (O.G.), Fondation Rothschild; Service de Neurologie (B. Bourre), CHU de Rouen; Department of Neurology (A.W.), Hôpital Henri Mondor, Créteil; Service de Neurologie (P.L.), CHU de Montpellier; Service de Neurologie (L. Magy), CHU de Limoges; Service de Neurologie (G.D.), CHU de Caen; CRC SEP and Department of Neurology (A.-M.G.), CHU Bretonneau, Tours; Department of Neurology (N.M.), CHU La Milétrie, Poitiers; Department of Neurology (C. Labeyrie), CHU Bicêtre, Le Kremlin Bicêtre; Department of Neurology (I.P.), Hôpital Sud Francilien, Corbeil Essonnes; Department of Neurology (C.N.), CHU Versailles; Department of Neurology (O.C.), CHU de Grenoble; Ecole des Hautes Etudes en Santé Publique (E.L.), Rennes; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation (S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon/Bron; and INSERM (Y.F.), UMR 1246-SPHERE, Nantes University, Tours University, Nantes, France.
| | - Romain Casey
- From INSERM (D.-A.L., L.B.), CIC 0004, Nantes; CRTI-INSERM UMR U1064 (D.-A.L.), Université de Nantes; Service de Neurologie (D.-A.L., S.W., L. Michel), CHU Nantes; Centre des Neurosciences de Lyon (R.C., F.R., S.V.), Observatoire Français de la Sclérose en Plaques, INSERM 1028 and CNRS UMR5292, Lyon; Université Claude Bernard Lyon 1 (R.C., F.R., S.V.), Université de Lyon; Department of Neurology (M.D.), Nancy University Hospital; Université de Lorraine (M.D.), EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology and Clinical Investigation Center (J.D.S.), CHU de Strasbourg, INSERM 1434; Department of Neurology (D.B.), CHU de Toulouse; Service de Neurologie (B. Brochet), CHU de Bordeaux; Service de Neurologie (J.P.), Hôpital de la Timone, CRMBM, CNRS, APHM, Aix Marseille Univ, Marseille; Univ Lille (P.V.), CHU Lille, LIRIC (Lille Inflammation Research International Center), INSERM UMR995; Service de Neurologie (G.E., L. Michel), CHU de Rennes; CRCSEP Nice (C.L.-F.), Neurologie Pasteur 2, Université Nice Cote d'Azur, Nice; Service de Neurologie (P. Clavelou), CHU de Clermont-Ferrand; Service de Neurologie (E.T.), CHU de Nîmes; Department of Neurology (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; Service de Neurologie et Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; Service de Neurologie (B.S.), CHU Saint-Antoine; Service de Neurologie (A.A.K.), CHU d'Amiens; Service de Neurologie (P. Cabre), CHU de Fort de France; Service de Neurologie (C. Lubetzki, C.P.), CHU Pitié-Salpêtrière; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (T.D.), CH de Saint-Denis; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (O.G.), Fondation Rothschild; Service de Neurologie (B. Bourre), CHU de Rouen; Department of Neurology (A.W.), Hôpital Henri Mondor, Créteil; Service de Neurologie (P.L.), CHU de Montpellier; Service de Neurologie (L. Magy), CHU de Limoges; Service de Neurologie (G.D.), CHU de Caen; CRC SEP and Department of Neurology (A.-M.G.), CHU Bretonneau, Tours; Department of Neurology (N.M.), CHU La Milétrie, Poitiers; Department of Neurology (C. Labeyrie), CHU Bicêtre, Le Kremlin Bicêtre; Department of Neurology (I.P.), Hôpital Sud Francilien, Corbeil Essonnes; Department of Neurology (C.N.), CHU Versailles; Department of Neurology (O.C.), CHU de Grenoble; Ecole des Hautes Etudes en Santé Publique (E.L.), Rennes; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation (S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon/Bron; and INSERM (Y.F.), UMR 1246-SPHERE, Nantes University, Tours University, Nantes, France
| | - Laetitia Barbin
- From INSERM (D.-A.L., L.B.), CIC 0004, Nantes; CRTI-INSERM UMR U1064 (D.-A.L.), Université de Nantes; Service de Neurologie (D.-A.L., S.W., L. Michel), CHU Nantes; Centre des Neurosciences de Lyon (R.C., F.R., S.V.), Observatoire Français de la Sclérose en Plaques, INSERM 1028 and CNRS UMR5292, Lyon; Université Claude Bernard Lyon 1 (R.C., F.R., S.V.), Université de Lyon; Department of Neurology (M.D.), Nancy University Hospital; Université de Lorraine (M.D.), EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology and Clinical Investigation Center (J.D.S.), CHU de Strasbourg, INSERM 1434; Department of Neurology (D.B.), CHU de Toulouse; Service de Neurologie (B. Brochet), CHU de Bordeaux; Service de Neurologie (J.P.), Hôpital de la Timone, CRMBM, CNRS, APHM, Aix Marseille Univ, Marseille; Univ Lille (P.V.), CHU Lille, LIRIC (Lille Inflammation Research International Center), INSERM UMR995; Service de Neurologie (G.E., L. Michel), CHU de Rennes; CRCSEP Nice (C.L.-F.), Neurologie Pasteur 2, Université Nice Cote d'Azur, Nice; Service de Neurologie (P. Clavelou), CHU de Clermont-Ferrand; Service de Neurologie (E.T.), CHU de Nîmes; Department of Neurology (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; Service de Neurologie et Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; Service de Neurologie (B.S.), CHU Saint-Antoine; Service de Neurologie (A.A.K.), CHU d'Amiens; Service de Neurologie (P. Cabre), CHU de Fort de France; Service de Neurologie (C. Lubetzki, C.P.), CHU Pitié-Salpêtrière; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (T.D.), CH de Saint-Denis; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (O.G.), Fondation Rothschild; Service de Neurologie (B. Bourre), CHU de Rouen; Department of Neurology (A.W.), Hôpital Henri Mondor, Créteil; Service de Neurologie (P.L.), CHU de Montpellier; Service de Neurologie (L. Magy), CHU de Limoges; Service de Neurologie (G.D.), CHU de Caen; CRC SEP and Department of Neurology (A.-M.G.), CHU Bretonneau, Tours; Department of Neurology (N.M.), CHU La Milétrie, Poitiers; Department of Neurology (C. Labeyrie), CHU Bicêtre, Le Kremlin Bicêtre; Department of Neurology (I.P.), Hôpital Sud Francilien, Corbeil Essonnes; Department of Neurology (C.N.), CHU Versailles; Department of Neurology (O.C.), CHU de Grenoble; Ecole des Hautes Etudes en Santé Publique (E.L.), Rennes; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation (S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon/Bron; and INSERM (Y.F.), UMR 1246-SPHERE, Nantes University, Tours University, Nantes, France
| | - Marc Debouverie
- From INSERM (D.-A.L., L.B.), CIC 0004, Nantes; CRTI-INSERM UMR U1064 (D.-A.L.), Université de Nantes; Service de Neurologie (D.-A.L., S.W., L. Michel), CHU Nantes; Centre des Neurosciences de Lyon (R.C., F.R., S.V.), Observatoire Français de la Sclérose en Plaques, INSERM 1028 and CNRS UMR5292, Lyon; Université Claude Bernard Lyon 1 (R.C., F.R., S.V.), Université de Lyon; Department of Neurology (M.D.), Nancy University Hospital; Université de Lorraine (M.D.), EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology and Clinical Investigation Center (J.D.S.), CHU de Strasbourg, INSERM 1434; Department of Neurology (D.B.), CHU de Toulouse; Service de Neurologie (B. Brochet), CHU de Bordeaux; Service de Neurologie (J.P.), Hôpital de la Timone, CRMBM, CNRS, APHM, Aix Marseille Univ, Marseille; Univ Lille (P.V.), CHU Lille, LIRIC (Lille Inflammation Research International Center), INSERM UMR995; Service de Neurologie (G.E., L. Michel), CHU de Rennes; CRCSEP Nice (C.L.-F.), Neurologie Pasteur 2, Université Nice Cote d'Azur, Nice; Service de Neurologie (P. Clavelou), CHU de Clermont-Ferrand; Service de Neurologie (E.T.), CHU de Nîmes; Department of Neurology (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; Service de Neurologie et Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; Service de Neurologie (B.S.), CHU Saint-Antoine; Service de Neurologie (A.A.K.), CHU d'Amiens; Service de Neurologie (P. Cabre), CHU de Fort de France; Service de Neurologie (C. Lubetzki, C.P.), CHU Pitié-Salpêtrière; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (T.D.), CH de Saint-Denis; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (O.G.), Fondation Rothschild; Service de Neurologie (B. Bourre), CHU de Rouen; Department of Neurology (A.W.), Hôpital Henri Mondor, Créteil; Service de Neurologie (P.L.), CHU de Montpellier; Service de Neurologie (L. Magy), CHU de Limoges; Service de Neurologie (G.D.), CHU de Caen; CRC SEP and Department of Neurology (A.-M.G.), CHU Bretonneau, Tours; Department of Neurology (N.M.), CHU La Milétrie, Poitiers; Department of Neurology (C. Labeyrie), CHU Bicêtre, Le Kremlin Bicêtre; Department of Neurology (I.P.), Hôpital Sud Francilien, Corbeil Essonnes; Department of Neurology (C.N.), CHU Versailles; Department of Neurology (O.C.), CHU de Grenoble; Ecole des Hautes Etudes en Santé Publique (E.L.), Rennes; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation (S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon/Bron; and INSERM (Y.F.), UMR 1246-SPHERE, Nantes University, Tours University, Nantes, France
| | - Jérôme De Sèze
- From INSERM (D.-A.L., L.B.), CIC 0004, Nantes; CRTI-INSERM UMR U1064 (D.-A.L.), Université de Nantes; Service de Neurologie (D.-A.L., S.W., L. Michel), CHU Nantes; Centre des Neurosciences de Lyon (R.C., F.R., S.V.), Observatoire Français de la Sclérose en Plaques, INSERM 1028 and CNRS UMR5292, Lyon; Université Claude Bernard Lyon 1 (R.C., F.R., S.V.), Université de Lyon; Department of Neurology (M.D.), Nancy University Hospital; Université de Lorraine (M.D.), EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology and Clinical Investigation Center (J.D.S.), CHU de Strasbourg, INSERM 1434; Department of Neurology (D.B.), CHU de Toulouse; Service de Neurologie (B. Brochet), CHU de Bordeaux; Service de Neurologie (J.P.), Hôpital de la Timone, CRMBM, CNRS, APHM, Aix Marseille Univ, Marseille; Univ Lille (P.V.), CHU Lille, LIRIC (Lille Inflammation Research International Center), INSERM UMR995; Service de Neurologie (G.E., L. Michel), CHU de Rennes; CRCSEP Nice (C.L.-F.), Neurologie Pasteur 2, Université Nice Cote d'Azur, Nice; Service de Neurologie (P. Clavelou), CHU de Clermont-Ferrand; Service de Neurologie (E.T.), CHU de Nîmes; Department of Neurology (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; Service de Neurologie et Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; Service de Neurologie (B.S.), CHU Saint-Antoine; Service de Neurologie (A.A.K.), CHU d'Amiens; Service de Neurologie (P. Cabre), CHU de Fort de France; Service de Neurologie (C. Lubetzki, C.P.), CHU Pitié-Salpêtrière; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (T.D.), CH de Saint-Denis; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (O.G.), Fondation Rothschild; Service de Neurologie (B. Bourre), CHU de Rouen; Department of Neurology (A.W.), Hôpital Henri Mondor, Créteil; Service de Neurologie (P.L.), CHU de Montpellier; Service de Neurologie (L. Magy), CHU de Limoges; Service de Neurologie (G.D.), CHU de Caen; CRC SEP and Department of Neurology (A.-M.G.), CHU Bretonneau, Tours; Department of Neurology (N.M.), CHU La Milétrie, Poitiers; Department of Neurology (C. Labeyrie), CHU Bicêtre, Le Kremlin Bicêtre; Department of Neurology (I.P.), Hôpital Sud Francilien, Corbeil Essonnes; Department of Neurology (C.N.), CHU Versailles; Department of Neurology (O.C.), CHU de Grenoble; Ecole des Hautes Etudes en Santé Publique (E.L.), Rennes; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation (S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon/Bron; and INSERM (Y.F.), UMR 1246-SPHERE, Nantes University, Tours University, Nantes, France
| | - David Brassat
- From INSERM (D.-A.L., L.B.), CIC 0004, Nantes; CRTI-INSERM UMR U1064 (D.-A.L.), Université de Nantes; Service de Neurologie (D.-A.L., S.W., L. Michel), CHU Nantes; Centre des Neurosciences de Lyon (R.C., F.R., S.V.), Observatoire Français de la Sclérose en Plaques, INSERM 1028 and CNRS UMR5292, Lyon; Université Claude Bernard Lyon 1 (R.C., F.R., S.V.), Université de Lyon; Department of Neurology (M.D.), Nancy University Hospital; Université de Lorraine (M.D.), EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology and Clinical Investigation Center (J.D.S.), CHU de Strasbourg, INSERM 1434; Department of Neurology (D.B.), CHU de Toulouse; Service de Neurologie (B. Brochet), CHU de Bordeaux; Service de Neurologie (J.P.), Hôpital de la Timone, CRMBM, CNRS, APHM, Aix Marseille Univ, Marseille; Univ Lille (P.V.), CHU Lille, LIRIC (Lille Inflammation Research International Center), INSERM UMR995; Service de Neurologie (G.E., L. Michel), CHU de Rennes; CRCSEP Nice (C.L.-F.), Neurologie Pasteur 2, Université Nice Cote d'Azur, Nice; Service de Neurologie (P. Clavelou), CHU de Clermont-Ferrand; Service de Neurologie (E.T.), CHU de Nîmes; Department of Neurology (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; Service de Neurologie et Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; Service de Neurologie (B.S.), CHU Saint-Antoine; Service de Neurologie (A.A.K.), CHU d'Amiens; Service de Neurologie (P. Cabre), CHU de Fort de France; Service de Neurologie (C. Lubetzki, C.P.), CHU Pitié-Salpêtrière; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (T.D.), CH de Saint-Denis; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (O.G.), Fondation Rothschild; Service de Neurologie (B. Bourre), CHU de Rouen; Department of Neurology (A.W.), Hôpital Henri Mondor, Créteil; Service de Neurologie (P.L.), CHU de Montpellier; Service de Neurologie (L. Magy), CHU de Limoges; Service de Neurologie (G.D.), CHU de Caen; CRC SEP and Department of Neurology (A.-M.G.), CHU Bretonneau, Tours; Department of Neurology (N.M.), CHU La Milétrie, Poitiers; Department of Neurology (C. Labeyrie), CHU Bicêtre, Le Kremlin Bicêtre; Department of Neurology (I.P.), Hôpital Sud Francilien, Corbeil Essonnes; Department of Neurology (C.N.), CHU Versailles; Department of Neurology (O.C.), CHU de Grenoble; Ecole des Hautes Etudes en Santé Publique (E.L.), Rennes; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation (S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon/Bron; and INSERM (Y.F.), UMR 1246-SPHERE, Nantes University, Tours University, Nantes, France
| | - Sandrine Wiertlewski
- From INSERM (D.-A.L., L.B.), CIC 0004, Nantes; CRTI-INSERM UMR U1064 (D.-A.L.), Université de Nantes; Service de Neurologie (D.-A.L., S.W., L. Michel), CHU Nantes; Centre des Neurosciences de Lyon (R.C., F.R., S.V.), Observatoire Français de la Sclérose en Plaques, INSERM 1028 and CNRS UMR5292, Lyon; Université Claude Bernard Lyon 1 (R.C., F.R., S.V.), Université de Lyon; Department of Neurology (M.D.), Nancy University Hospital; Université de Lorraine (M.D.), EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology and Clinical Investigation Center (J.D.S.), CHU de Strasbourg, INSERM 1434; Department of Neurology (D.B.), CHU de Toulouse; Service de Neurologie (B. Brochet), CHU de Bordeaux; Service de Neurologie (J.P.), Hôpital de la Timone, CRMBM, CNRS, APHM, Aix Marseille Univ, Marseille; Univ Lille (P.V.), CHU Lille, LIRIC (Lille Inflammation Research International Center), INSERM UMR995; Service de Neurologie (G.E., L. Michel), CHU de Rennes; CRCSEP Nice (C.L.-F.), Neurologie Pasteur 2, Université Nice Cote d'Azur, Nice; Service de Neurologie (P. Clavelou), CHU de Clermont-Ferrand; Service de Neurologie (E.T.), CHU de Nîmes; Department of Neurology (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; Service de Neurologie et Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; Service de Neurologie (B.S.), CHU Saint-Antoine; Service de Neurologie (A.A.K.), CHU d'Amiens; Service de Neurologie (P. Cabre), CHU de Fort de France; Service de Neurologie (C. Lubetzki, C.P.), CHU Pitié-Salpêtrière; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (T.D.), CH de Saint-Denis; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (O.G.), Fondation Rothschild; Service de Neurologie (B. Bourre), CHU de Rouen; Department of Neurology (A.W.), Hôpital Henri Mondor, Créteil; Service de Neurologie (P.L.), CHU de Montpellier; Service de Neurologie (L. Magy), CHU de Limoges; Service de Neurologie (G.D.), CHU de Caen; CRC SEP and Department of Neurology (A.-M.G.), CHU Bretonneau, Tours; Department of Neurology (N.M.), CHU La Milétrie, Poitiers; Department of Neurology (C. Labeyrie), CHU Bicêtre, Le Kremlin Bicêtre; Department of Neurology (I.P.), Hôpital Sud Francilien, Corbeil Essonnes; Department of Neurology (C.N.), CHU Versailles; Department of Neurology (O.C.), CHU de Grenoble; Ecole des Hautes Etudes en Santé Publique (E.L.), Rennes; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation (S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon/Bron; and INSERM (Y.F.), UMR 1246-SPHERE, Nantes University, Tours University, Nantes, France
| | - Bruno Brochet
- From INSERM (D.-A.L., L.B.), CIC 0004, Nantes; CRTI-INSERM UMR U1064 (D.-A.L.), Université de Nantes; Service de Neurologie (D.-A.L., S.W., L. Michel), CHU Nantes; Centre des Neurosciences de Lyon (R.C., F.R., S.V.), Observatoire Français de la Sclérose en Plaques, INSERM 1028 and CNRS UMR5292, Lyon; Université Claude Bernard Lyon 1 (R.C., F.R., S.V.), Université de Lyon; Department of Neurology (M.D.), Nancy University Hospital; Université de Lorraine (M.D.), EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology and Clinical Investigation Center (J.D.S.), CHU de Strasbourg, INSERM 1434; Department of Neurology (D.B.), CHU de Toulouse; Service de Neurologie (B. Brochet), CHU de Bordeaux; Service de Neurologie (J.P.), Hôpital de la Timone, CRMBM, CNRS, APHM, Aix Marseille Univ, Marseille; Univ Lille (P.V.), CHU Lille, LIRIC (Lille Inflammation Research International Center), INSERM UMR995; Service de Neurologie (G.E., L. Michel), CHU de Rennes; CRCSEP Nice (C.L.-F.), Neurologie Pasteur 2, Université Nice Cote d'Azur, Nice; Service de Neurologie (P. Clavelou), CHU de Clermont-Ferrand; Service de Neurologie (E.T.), CHU de Nîmes; Department of Neurology (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; Service de Neurologie et Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; Service de Neurologie (B.S.), CHU Saint-Antoine; Service de Neurologie (A.A.K.), CHU d'Amiens; Service de Neurologie (P. Cabre), CHU de Fort de France; Service de Neurologie (C. Lubetzki, C.P.), CHU Pitié-Salpêtrière; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (T.D.), CH de Saint-Denis; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (O.G.), Fondation Rothschild; Service de Neurologie (B. Bourre), CHU de Rouen; Department of Neurology (A.W.), Hôpital Henri Mondor, Créteil; Service de Neurologie (P.L.), CHU de Montpellier; Service de Neurologie (L. Magy), CHU de Limoges; Service de Neurologie (G.D.), CHU de Caen; CRC SEP and Department of Neurology (A.-M.G.), CHU Bretonneau, Tours; Department of Neurology (N.M.), CHU La Milétrie, Poitiers; Department of Neurology (C. Labeyrie), CHU Bicêtre, Le Kremlin Bicêtre; Department of Neurology (I.P.), Hôpital Sud Francilien, Corbeil Essonnes; Department of Neurology (C.N.), CHU Versailles; Department of Neurology (O.C.), CHU de Grenoble; Ecole des Hautes Etudes en Santé Publique (E.L.), Rennes; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation (S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon/Bron; and INSERM (Y.F.), UMR 1246-SPHERE, Nantes University, Tours University, Nantes, France
| | - Jean Pelletier
- From INSERM (D.-A.L., L.B.), CIC 0004, Nantes; CRTI-INSERM UMR U1064 (D.-A.L.), Université de Nantes; Service de Neurologie (D.-A.L., S.W., L. Michel), CHU Nantes; Centre des Neurosciences de Lyon (R.C., F.R., S.V.), Observatoire Français de la Sclérose en Plaques, INSERM 1028 and CNRS UMR5292, Lyon; Université Claude Bernard Lyon 1 (R.C., F.R., S.V.), Université de Lyon; Department of Neurology (M.D.), Nancy University Hospital; Université de Lorraine (M.D.), EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology and Clinical Investigation Center (J.D.S.), CHU de Strasbourg, INSERM 1434; Department of Neurology (D.B.), CHU de Toulouse; Service de Neurologie (B. Brochet), CHU de Bordeaux; Service de Neurologie (J.P.), Hôpital de la Timone, CRMBM, CNRS, APHM, Aix Marseille Univ, Marseille; Univ Lille (P.V.), CHU Lille, LIRIC (Lille Inflammation Research International Center), INSERM UMR995; Service de Neurologie (G.E., L. Michel), CHU de Rennes; CRCSEP Nice (C.L.-F.), Neurologie Pasteur 2, Université Nice Cote d'Azur, Nice; Service de Neurologie (P. Clavelou), CHU de Clermont-Ferrand; Service de Neurologie (E.T.), CHU de Nîmes; Department of Neurology (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; Service de Neurologie et Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; Service de Neurologie (B.S.), CHU Saint-Antoine; Service de Neurologie (A.A.K.), CHU d'Amiens; Service de Neurologie (P. Cabre), CHU de Fort de France; Service de Neurologie (C. Lubetzki, C.P.), CHU Pitié-Salpêtrière; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (T.D.), CH de Saint-Denis; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (O.G.), Fondation Rothschild; Service de Neurologie (B. Bourre), CHU de Rouen; Department of Neurology (A.W.), Hôpital Henri Mondor, Créteil; Service de Neurologie (P.L.), CHU de Montpellier; Service de Neurologie (L. Magy), CHU de Limoges; Service de Neurologie (G.D.), CHU de Caen; CRC SEP and Department of Neurology (A.-M.G.), CHU Bretonneau, Tours; Department of Neurology (N.M.), CHU La Milétrie, Poitiers; Department of Neurology (C. Labeyrie), CHU Bicêtre, Le Kremlin Bicêtre; Department of Neurology (I.P.), Hôpital Sud Francilien, Corbeil Essonnes; Department of Neurology (C.N.), CHU Versailles; Department of Neurology (O.C.), CHU de Grenoble; Ecole des Hautes Etudes en Santé Publique (E.L.), Rennes; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation (S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon/Bron; and INSERM (Y.F.), UMR 1246-SPHERE, Nantes University, Tours University, Nantes, France
| | - Patrick Vermersch
- From INSERM (D.-A.L., L.B.), CIC 0004, Nantes; CRTI-INSERM UMR U1064 (D.-A.L.), Université de Nantes; Service de Neurologie (D.-A.L., S.W., L. Michel), CHU Nantes; Centre des Neurosciences de Lyon (R.C., F.R., S.V.), Observatoire Français de la Sclérose en Plaques, INSERM 1028 and CNRS UMR5292, Lyon; Université Claude Bernard Lyon 1 (R.C., F.R., S.V.), Université de Lyon; Department of Neurology (M.D.), Nancy University Hospital; Université de Lorraine (M.D.), EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology and Clinical Investigation Center (J.D.S.), CHU de Strasbourg, INSERM 1434; Department of Neurology (D.B.), CHU de Toulouse; Service de Neurologie (B. Brochet), CHU de Bordeaux; Service de Neurologie (J.P.), Hôpital de la Timone, CRMBM, CNRS, APHM, Aix Marseille Univ, Marseille; Univ Lille (P.V.), CHU Lille, LIRIC (Lille Inflammation Research International Center), INSERM UMR995; Service de Neurologie (G.E., L. Michel), CHU de Rennes; CRCSEP Nice (C.L.-F.), Neurologie Pasteur 2, Université Nice Cote d'Azur, Nice; Service de Neurologie (P. Clavelou), CHU de Clermont-Ferrand; Service de Neurologie (E.T.), CHU de Nîmes; Department of Neurology (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; Service de Neurologie et Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; Service de Neurologie (B.S.), CHU Saint-Antoine; Service de Neurologie (A.A.K.), CHU d'Amiens; Service de Neurologie (P. Cabre), CHU de Fort de France; Service de Neurologie (C. Lubetzki, C.P.), CHU Pitié-Salpêtrière; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (T.D.), CH de Saint-Denis; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (O.G.), Fondation Rothschild; Service de Neurologie (B. Bourre), CHU de Rouen; Department of Neurology (A.W.), Hôpital Henri Mondor, Créteil; Service de Neurologie (P.L.), CHU de Montpellier; Service de Neurologie (L. Magy), CHU de Limoges; Service de Neurologie (G.D.), CHU de Caen; CRC SEP and Department of Neurology (A.-M.G.), CHU Bretonneau, Tours; Department of Neurology (N.M.), CHU La Milétrie, Poitiers; Department of Neurology (C. Labeyrie), CHU Bicêtre, Le Kremlin Bicêtre; Department of Neurology (I.P.), Hôpital Sud Francilien, Corbeil Essonnes; Department of Neurology (C.N.), CHU Versailles; Department of Neurology (O.C.), CHU de Grenoble; Ecole des Hautes Etudes en Santé Publique (E.L.), Rennes; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation (S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon/Bron; and INSERM (Y.F.), UMR 1246-SPHERE, Nantes University, Tours University, Nantes, France
| | - Gilles Edan
- From INSERM (D.-A.L., L.B.), CIC 0004, Nantes; CRTI-INSERM UMR U1064 (D.-A.L.), Université de Nantes; Service de Neurologie (D.-A.L., S.W., L. Michel), CHU Nantes; Centre des Neurosciences de Lyon (R.C., F.R., S.V.), Observatoire Français de la Sclérose en Plaques, INSERM 1028 and CNRS UMR5292, Lyon; Université Claude Bernard Lyon 1 (R.C., F.R., S.V.), Université de Lyon; Department of Neurology (M.D.), Nancy University Hospital; Université de Lorraine (M.D.), EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology and Clinical Investigation Center (J.D.S.), CHU de Strasbourg, INSERM 1434; Department of Neurology (D.B.), CHU de Toulouse; Service de Neurologie (B. Brochet), CHU de Bordeaux; Service de Neurologie (J.P.), Hôpital de la Timone, CRMBM, CNRS, APHM, Aix Marseille Univ, Marseille; Univ Lille (P.V.), CHU Lille, LIRIC (Lille Inflammation Research International Center), INSERM UMR995; Service de Neurologie (G.E., L. Michel), CHU de Rennes; CRCSEP Nice (C.L.-F.), Neurologie Pasteur 2, Université Nice Cote d'Azur, Nice; Service de Neurologie (P. Clavelou), CHU de Clermont-Ferrand; Service de Neurologie (E.T.), CHU de Nîmes; Department of Neurology (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; Service de Neurologie et Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; Service de Neurologie (B.S.), CHU Saint-Antoine; Service de Neurologie (A.A.K.), CHU d'Amiens; Service de Neurologie (P. Cabre), CHU de Fort de France; Service de Neurologie (C. Lubetzki, C.P.), CHU Pitié-Salpêtrière; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (T.D.), CH de Saint-Denis; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (O.G.), Fondation Rothschild; Service de Neurologie (B. Bourre), CHU de Rouen; Department of Neurology (A.W.), Hôpital Henri Mondor, Créteil; Service de Neurologie (P.L.), CHU de Montpellier; Service de Neurologie (L. Magy), CHU de Limoges; Service de Neurologie (G.D.), CHU de Caen; CRC SEP and Department of Neurology (A.-M.G.), CHU Bretonneau, Tours; Department of Neurology (N.M.), CHU La Milétrie, Poitiers; Department of Neurology (C. Labeyrie), CHU Bicêtre, Le Kremlin Bicêtre; Department of Neurology (I.P.), Hôpital Sud Francilien, Corbeil Essonnes; Department of Neurology (C.N.), CHU Versailles; Department of Neurology (O.C.), CHU de Grenoble; Ecole des Hautes Etudes en Santé Publique (E.L.), Rennes; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation (S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon/Bron; and INSERM (Y.F.), UMR 1246-SPHERE, Nantes University, Tours University, Nantes, France
| | - Christine Lebrun-Frenay
- From INSERM (D.-A.L., L.B.), CIC 0004, Nantes; CRTI-INSERM UMR U1064 (D.-A.L.), Université de Nantes; Service de Neurologie (D.-A.L., S.W., L. Michel), CHU Nantes; Centre des Neurosciences de Lyon (R.C., F.R., S.V.), Observatoire Français de la Sclérose en Plaques, INSERM 1028 and CNRS UMR5292, Lyon; Université Claude Bernard Lyon 1 (R.C., F.R., S.V.), Université de Lyon; Department of Neurology (M.D.), Nancy University Hospital; Université de Lorraine (M.D.), EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology and Clinical Investigation Center (J.D.S.), CHU de Strasbourg, INSERM 1434; Department of Neurology (D.B.), CHU de Toulouse; Service de Neurologie (B. Brochet), CHU de Bordeaux; Service de Neurologie (J.P.), Hôpital de la Timone, CRMBM, CNRS, APHM, Aix Marseille Univ, Marseille; Univ Lille (P.V.), CHU Lille, LIRIC (Lille Inflammation Research International Center), INSERM UMR995; Service de Neurologie (G.E., L. Michel), CHU de Rennes; CRCSEP Nice (C.L.-F.), Neurologie Pasteur 2, Université Nice Cote d'Azur, Nice; Service de Neurologie (P. Clavelou), CHU de Clermont-Ferrand; Service de Neurologie (E.T.), CHU de Nîmes; Department of Neurology (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; Service de Neurologie et Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; Service de Neurologie (B.S.), CHU Saint-Antoine; Service de Neurologie (A.A.K.), CHU d'Amiens; Service de Neurologie (P. Cabre), CHU de Fort de France; Service de Neurologie (C. Lubetzki, C.P.), CHU Pitié-Salpêtrière; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (T.D.), CH de Saint-Denis; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (O.G.), Fondation Rothschild; Service de Neurologie (B. Bourre), CHU de Rouen; Department of Neurology (A.W.), Hôpital Henri Mondor, Créteil; Service de Neurologie (P.L.), CHU de Montpellier; Service de Neurologie (L. Magy), CHU de Limoges; Service de Neurologie (G.D.), CHU de Caen; CRC SEP and Department of Neurology (A.-M.G.), CHU Bretonneau, Tours; Department of Neurology (N.M.), CHU La Milétrie, Poitiers; Department of Neurology (C. Labeyrie), CHU Bicêtre, Le Kremlin Bicêtre; Department of Neurology (I.P.), Hôpital Sud Francilien, Corbeil Essonnes; Department of Neurology (C.N.), CHU Versailles; Department of Neurology (O.C.), CHU de Grenoble; Ecole des Hautes Etudes en Santé Publique (E.L.), Rennes; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation (S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon/Bron; and INSERM (Y.F.), UMR 1246-SPHERE, Nantes University, Tours University, Nantes, France
| | - Pierre Clavelou
- From INSERM (D.-A.L., L.B.), CIC 0004, Nantes; CRTI-INSERM UMR U1064 (D.-A.L.), Université de Nantes; Service de Neurologie (D.-A.L., S.W., L. Michel), CHU Nantes; Centre des Neurosciences de Lyon (R.C., F.R., S.V.), Observatoire Français de la Sclérose en Plaques, INSERM 1028 and CNRS UMR5292, Lyon; Université Claude Bernard Lyon 1 (R.C., F.R., S.V.), Université de Lyon; Department of Neurology (M.D.), Nancy University Hospital; Université de Lorraine (M.D.), EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology and Clinical Investigation Center (J.D.S.), CHU de Strasbourg, INSERM 1434; Department of Neurology (D.B.), CHU de Toulouse; Service de Neurologie (B. Brochet), CHU de Bordeaux; Service de Neurologie (J.P.), Hôpital de la Timone, CRMBM, CNRS, APHM, Aix Marseille Univ, Marseille; Univ Lille (P.V.), CHU Lille, LIRIC (Lille Inflammation Research International Center), INSERM UMR995; Service de Neurologie (G.E., L. Michel), CHU de Rennes; CRCSEP Nice (C.L.-F.), Neurologie Pasteur 2, Université Nice Cote d'Azur, Nice; Service de Neurologie (P. Clavelou), CHU de Clermont-Ferrand; Service de Neurologie (E.T.), CHU de Nîmes; Department of Neurology (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; Service de Neurologie et Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; Service de Neurologie (B.S.), CHU Saint-Antoine; Service de Neurologie (A.A.K.), CHU d'Amiens; Service de Neurologie (P. Cabre), CHU de Fort de France; Service de Neurologie (C. Lubetzki, C.P.), CHU Pitié-Salpêtrière; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (T.D.), CH de Saint-Denis; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (O.G.), Fondation Rothschild; Service de Neurologie (B. Bourre), CHU de Rouen; Department of Neurology (A.W.), Hôpital Henri Mondor, Créteil; Service de Neurologie (P.L.), CHU de Montpellier; Service de Neurologie (L. Magy), CHU de Limoges; Service de Neurologie (G.D.), CHU de Caen; CRC SEP and Department of Neurology (A.-M.G.), CHU Bretonneau, Tours; Department of Neurology (N.M.), CHU La Milétrie, Poitiers; Department of Neurology (C. Labeyrie), CHU Bicêtre, Le Kremlin Bicêtre; Department of Neurology (I.P.), Hôpital Sud Francilien, Corbeil Essonnes; Department of Neurology (C.N.), CHU Versailles; Department of Neurology (O.C.), CHU de Grenoble; Ecole des Hautes Etudes en Santé Publique (E.L.), Rennes; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation (S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon/Bron; and INSERM (Y.F.), UMR 1246-SPHERE, Nantes University, Tours University, Nantes, France
| | - Eric Thouvenot
- From INSERM (D.-A.L., L.B.), CIC 0004, Nantes; CRTI-INSERM UMR U1064 (D.-A.L.), Université de Nantes; Service de Neurologie (D.-A.L., S.W., L. Michel), CHU Nantes; Centre des Neurosciences de Lyon (R.C., F.R., S.V.), Observatoire Français de la Sclérose en Plaques, INSERM 1028 and CNRS UMR5292, Lyon; Université Claude Bernard Lyon 1 (R.C., F.R., S.V.), Université de Lyon; Department of Neurology (M.D.), Nancy University Hospital; Université de Lorraine (M.D.), EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology and Clinical Investigation Center (J.D.S.), CHU de Strasbourg, INSERM 1434; Department of Neurology (D.B.), CHU de Toulouse; Service de Neurologie (B. Brochet), CHU de Bordeaux; Service de Neurologie (J.P.), Hôpital de la Timone, CRMBM, CNRS, APHM, Aix Marseille Univ, Marseille; Univ Lille (P.V.), CHU Lille, LIRIC (Lille Inflammation Research International Center), INSERM UMR995; Service de Neurologie (G.E., L. Michel), CHU de Rennes; CRCSEP Nice (C.L.-F.), Neurologie Pasteur 2, Université Nice Cote d'Azur, Nice; Service de Neurologie (P. Clavelou), CHU de Clermont-Ferrand; Service de Neurologie (E.T.), CHU de Nîmes; Department of Neurology (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; Service de Neurologie et Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; Service de Neurologie (B.S.), CHU Saint-Antoine; Service de Neurologie (A.A.K.), CHU d'Amiens; Service de Neurologie (P. Cabre), CHU de Fort de France; Service de Neurologie (C. Lubetzki, C.P.), CHU Pitié-Salpêtrière; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (T.D.), CH de Saint-Denis; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (O.G.), Fondation Rothschild; Service de Neurologie (B. Bourre), CHU de Rouen; Department of Neurology (A.W.), Hôpital Henri Mondor, Créteil; Service de Neurologie (P.L.), CHU de Montpellier; Service de Neurologie (L. Magy), CHU de Limoges; Service de Neurologie (G.D.), CHU de Caen; CRC SEP and Department of Neurology (A.-M.G.), CHU Bretonneau, Tours; Department of Neurology (N.M.), CHU La Milétrie, Poitiers; Department of Neurology (C. Labeyrie), CHU Bicêtre, Le Kremlin Bicêtre; Department of Neurology (I.P.), Hôpital Sud Francilien, Corbeil Essonnes; Department of Neurology (C.N.), CHU Versailles; Department of Neurology (O.C.), CHU de Grenoble; Ecole des Hautes Etudes en Santé Publique (E.L.), Rennes; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation (S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon/Bron; and INSERM (Y.F.), UMR 1246-SPHERE, Nantes University, Tours University, Nantes, France
| | - Jean-Philippe Camdessanché
- From INSERM (D.-A.L., L.B.), CIC 0004, Nantes; CRTI-INSERM UMR U1064 (D.-A.L.), Université de Nantes; Service de Neurologie (D.-A.L., S.W., L. Michel), CHU Nantes; Centre des Neurosciences de Lyon (R.C., F.R., S.V.), Observatoire Français de la Sclérose en Plaques, INSERM 1028 and CNRS UMR5292, Lyon; Université Claude Bernard Lyon 1 (R.C., F.R., S.V.), Université de Lyon; Department of Neurology (M.D.), Nancy University Hospital; Université de Lorraine (M.D.), EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology and Clinical Investigation Center (J.D.S.), CHU de Strasbourg, INSERM 1434; Department of Neurology (D.B.), CHU de Toulouse; Service de Neurologie (B. Brochet), CHU de Bordeaux; Service de Neurologie (J.P.), Hôpital de la Timone, CRMBM, CNRS, APHM, Aix Marseille Univ, Marseille; Univ Lille (P.V.), CHU Lille, LIRIC (Lille Inflammation Research International Center), INSERM UMR995; Service de Neurologie (G.E., L. Michel), CHU de Rennes; CRCSEP Nice (C.L.-F.), Neurologie Pasteur 2, Université Nice Cote d'Azur, Nice; Service de Neurologie (P. Clavelou), CHU de Clermont-Ferrand; Service de Neurologie (E.T.), CHU de Nîmes; Department of Neurology (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; Service de Neurologie et Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; Service de Neurologie (B.S.), CHU Saint-Antoine; Service de Neurologie (A.A.K.), CHU d'Amiens; Service de Neurologie (P. Cabre), CHU de Fort de France; Service de Neurologie (C. Lubetzki, C.P.), CHU Pitié-Salpêtrière; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (T.D.), CH de Saint-Denis; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (O.G.), Fondation Rothschild; Service de Neurologie (B. Bourre), CHU de Rouen; Department of Neurology (A.W.), Hôpital Henri Mondor, Créteil; Service de Neurologie (P.L.), CHU de Montpellier; Service de Neurologie (L. Magy), CHU de Limoges; Service de Neurologie (G.D.), CHU de Caen; CRC SEP and Department of Neurology (A.-M.G.), CHU Bretonneau, Tours; Department of Neurology (N.M.), CHU La Milétrie, Poitiers; Department of Neurology (C. Labeyrie), CHU Bicêtre, Le Kremlin Bicêtre; Department of Neurology (I.P.), Hôpital Sud Francilien, Corbeil Essonnes; Department of Neurology (C.N.), CHU Versailles; Department of Neurology (O.C.), CHU de Grenoble; Ecole des Hautes Etudes en Santé Publique (E.L.), Rennes; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation (S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon/Bron; and INSERM (Y.F.), UMR 1246-SPHERE, Nantes University, Tours University, Nantes, France
| | - Ayman Tourbah
- From INSERM (D.-A.L., L.B.), CIC 0004, Nantes; CRTI-INSERM UMR U1064 (D.-A.L.), Université de Nantes; Service de Neurologie (D.-A.L., S.W., L. Michel), CHU Nantes; Centre des Neurosciences de Lyon (R.C., F.R., S.V.), Observatoire Français de la Sclérose en Plaques, INSERM 1028 and CNRS UMR5292, Lyon; Université Claude Bernard Lyon 1 (R.C., F.R., S.V.), Université de Lyon; Department of Neurology (M.D.), Nancy University Hospital; Université de Lorraine (M.D.), EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology and Clinical Investigation Center (J.D.S.), CHU de Strasbourg, INSERM 1434; Department of Neurology (D.B.), CHU de Toulouse; Service de Neurologie (B. Brochet), CHU de Bordeaux; Service de Neurologie (J.P.), Hôpital de la Timone, CRMBM, CNRS, APHM, Aix Marseille Univ, Marseille; Univ Lille (P.V.), CHU Lille, LIRIC (Lille Inflammation Research International Center), INSERM UMR995; Service de Neurologie (G.E., L. Michel), CHU de Rennes; CRCSEP Nice (C.L.-F.), Neurologie Pasteur 2, Université Nice Cote d'Azur, Nice; Service de Neurologie (P. Clavelou), CHU de Clermont-Ferrand; Service de Neurologie (E.T.), CHU de Nîmes; Department of Neurology (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; Service de Neurologie et Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; Service de Neurologie (B.S.), CHU Saint-Antoine; Service de Neurologie (A.A.K.), CHU d'Amiens; Service de Neurologie (P. Cabre), CHU de Fort de France; Service de Neurologie (C. Lubetzki, C.P.), CHU Pitié-Salpêtrière; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (T.D.), CH de Saint-Denis; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (O.G.), Fondation Rothschild; Service de Neurologie (B. Bourre), CHU de Rouen; Department of Neurology (A.W.), Hôpital Henri Mondor, Créteil; Service de Neurologie (P.L.), CHU de Montpellier; Service de Neurologie (L. Magy), CHU de Limoges; Service de Neurologie (G.D.), CHU de Caen; CRC SEP and Department of Neurology (A.-M.G.), CHU Bretonneau, Tours; Department of Neurology (N.M.), CHU La Milétrie, Poitiers; Department of Neurology (C. Labeyrie), CHU Bicêtre, Le Kremlin Bicêtre; Department of Neurology (I.P.), Hôpital Sud Francilien, Corbeil Essonnes; Department of Neurology (C.N.), CHU Versailles; Department of Neurology (O.C.), CHU de Grenoble; Ecole des Hautes Etudes en Santé Publique (E.L.), Rennes; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation (S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon/Bron; and INSERM (Y.F.), UMR 1246-SPHERE, Nantes University, Tours University, Nantes, France
| | - Bruno Stankoff
- From INSERM (D.-A.L., L.B.), CIC 0004, Nantes; CRTI-INSERM UMR U1064 (D.-A.L.), Université de Nantes; Service de Neurologie (D.-A.L., S.W., L. Michel), CHU Nantes; Centre des Neurosciences de Lyon (R.C., F.R., S.V.), Observatoire Français de la Sclérose en Plaques, INSERM 1028 and CNRS UMR5292, Lyon; Université Claude Bernard Lyon 1 (R.C., F.R., S.V.), Université de Lyon; Department of Neurology (M.D.), Nancy University Hospital; Université de Lorraine (M.D.), EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology and Clinical Investigation Center (J.D.S.), CHU de Strasbourg, INSERM 1434; Department of Neurology (D.B.), CHU de Toulouse; Service de Neurologie (B. Brochet), CHU de Bordeaux; Service de Neurologie (J.P.), Hôpital de la Timone, CRMBM, CNRS, APHM, Aix Marseille Univ, Marseille; Univ Lille (P.V.), CHU Lille, LIRIC (Lille Inflammation Research International Center), INSERM UMR995; Service de Neurologie (G.E., L. Michel), CHU de Rennes; CRCSEP Nice (C.L.-F.), Neurologie Pasteur 2, Université Nice Cote d'Azur, Nice; Service de Neurologie (P. Clavelou), CHU de Clermont-Ferrand; Service de Neurologie (E.T.), CHU de Nîmes; Department of Neurology (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; Service de Neurologie et Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; Service de Neurologie (B.S.), CHU Saint-Antoine; Service de Neurologie (A.A.K.), CHU d'Amiens; Service de Neurologie (P. Cabre), CHU de Fort de France; Service de Neurologie (C. Lubetzki, C.P.), CHU Pitié-Salpêtrière; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (T.D.), CH de Saint-Denis; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (O.G.), Fondation Rothschild; Service de Neurologie (B. Bourre), CHU de Rouen; Department of Neurology (A.W.), Hôpital Henri Mondor, Créteil; Service de Neurologie (P.L.), CHU de Montpellier; Service de Neurologie (L. Magy), CHU de Limoges; Service de Neurologie (G.D.), CHU de Caen; CRC SEP and Department of Neurology (A.-M.G.), CHU Bretonneau, Tours; Department of Neurology (N.M.), CHU La Milétrie, Poitiers; Department of Neurology (C. Labeyrie), CHU Bicêtre, Le Kremlin Bicêtre; Department of Neurology (I.P.), Hôpital Sud Francilien, Corbeil Essonnes; Department of Neurology (C.N.), CHU Versailles; Department of Neurology (O.C.), CHU de Grenoble; Ecole des Hautes Etudes en Santé Publique (E.L.), Rennes; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation (S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon/Bron; and INSERM (Y.F.), UMR 1246-SPHERE, Nantes University, Tours University, Nantes, France
| | - Abdullatif Al Khedr
- From INSERM (D.-A.L., L.B.), CIC 0004, Nantes; CRTI-INSERM UMR U1064 (D.-A.L.), Université de Nantes; Service de Neurologie (D.-A.L., S.W., L. Michel), CHU Nantes; Centre des Neurosciences de Lyon (R.C., F.R., S.V.), Observatoire Français de la Sclérose en Plaques, INSERM 1028 and CNRS UMR5292, Lyon; Université Claude Bernard Lyon 1 (R.C., F.R., S.V.), Université de Lyon; Department of Neurology (M.D.), Nancy University Hospital; Université de Lorraine (M.D.), EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology and Clinical Investigation Center (J.D.S.), CHU de Strasbourg, INSERM 1434; Department of Neurology (D.B.), CHU de Toulouse; Service de Neurologie (B. Brochet), CHU de Bordeaux; Service de Neurologie (J.P.), Hôpital de la Timone, CRMBM, CNRS, APHM, Aix Marseille Univ, Marseille; Univ Lille (P.V.), CHU Lille, LIRIC (Lille Inflammation Research International Center), INSERM UMR995; Service de Neurologie (G.E., L. Michel), CHU de Rennes; CRCSEP Nice (C.L.-F.), Neurologie Pasteur 2, Université Nice Cote d'Azur, Nice; Service de Neurologie (P. Clavelou), CHU de Clermont-Ferrand; Service de Neurologie (E.T.), CHU de Nîmes; Department of Neurology (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; Service de Neurologie et Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; Service de Neurologie (B.S.), CHU Saint-Antoine; Service de Neurologie (A.A.K.), CHU d'Amiens; Service de Neurologie (P. Cabre), CHU de Fort de France; Service de Neurologie (C. Lubetzki, C.P.), CHU Pitié-Salpêtrière; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (T.D.), CH de Saint-Denis; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (O.G.), Fondation Rothschild; Service de Neurologie (B. Bourre), CHU de Rouen; Department of Neurology (A.W.), Hôpital Henri Mondor, Créteil; Service de Neurologie (P.L.), CHU de Montpellier; Service de Neurologie (L. Magy), CHU de Limoges; Service de Neurologie (G.D.), CHU de Caen; CRC SEP and Department of Neurology (A.-M.G.), CHU Bretonneau, Tours; Department of Neurology (N.M.), CHU La Milétrie, Poitiers; Department of Neurology (C. Labeyrie), CHU Bicêtre, Le Kremlin Bicêtre; Department of Neurology (I.P.), Hôpital Sud Francilien, Corbeil Essonnes; Department of Neurology (C.N.), CHU Versailles; Department of Neurology (O.C.), CHU de Grenoble; Ecole des Hautes Etudes en Santé Publique (E.L.), Rennes; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation (S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon/Bron; and INSERM (Y.F.), UMR 1246-SPHERE, Nantes University, Tours University, Nantes, France
| | - Philippe Cabre
- From INSERM (D.-A.L., L.B.), CIC 0004, Nantes; CRTI-INSERM UMR U1064 (D.-A.L.), Université de Nantes; Service de Neurologie (D.-A.L., S.W., L. Michel), CHU Nantes; Centre des Neurosciences de Lyon (R.C., F.R., S.V.), Observatoire Français de la Sclérose en Plaques, INSERM 1028 and CNRS UMR5292, Lyon; Université Claude Bernard Lyon 1 (R.C., F.R., S.V.), Université de Lyon; Department of Neurology (M.D.), Nancy University Hospital; Université de Lorraine (M.D.), EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology and Clinical Investigation Center (J.D.S.), CHU de Strasbourg, INSERM 1434; Department of Neurology (D.B.), CHU de Toulouse; Service de Neurologie (B. Brochet), CHU de Bordeaux; Service de Neurologie (J.P.), Hôpital de la Timone, CRMBM, CNRS, APHM, Aix Marseille Univ, Marseille; Univ Lille (P.V.), CHU Lille, LIRIC (Lille Inflammation Research International Center), INSERM UMR995; Service de Neurologie (G.E., L. Michel), CHU de Rennes; CRCSEP Nice (C.L.-F.), Neurologie Pasteur 2, Université Nice Cote d'Azur, Nice; Service de Neurologie (P. Clavelou), CHU de Clermont-Ferrand; Service de Neurologie (E.T.), CHU de Nîmes; Department of Neurology (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; Service de Neurologie et Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; Service de Neurologie (B.S.), CHU Saint-Antoine; Service de Neurologie (A.A.K.), CHU d'Amiens; Service de Neurologie (P. Cabre), CHU de Fort de France; Service de Neurologie (C. Lubetzki, C.P.), CHU Pitié-Salpêtrière; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (T.D.), CH de Saint-Denis; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (O.G.), Fondation Rothschild; Service de Neurologie (B. Bourre), CHU de Rouen; Department of Neurology (A.W.), Hôpital Henri Mondor, Créteil; Service de Neurologie (P.L.), CHU de Montpellier; Service de Neurologie (L. Magy), CHU de Limoges; Service de Neurologie (G.D.), CHU de Caen; CRC SEP and Department of Neurology (A.-M.G.), CHU Bretonneau, Tours; Department of Neurology (N.M.), CHU La Milétrie, Poitiers; Department of Neurology (C. Labeyrie), CHU Bicêtre, Le Kremlin Bicêtre; Department of Neurology (I.P.), Hôpital Sud Francilien, Corbeil Essonnes; Department of Neurology (C.N.), CHU Versailles; Department of Neurology (O.C.), CHU de Grenoble; Ecole des Hautes Etudes en Santé Publique (E.L.), Rennes; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation (S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon/Bron; and INSERM (Y.F.), UMR 1246-SPHERE, Nantes University, Tours University, Nantes, France
| | - Catherine Lubetzki
- From INSERM (D.-A.L., L.B.), CIC 0004, Nantes; CRTI-INSERM UMR U1064 (D.-A.L.), Université de Nantes; Service de Neurologie (D.-A.L., S.W., L. Michel), CHU Nantes; Centre des Neurosciences de Lyon (R.C., F.R., S.V.), Observatoire Français de la Sclérose en Plaques, INSERM 1028 and CNRS UMR5292, Lyon; Université Claude Bernard Lyon 1 (R.C., F.R., S.V.), Université de Lyon; Department of Neurology (M.D.), Nancy University Hospital; Université de Lorraine (M.D.), EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology and Clinical Investigation Center (J.D.S.), CHU de Strasbourg, INSERM 1434; Department of Neurology (D.B.), CHU de Toulouse; Service de Neurologie (B. Brochet), CHU de Bordeaux; Service de Neurologie (J.P.), Hôpital de la Timone, CRMBM, CNRS, APHM, Aix Marseille Univ, Marseille; Univ Lille (P.V.), CHU Lille, LIRIC (Lille Inflammation Research International Center), INSERM UMR995; Service de Neurologie (G.E., L. Michel), CHU de Rennes; CRCSEP Nice (C.L.-F.), Neurologie Pasteur 2, Université Nice Cote d'Azur, Nice; Service de Neurologie (P. Clavelou), CHU de Clermont-Ferrand; Service de Neurologie (E.T.), CHU de Nîmes; Department of Neurology (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; Service de Neurologie et Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; Service de Neurologie (B.S.), CHU Saint-Antoine; Service de Neurologie (A.A.K.), CHU d'Amiens; Service de Neurologie (P. Cabre), CHU de Fort de France; Service de Neurologie (C. Lubetzki, C.P.), CHU Pitié-Salpêtrière; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (T.D.), CH de Saint-Denis; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (O.G.), Fondation Rothschild; Service de Neurologie (B. Bourre), CHU de Rouen; Department of Neurology (A.W.), Hôpital Henri Mondor, Créteil; Service de Neurologie (P.L.), CHU de Montpellier; Service de Neurologie (L. Magy), CHU de Limoges; Service de Neurologie (G.D.), CHU de Caen; CRC SEP and Department of Neurology (A.-M.G.), CHU Bretonneau, Tours; Department of Neurology (N.M.), CHU La Milétrie, Poitiers; Department of Neurology (C. Labeyrie), CHU Bicêtre, Le Kremlin Bicêtre; Department of Neurology (I.P.), Hôpital Sud Francilien, Corbeil Essonnes; Department of Neurology (C.N.), CHU Versailles; Department of Neurology (O.C.), CHU de Grenoble; Ecole des Hautes Etudes en Santé Publique (E.L.), Rennes; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation (S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon/Bron; and INSERM (Y.F.), UMR 1246-SPHERE, Nantes University, Tours University, Nantes, France
| | - Caroline Papeix
- From INSERM (D.-A.L., L.B.), CIC 0004, Nantes; CRTI-INSERM UMR U1064 (D.-A.L.), Université de Nantes; Service de Neurologie (D.-A.L., S.W., L. Michel), CHU Nantes; Centre des Neurosciences de Lyon (R.C., F.R., S.V.), Observatoire Français de la Sclérose en Plaques, INSERM 1028 and CNRS UMR5292, Lyon; Université Claude Bernard Lyon 1 (R.C., F.R., S.V.), Université de Lyon; Department of Neurology (M.D.), Nancy University Hospital; Université de Lorraine (M.D.), EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology and Clinical Investigation Center (J.D.S.), CHU de Strasbourg, INSERM 1434; Department of Neurology (D.B.), CHU de Toulouse; Service de Neurologie (B. Brochet), CHU de Bordeaux; Service de Neurologie (J.P.), Hôpital de la Timone, CRMBM, CNRS, APHM, Aix Marseille Univ, Marseille; Univ Lille (P.V.), CHU Lille, LIRIC (Lille Inflammation Research International Center), INSERM UMR995; Service de Neurologie (G.E., L. Michel), CHU de Rennes; CRCSEP Nice (C.L.-F.), Neurologie Pasteur 2, Université Nice Cote d'Azur, Nice; Service de Neurologie (P. Clavelou), CHU de Clermont-Ferrand; Service de Neurologie (E.T.), CHU de Nîmes; Department of Neurology (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; Service de Neurologie et Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; Service de Neurologie (B.S.), CHU Saint-Antoine; Service de Neurologie (A.A.K.), CHU d'Amiens; Service de Neurologie (P. Cabre), CHU de Fort de France; Service de Neurologie (C. Lubetzki, C.P.), CHU Pitié-Salpêtrière; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (T.D.), CH de Saint-Denis; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (O.G.), Fondation Rothschild; Service de Neurologie (B. Bourre), CHU de Rouen; Department of Neurology (A.W.), Hôpital Henri Mondor, Créteil; Service de Neurologie (P.L.), CHU de Montpellier; Service de Neurologie (L. Magy), CHU de Limoges; Service de Neurologie (G.D.), CHU de Caen; CRC SEP and Department of Neurology (A.-M.G.), CHU Bretonneau, Tours; Department of Neurology (N.M.), CHU La Milétrie, Poitiers; Department of Neurology (C. Labeyrie), CHU Bicêtre, Le Kremlin Bicêtre; Department of Neurology (I.P.), Hôpital Sud Francilien, Corbeil Essonnes; Department of Neurology (C.N.), CHU Versailles; Department of Neurology (O.C.), CHU de Grenoble; Ecole des Hautes Etudes en Santé Publique (E.L.), Rennes; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation (S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon/Bron; and INSERM (Y.F.), UMR 1246-SPHERE, Nantes University, Tours University, Nantes, France
| | - Eric Berger
- From INSERM (D.-A.L., L.B.), CIC 0004, Nantes; CRTI-INSERM UMR U1064 (D.-A.L.), Université de Nantes; Service de Neurologie (D.-A.L., S.W., L. Michel), CHU Nantes; Centre des Neurosciences de Lyon (R.C., F.R., S.V.), Observatoire Français de la Sclérose en Plaques, INSERM 1028 and CNRS UMR5292, Lyon; Université Claude Bernard Lyon 1 (R.C., F.R., S.V.), Université de Lyon; Department of Neurology (M.D.), Nancy University Hospital; Université de Lorraine (M.D.), EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology and Clinical Investigation Center (J.D.S.), CHU de Strasbourg, INSERM 1434; Department of Neurology (D.B.), CHU de Toulouse; Service de Neurologie (B. Brochet), CHU de Bordeaux; Service de Neurologie (J.P.), Hôpital de la Timone, CRMBM, CNRS, APHM, Aix Marseille Univ, Marseille; Univ Lille (P.V.), CHU Lille, LIRIC (Lille Inflammation Research International Center), INSERM UMR995; Service de Neurologie (G.E., L. Michel), CHU de Rennes; CRCSEP Nice (C.L.-F.), Neurologie Pasteur 2, Université Nice Cote d'Azur, Nice; Service de Neurologie (P. Clavelou), CHU de Clermont-Ferrand; Service de Neurologie (E.T.), CHU de Nîmes; Department of Neurology (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; Service de Neurologie et Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; Service de Neurologie (B.S.), CHU Saint-Antoine; Service de Neurologie (A.A.K.), CHU d'Amiens; Service de Neurologie (P. Cabre), CHU de Fort de France; Service de Neurologie (C. Lubetzki, C.P.), CHU Pitié-Salpêtrière; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (T.D.), CH de Saint-Denis; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (O.G.), Fondation Rothschild; Service de Neurologie (B. Bourre), CHU de Rouen; Department of Neurology (A.W.), Hôpital Henri Mondor, Créteil; Service de Neurologie (P.L.), CHU de Montpellier; Service de Neurologie (L. Magy), CHU de Limoges; Service de Neurologie (G.D.), CHU de Caen; CRC SEP and Department of Neurology (A.-M.G.), CHU Bretonneau, Tours; Department of Neurology (N.M.), CHU La Milétrie, Poitiers; Department of Neurology (C. Labeyrie), CHU Bicêtre, Le Kremlin Bicêtre; Department of Neurology (I.P.), Hôpital Sud Francilien, Corbeil Essonnes; Department of Neurology (C.N.), CHU Versailles; Department of Neurology (O.C.), CHU de Grenoble; Ecole des Hautes Etudes en Santé Publique (E.L.), Rennes; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation (S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon/Bron; and INSERM (Y.F.), UMR 1246-SPHERE, Nantes University, Tours University, Nantes, France
| | - Olivier Heinzlef
- From INSERM (D.-A.L., L.B.), CIC 0004, Nantes; CRTI-INSERM UMR U1064 (D.-A.L.), Université de Nantes; Service de Neurologie (D.-A.L., S.W., L. Michel), CHU Nantes; Centre des Neurosciences de Lyon (R.C., F.R., S.V.), Observatoire Français de la Sclérose en Plaques, INSERM 1028 and CNRS UMR5292, Lyon; Université Claude Bernard Lyon 1 (R.C., F.R., S.V.), Université de Lyon; Department of Neurology (M.D.), Nancy University Hospital; Université de Lorraine (M.D.), EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology and Clinical Investigation Center (J.D.S.), CHU de Strasbourg, INSERM 1434; Department of Neurology (D.B.), CHU de Toulouse; Service de Neurologie (B. Brochet), CHU de Bordeaux; Service de Neurologie (J.P.), Hôpital de la Timone, CRMBM, CNRS, APHM, Aix Marseille Univ, Marseille; Univ Lille (P.V.), CHU Lille, LIRIC (Lille Inflammation Research International Center), INSERM UMR995; Service de Neurologie (G.E., L. Michel), CHU de Rennes; CRCSEP Nice (C.L.-F.), Neurologie Pasteur 2, Université Nice Cote d'Azur, Nice; Service de Neurologie (P. Clavelou), CHU de Clermont-Ferrand; Service de Neurologie (E.T.), CHU de Nîmes; Department of Neurology (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; Service de Neurologie et Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; Service de Neurologie (B.S.), CHU Saint-Antoine; Service de Neurologie (A.A.K.), CHU d'Amiens; Service de Neurologie (P. Cabre), CHU de Fort de France; Service de Neurologie (C. Lubetzki, C.P.), CHU Pitié-Salpêtrière; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (T.D.), CH de Saint-Denis; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (O.G.), Fondation Rothschild; Service de Neurologie (B. Bourre), CHU de Rouen; Department of Neurology (A.W.), Hôpital Henri Mondor, Créteil; Service de Neurologie (P.L.), CHU de Montpellier; Service de Neurologie (L. Magy), CHU de Limoges; Service de Neurologie (G.D.), CHU de Caen; CRC SEP and Department of Neurology (A.-M.G.), CHU Bretonneau, Tours; Department of Neurology (N.M.), CHU La Milétrie, Poitiers; Department of Neurology (C. Labeyrie), CHU Bicêtre, Le Kremlin Bicêtre; Department of Neurology (I.P.), Hôpital Sud Francilien, Corbeil Essonnes; Department of Neurology (C.N.), CHU Versailles; Department of Neurology (O.C.), CHU de Grenoble; Ecole des Hautes Etudes en Santé Publique (E.L.), Rennes; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation (S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon/Bron; and INSERM (Y.F.), UMR 1246-SPHERE, Nantes University, Tours University, Nantes, France
| | - Thomas Debroucker
- From INSERM (D.-A.L., L.B.), CIC 0004, Nantes; CRTI-INSERM UMR U1064 (D.-A.L.), Université de Nantes; Service de Neurologie (D.-A.L., S.W., L. Michel), CHU Nantes; Centre des Neurosciences de Lyon (R.C., F.R., S.V.), Observatoire Français de la Sclérose en Plaques, INSERM 1028 and CNRS UMR5292, Lyon; Université Claude Bernard Lyon 1 (R.C., F.R., S.V.), Université de Lyon; Department of Neurology (M.D.), Nancy University Hospital; Université de Lorraine (M.D.), EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology and Clinical Investigation Center (J.D.S.), CHU de Strasbourg, INSERM 1434; Department of Neurology (D.B.), CHU de Toulouse; Service de Neurologie (B. Brochet), CHU de Bordeaux; Service de Neurologie (J.P.), Hôpital de la Timone, CRMBM, CNRS, APHM, Aix Marseille Univ, Marseille; Univ Lille (P.V.), CHU Lille, LIRIC (Lille Inflammation Research International Center), INSERM UMR995; Service de Neurologie (G.E., L. Michel), CHU de Rennes; CRCSEP Nice (C.L.-F.), Neurologie Pasteur 2, Université Nice Cote d'Azur, Nice; Service de Neurologie (P. Clavelou), CHU de Clermont-Ferrand; Service de Neurologie (E.T.), CHU de Nîmes; Department of Neurology (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; Service de Neurologie et Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; Service de Neurologie (B.S.), CHU Saint-Antoine; Service de Neurologie (A.A.K.), CHU d'Amiens; Service de Neurologie (P. Cabre), CHU de Fort de France; Service de Neurologie (C. Lubetzki, C.P.), CHU Pitié-Salpêtrière; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (T.D.), CH de Saint-Denis; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (O.G.), Fondation Rothschild; Service de Neurologie (B. Bourre), CHU de Rouen; Department of Neurology (A.W.), Hôpital Henri Mondor, Créteil; Service de Neurologie (P.L.), CHU de Montpellier; Service de Neurologie (L. Magy), CHU de Limoges; Service de Neurologie (G.D.), CHU de Caen; CRC SEP and Department of Neurology (A.-M.G.), CHU Bretonneau, Tours; Department of Neurology (N.M.), CHU La Milétrie, Poitiers; Department of Neurology (C. Labeyrie), CHU Bicêtre, Le Kremlin Bicêtre; Department of Neurology (I.P.), Hôpital Sud Francilien, Corbeil Essonnes; Department of Neurology (C.N.), CHU Versailles; Department of Neurology (O.C.), CHU de Grenoble; Ecole des Hautes Etudes en Santé Publique (E.L.), Rennes; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation (S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon/Bron; and INSERM (Y.F.), UMR 1246-SPHERE, Nantes University, Tours University, Nantes, France
| | - Thibault Moreau
- From INSERM (D.-A.L., L.B.), CIC 0004, Nantes; CRTI-INSERM UMR U1064 (D.-A.L.), Université de Nantes; Service de Neurologie (D.-A.L., S.W., L. Michel), CHU Nantes; Centre des Neurosciences de Lyon (R.C., F.R., S.V.), Observatoire Français de la Sclérose en Plaques, INSERM 1028 and CNRS UMR5292, Lyon; Université Claude Bernard Lyon 1 (R.C., F.R., S.V.), Université de Lyon; Department of Neurology (M.D.), Nancy University Hospital; Université de Lorraine (M.D.), EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology and Clinical Investigation Center (J.D.S.), CHU de Strasbourg, INSERM 1434; Department of Neurology (D.B.), CHU de Toulouse; Service de Neurologie (B. Brochet), CHU de Bordeaux; Service de Neurologie (J.P.), Hôpital de la Timone, CRMBM, CNRS, APHM, Aix Marseille Univ, Marseille; Univ Lille (P.V.), CHU Lille, LIRIC (Lille Inflammation Research International Center), INSERM UMR995; Service de Neurologie (G.E., L. Michel), CHU de Rennes; CRCSEP Nice (C.L.-F.), Neurologie Pasteur 2, Université Nice Cote d'Azur, Nice; Service de Neurologie (P. Clavelou), CHU de Clermont-Ferrand; Service de Neurologie (E.T.), CHU de Nîmes; Department of Neurology (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; Service de Neurologie et Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; Service de Neurologie (B.S.), CHU Saint-Antoine; Service de Neurologie (A.A.K.), CHU d'Amiens; Service de Neurologie (P. Cabre), CHU de Fort de France; Service de Neurologie (C. Lubetzki, C.P.), CHU Pitié-Salpêtrière; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (T.D.), CH de Saint-Denis; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (O.G.), Fondation Rothschild; Service de Neurologie (B. Bourre), CHU de Rouen; Department of Neurology (A.W.), Hôpital Henri Mondor, Créteil; Service de Neurologie (P.L.), CHU de Montpellier; Service de Neurologie (L. Magy), CHU de Limoges; Service de Neurologie (G.D.), CHU de Caen; CRC SEP and Department of Neurology (A.-M.G.), CHU Bretonneau, Tours; Department of Neurology (N.M.), CHU La Milétrie, Poitiers; Department of Neurology (C. Labeyrie), CHU Bicêtre, Le Kremlin Bicêtre; Department of Neurology (I.P.), Hôpital Sud Francilien, Corbeil Essonnes; Department of Neurology (C.N.), CHU Versailles; Department of Neurology (O.C.), CHU de Grenoble; Ecole des Hautes Etudes en Santé Publique (E.L.), Rennes; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation (S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon/Bron; and INSERM (Y.F.), UMR 1246-SPHERE, Nantes University, Tours University, Nantes, France
| | - Olivier Gout
- From INSERM (D.-A.L., L.B.), CIC 0004, Nantes; CRTI-INSERM UMR U1064 (D.-A.L.), Université de Nantes; Service de Neurologie (D.-A.L., S.W., L. Michel), CHU Nantes; Centre des Neurosciences de Lyon (R.C., F.R., S.V.), Observatoire Français de la Sclérose en Plaques, INSERM 1028 and CNRS UMR5292, Lyon; Université Claude Bernard Lyon 1 (R.C., F.R., S.V.), Université de Lyon; Department of Neurology (M.D.), Nancy University Hospital; Université de Lorraine (M.D.), EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology and Clinical Investigation Center (J.D.S.), CHU de Strasbourg, INSERM 1434; Department of Neurology (D.B.), CHU de Toulouse; Service de Neurologie (B. Brochet), CHU de Bordeaux; Service de Neurologie (J.P.), Hôpital de la Timone, CRMBM, CNRS, APHM, Aix Marseille Univ, Marseille; Univ Lille (P.V.), CHU Lille, LIRIC (Lille Inflammation Research International Center), INSERM UMR995; Service de Neurologie (G.E., L. Michel), CHU de Rennes; CRCSEP Nice (C.L.-F.), Neurologie Pasteur 2, Université Nice Cote d'Azur, Nice; Service de Neurologie (P. Clavelou), CHU de Clermont-Ferrand; Service de Neurologie (E.T.), CHU de Nîmes; Department of Neurology (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; Service de Neurologie et Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; Service de Neurologie (B.S.), CHU Saint-Antoine; Service de Neurologie (A.A.K.), CHU d'Amiens; Service de Neurologie (P. Cabre), CHU de Fort de France; Service de Neurologie (C. Lubetzki, C.P.), CHU Pitié-Salpêtrière; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (T.D.), CH de Saint-Denis; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (O.G.), Fondation Rothschild; Service de Neurologie (B. Bourre), CHU de Rouen; Department of Neurology (A.W.), Hôpital Henri Mondor, Créteil; Service de Neurologie (P.L.), CHU de Montpellier; Service de Neurologie (L. Magy), CHU de Limoges; Service de Neurologie (G.D.), CHU de Caen; CRC SEP and Department of Neurology (A.-M.G.), CHU Bretonneau, Tours; Department of Neurology (N.M.), CHU La Milétrie, Poitiers; Department of Neurology (C. Labeyrie), CHU Bicêtre, Le Kremlin Bicêtre; Department of Neurology (I.P.), Hôpital Sud Francilien, Corbeil Essonnes; Department of Neurology (C.N.), CHU Versailles; Department of Neurology (O.C.), CHU de Grenoble; Ecole des Hautes Etudes en Santé Publique (E.L.), Rennes; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation (S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon/Bron; and INSERM (Y.F.), UMR 1246-SPHERE, Nantes University, Tours University, Nantes, France
| | - Bertrand Bourre
- From INSERM (D.-A.L., L.B.), CIC 0004, Nantes; CRTI-INSERM UMR U1064 (D.-A.L.), Université de Nantes; Service de Neurologie (D.-A.L., S.W., L. Michel), CHU Nantes; Centre des Neurosciences de Lyon (R.C., F.R., S.V.), Observatoire Français de la Sclérose en Plaques, INSERM 1028 and CNRS UMR5292, Lyon; Université Claude Bernard Lyon 1 (R.C., F.R., S.V.), Université de Lyon; Department of Neurology (M.D.), Nancy University Hospital; Université de Lorraine (M.D.), EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology and Clinical Investigation Center (J.D.S.), CHU de Strasbourg, INSERM 1434; Department of Neurology (D.B.), CHU de Toulouse; Service de Neurologie (B. Brochet), CHU de Bordeaux; Service de Neurologie (J.P.), Hôpital de la Timone, CRMBM, CNRS, APHM, Aix Marseille Univ, Marseille; Univ Lille (P.V.), CHU Lille, LIRIC (Lille Inflammation Research International Center), INSERM UMR995; Service de Neurologie (G.E., L. Michel), CHU de Rennes; CRCSEP Nice (C.L.-F.), Neurologie Pasteur 2, Université Nice Cote d'Azur, Nice; Service de Neurologie (P. Clavelou), CHU de Clermont-Ferrand; Service de Neurologie (E.T.), CHU de Nîmes; Department of Neurology (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; Service de Neurologie et Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; Service de Neurologie (B.S.), CHU Saint-Antoine; Service de Neurologie (A.A.K.), CHU d'Amiens; Service de Neurologie (P. Cabre), CHU de Fort de France; Service de Neurologie (C. Lubetzki, C.P.), CHU Pitié-Salpêtrière; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (T.D.), CH de Saint-Denis; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (O.G.), Fondation Rothschild; Service de Neurologie (B. Bourre), CHU de Rouen; Department of Neurology (A.W.), Hôpital Henri Mondor, Créteil; Service de Neurologie (P.L.), CHU de Montpellier; Service de Neurologie (L. Magy), CHU de Limoges; Service de Neurologie (G.D.), CHU de Caen; CRC SEP and Department of Neurology (A.-M.G.), CHU Bretonneau, Tours; Department of Neurology (N.M.), CHU La Milétrie, Poitiers; Department of Neurology (C. Labeyrie), CHU Bicêtre, Le Kremlin Bicêtre; Department of Neurology (I.P.), Hôpital Sud Francilien, Corbeil Essonnes; Department of Neurology (C.N.), CHU Versailles; Department of Neurology (O.C.), CHU de Grenoble; Ecole des Hautes Etudes en Santé Publique (E.L.), Rennes; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation (S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon/Bron; and INSERM (Y.F.), UMR 1246-SPHERE, Nantes University, Tours University, Nantes, France
| | - Abir Wahab
- From INSERM (D.-A.L., L.B.), CIC 0004, Nantes; CRTI-INSERM UMR U1064 (D.-A.L.), Université de Nantes; Service de Neurologie (D.-A.L., S.W., L. Michel), CHU Nantes; Centre des Neurosciences de Lyon (R.C., F.R., S.V.), Observatoire Français de la Sclérose en Plaques, INSERM 1028 and CNRS UMR5292, Lyon; Université Claude Bernard Lyon 1 (R.C., F.R., S.V.), Université de Lyon; Department of Neurology (M.D.), Nancy University Hospital; Université de Lorraine (M.D.), EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology and Clinical Investigation Center (J.D.S.), CHU de Strasbourg, INSERM 1434; Department of Neurology (D.B.), CHU de Toulouse; Service de Neurologie (B. Brochet), CHU de Bordeaux; Service de Neurologie (J.P.), Hôpital de la Timone, CRMBM, CNRS, APHM, Aix Marseille Univ, Marseille; Univ Lille (P.V.), CHU Lille, LIRIC (Lille Inflammation Research International Center), INSERM UMR995; Service de Neurologie (G.E., L. Michel), CHU de Rennes; CRCSEP Nice (C.L.-F.), Neurologie Pasteur 2, Université Nice Cote d'Azur, Nice; Service de Neurologie (P. Clavelou), CHU de Clermont-Ferrand; Service de Neurologie (E.T.), CHU de Nîmes; Department of Neurology (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; Service de Neurologie et Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; Service de Neurologie (B.S.), CHU Saint-Antoine; Service de Neurologie (A.A.K.), CHU d'Amiens; Service de Neurologie (P. Cabre), CHU de Fort de France; Service de Neurologie (C. Lubetzki, C.P.), CHU Pitié-Salpêtrière; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (T.D.), CH de Saint-Denis; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (O.G.), Fondation Rothschild; Service de Neurologie (B. Bourre), CHU de Rouen; Department of Neurology (A.W.), Hôpital Henri Mondor, Créteil; Service de Neurologie (P.L.), CHU de Montpellier; Service de Neurologie (L. Magy), CHU de Limoges; Service de Neurologie (G.D.), CHU de Caen; CRC SEP and Department of Neurology (A.-M.G.), CHU Bretonneau, Tours; Department of Neurology (N.M.), CHU La Milétrie, Poitiers; Department of Neurology (C. Labeyrie), CHU Bicêtre, Le Kremlin Bicêtre; Department of Neurology (I.P.), Hôpital Sud Francilien, Corbeil Essonnes; Department of Neurology (C.N.), CHU Versailles; Department of Neurology (O.C.), CHU de Grenoble; Ecole des Hautes Etudes en Santé Publique (E.L.), Rennes; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation (S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon/Bron; and INSERM (Y.F.), UMR 1246-SPHERE, Nantes University, Tours University, Nantes, France
| | - Pierre Labauge
- From INSERM (D.-A.L., L.B.), CIC 0004, Nantes; CRTI-INSERM UMR U1064 (D.-A.L.), Université de Nantes; Service de Neurologie (D.-A.L., S.W., L. Michel), CHU Nantes; Centre des Neurosciences de Lyon (R.C., F.R., S.V.), Observatoire Français de la Sclérose en Plaques, INSERM 1028 and CNRS UMR5292, Lyon; Université Claude Bernard Lyon 1 (R.C., F.R., S.V.), Université de Lyon; Department of Neurology (M.D.), Nancy University Hospital; Université de Lorraine (M.D.), EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology and Clinical Investigation Center (J.D.S.), CHU de Strasbourg, INSERM 1434; Department of Neurology (D.B.), CHU de Toulouse; Service de Neurologie (B. Brochet), CHU de Bordeaux; Service de Neurologie (J.P.), Hôpital de la Timone, CRMBM, CNRS, APHM, Aix Marseille Univ, Marseille; Univ Lille (P.V.), CHU Lille, LIRIC (Lille Inflammation Research International Center), INSERM UMR995; Service de Neurologie (G.E., L. Michel), CHU de Rennes; CRCSEP Nice (C.L.-F.), Neurologie Pasteur 2, Université Nice Cote d'Azur, Nice; Service de Neurologie (P. Clavelou), CHU de Clermont-Ferrand; Service de Neurologie (E.T.), CHU de Nîmes; Department of Neurology (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; Service de Neurologie et Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; Service de Neurologie (B.S.), CHU Saint-Antoine; Service de Neurologie (A.A.K.), CHU d'Amiens; Service de Neurologie (P. Cabre), CHU de Fort de France; Service de Neurologie (C. Lubetzki, C.P.), CHU Pitié-Salpêtrière; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (T.D.), CH de Saint-Denis; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (O.G.), Fondation Rothschild; Service de Neurologie (B. Bourre), CHU de Rouen; Department of Neurology (A.W.), Hôpital Henri Mondor, Créteil; Service de Neurologie (P.L.), CHU de Montpellier; Service de Neurologie (L. Magy), CHU de Limoges; Service de Neurologie (G.D.), CHU de Caen; CRC SEP and Department of Neurology (A.-M.G.), CHU Bretonneau, Tours; Department of Neurology (N.M.), CHU La Milétrie, Poitiers; Department of Neurology (C. Labeyrie), CHU Bicêtre, Le Kremlin Bicêtre; Department of Neurology (I.P.), Hôpital Sud Francilien, Corbeil Essonnes; Department of Neurology (C.N.), CHU Versailles; Department of Neurology (O.C.), CHU de Grenoble; Ecole des Hautes Etudes en Santé Publique (E.L.), Rennes; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation (S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon/Bron; and INSERM (Y.F.), UMR 1246-SPHERE, Nantes University, Tours University, Nantes, France
| | - Laurent Magy
- From INSERM (D.-A.L., L.B.), CIC 0004, Nantes; CRTI-INSERM UMR U1064 (D.-A.L.), Université de Nantes; Service de Neurologie (D.-A.L., S.W., L. Michel), CHU Nantes; Centre des Neurosciences de Lyon (R.C., F.R., S.V.), Observatoire Français de la Sclérose en Plaques, INSERM 1028 and CNRS UMR5292, Lyon; Université Claude Bernard Lyon 1 (R.C., F.R., S.V.), Université de Lyon; Department of Neurology (M.D.), Nancy University Hospital; Université de Lorraine (M.D.), EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology and Clinical Investigation Center (J.D.S.), CHU de Strasbourg, INSERM 1434; Department of Neurology (D.B.), CHU de Toulouse; Service de Neurologie (B. Brochet), CHU de Bordeaux; Service de Neurologie (J.P.), Hôpital de la Timone, CRMBM, CNRS, APHM, Aix Marseille Univ, Marseille; Univ Lille (P.V.), CHU Lille, LIRIC (Lille Inflammation Research International Center), INSERM UMR995; Service de Neurologie (G.E., L. Michel), CHU de Rennes; CRCSEP Nice (C.L.-F.), Neurologie Pasteur 2, Université Nice Cote d'Azur, Nice; Service de Neurologie (P. Clavelou), CHU de Clermont-Ferrand; Service de Neurologie (E.T.), CHU de Nîmes; Department of Neurology (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; Service de Neurologie et Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; Service de Neurologie (B.S.), CHU Saint-Antoine; Service de Neurologie (A.A.K.), CHU d'Amiens; Service de Neurologie (P. Cabre), CHU de Fort de France; Service de Neurologie (C. Lubetzki, C.P.), CHU Pitié-Salpêtrière; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (T.D.), CH de Saint-Denis; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (O.G.), Fondation Rothschild; Service de Neurologie (B. Bourre), CHU de Rouen; Department of Neurology (A.W.), Hôpital Henri Mondor, Créteil; Service de Neurologie (P.L.), CHU de Montpellier; Service de Neurologie (L. Magy), CHU de Limoges; Service de Neurologie (G.D.), CHU de Caen; CRC SEP and Department of Neurology (A.-M.G.), CHU Bretonneau, Tours; Department of Neurology (N.M.), CHU La Milétrie, Poitiers; Department of Neurology (C. Labeyrie), CHU Bicêtre, Le Kremlin Bicêtre; Department of Neurology (I.P.), Hôpital Sud Francilien, Corbeil Essonnes; Department of Neurology (C.N.), CHU Versailles; Department of Neurology (O.C.), CHU de Grenoble; Ecole des Hautes Etudes en Santé Publique (E.L.), Rennes; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation (S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon/Bron; and INSERM (Y.F.), UMR 1246-SPHERE, Nantes University, Tours University, Nantes, France
| | - Gilles Defer
- From INSERM (D.-A.L., L.B.), CIC 0004, Nantes; CRTI-INSERM UMR U1064 (D.-A.L.), Université de Nantes; Service de Neurologie (D.-A.L., S.W., L. Michel), CHU Nantes; Centre des Neurosciences de Lyon (R.C., F.R., S.V.), Observatoire Français de la Sclérose en Plaques, INSERM 1028 and CNRS UMR5292, Lyon; Université Claude Bernard Lyon 1 (R.C., F.R., S.V.), Université de Lyon; Department of Neurology (M.D.), Nancy University Hospital; Université de Lorraine (M.D.), EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology and Clinical Investigation Center (J.D.S.), CHU de Strasbourg, INSERM 1434; Department of Neurology (D.B.), CHU de Toulouse; Service de Neurologie (B. Brochet), CHU de Bordeaux; Service de Neurologie (J.P.), Hôpital de la Timone, CRMBM, CNRS, APHM, Aix Marseille Univ, Marseille; Univ Lille (P.V.), CHU Lille, LIRIC (Lille Inflammation Research International Center), INSERM UMR995; Service de Neurologie (G.E., L. Michel), CHU de Rennes; CRCSEP Nice (C.L.-F.), Neurologie Pasteur 2, Université Nice Cote d'Azur, Nice; Service de Neurologie (P. Clavelou), CHU de Clermont-Ferrand; Service de Neurologie (E.T.), CHU de Nîmes; Department of Neurology (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; Service de Neurologie et Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; Service de Neurologie (B.S.), CHU Saint-Antoine; Service de Neurologie (A.A.K.), CHU d'Amiens; Service de Neurologie (P. Cabre), CHU de Fort de France; Service de Neurologie (C. Lubetzki, C.P.), CHU Pitié-Salpêtrière; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (T.D.), CH de Saint-Denis; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (O.G.), Fondation Rothschild; Service de Neurologie (B. Bourre), CHU de Rouen; Department of Neurology (A.W.), Hôpital Henri Mondor, Créteil; Service de Neurologie (P.L.), CHU de Montpellier; Service de Neurologie (L. Magy), CHU de Limoges; Service de Neurologie (G.D.), CHU de Caen; CRC SEP and Department of Neurology (A.-M.G.), CHU Bretonneau, Tours; Department of Neurology (N.M.), CHU La Milétrie, Poitiers; Department of Neurology (C. Labeyrie), CHU Bicêtre, Le Kremlin Bicêtre; Department of Neurology (I.P.), Hôpital Sud Francilien, Corbeil Essonnes; Department of Neurology (C.N.), CHU Versailles; Department of Neurology (O.C.), CHU de Grenoble; Ecole des Hautes Etudes en Santé Publique (E.L.), Rennes; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation (S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon/Bron; and INSERM (Y.F.), UMR 1246-SPHERE, Nantes University, Tours University, Nantes, France
| | - Anne-Marie Guennoc
- From INSERM (D.-A.L., L.B.), CIC 0004, Nantes; CRTI-INSERM UMR U1064 (D.-A.L.), Université de Nantes; Service de Neurologie (D.-A.L., S.W., L. Michel), CHU Nantes; Centre des Neurosciences de Lyon (R.C., F.R., S.V.), Observatoire Français de la Sclérose en Plaques, INSERM 1028 and CNRS UMR5292, Lyon; Université Claude Bernard Lyon 1 (R.C., F.R., S.V.), Université de Lyon; Department of Neurology (M.D.), Nancy University Hospital; Université de Lorraine (M.D.), EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology and Clinical Investigation Center (J.D.S.), CHU de Strasbourg, INSERM 1434; Department of Neurology (D.B.), CHU de Toulouse; Service de Neurologie (B. Brochet), CHU de Bordeaux; Service de Neurologie (J.P.), Hôpital de la Timone, CRMBM, CNRS, APHM, Aix Marseille Univ, Marseille; Univ Lille (P.V.), CHU Lille, LIRIC (Lille Inflammation Research International Center), INSERM UMR995; Service de Neurologie (G.E., L. Michel), CHU de Rennes; CRCSEP Nice (C.L.-F.), Neurologie Pasteur 2, Université Nice Cote d'Azur, Nice; Service de Neurologie (P. Clavelou), CHU de Clermont-Ferrand; Service de Neurologie (E.T.), CHU de Nîmes; Department of Neurology (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; Service de Neurologie et Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; Service de Neurologie (B.S.), CHU Saint-Antoine; Service de Neurologie (A.A.K.), CHU d'Amiens; Service de Neurologie (P. Cabre), CHU de Fort de France; Service de Neurologie (C. Lubetzki, C.P.), CHU Pitié-Salpêtrière; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (T.D.), CH de Saint-Denis; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (O.G.), Fondation Rothschild; Service de Neurologie (B. Bourre), CHU de Rouen; Department of Neurology (A.W.), Hôpital Henri Mondor, Créteil; Service de Neurologie (P.L.), CHU de Montpellier; Service de Neurologie (L. Magy), CHU de Limoges; Service de Neurologie (G.D.), CHU de Caen; CRC SEP and Department of Neurology (A.-M.G.), CHU Bretonneau, Tours; Department of Neurology (N.M.), CHU La Milétrie, Poitiers; Department of Neurology (C. Labeyrie), CHU Bicêtre, Le Kremlin Bicêtre; Department of Neurology (I.P.), Hôpital Sud Francilien, Corbeil Essonnes; Department of Neurology (C.N.), CHU Versailles; Department of Neurology (O.C.), CHU de Grenoble; Ecole des Hautes Etudes en Santé Publique (E.L.), Rennes; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation (S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon/Bron; and INSERM (Y.F.), UMR 1246-SPHERE, Nantes University, Tours University, Nantes, France
| | - Nicolas Maubeuge
- From INSERM (D.-A.L., L.B.), CIC 0004, Nantes; CRTI-INSERM UMR U1064 (D.-A.L.), Université de Nantes; Service de Neurologie (D.-A.L., S.W., L. Michel), CHU Nantes; Centre des Neurosciences de Lyon (R.C., F.R., S.V.), Observatoire Français de la Sclérose en Plaques, INSERM 1028 and CNRS UMR5292, Lyon; Université Claude Bernard Lyon 1 (R.C., F.R., S.V.), Université de Lyon; Department of Neurology (M.D.), Nancy University Hospital; Université de Lorraine (M.D.), EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology and Clinical Investigation Center (J.D.S.), CHU de Strasbourg, INSERM 1434; Department of Neurology (D.B.), CHU de Toulouse; Service de Neurologie (B. Brochet), CHU de Bordeaux; Service de Neurologie (J.P.), Hôpital de la Timone, CRMBM, CNRS, APHM, Aix Marseille Univ, Marseille; Univ Lille (P.V.), CHU Lille, LIRIC (Lille Inflammation Research International Center), INSERM UMR995; Service de Neurologie (G.E., L. Michel), CHU de Rennes; CRCSEP Nice (C.L.-F.), Neurologie Pasteur 2, Université Nice Cote d'Azur, Nice; Service de Neurologie (P. Clavelou), CHU de Clermont-Ferrand; Service de Neurologie (E.T.), CHU de Nîmes; Department of Neurology (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; Service de Neurologie et Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; Service de Neurologie (B.S.), CHU Saint-Antoine; Service de Neurologie (A.A.K.), CHU d'Amiens; Service de Neurologie (P. Cabre), CHU de Fort de France; Service de Neurologie (C. Lubetzki, C.P.), CHU Pitié-Salpêtrière; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (T.D.), CH de Saint-Denis; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (O.G.), Fondation Rothschild; Service de Neurologie (B. Bourre), CHU de Rouen; Department of Neurology (A.W.), Hôpital Henri Mondor, Créteil; Service de Neurologie (P.L.), CHU de Montpellier; Service de Neurologie (L. Magy), CHU de Limoges; Service de Neurologie (G.D.), CHU de Caen; CRC SEP and Department of Neurology (A.-M.G.), CHU Bretonneau, Tours; Department of Neurology (N.M.), CHU La Milétrie, Poitiers; Department of Neurology (C. Labeyrie), CHU Bicêtre, Le Kremlin Bicêtre; Department of Neurology (I.P.), Hôpital Sud Francilien, Corbeil Essonnes; Department of Neurology (C.N.), CHU Versailles; Department of Neurology (O.C.), CHU de Grenoble; Ecole des Hautes Etudes en Santé Publique (E.L.), Rennes; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation (S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon/Bron; and INSERM (Y.F.), UMR 1246-SPHERE, Nantes University, Tours University, Nantes, France
| | - Céline Labeyrie
- From INSERM (D.-A.L., L.B.), CIC 0004, Nantes; CRTI-INSERM UMR U1064 (D.-A.L.), Université de Nantes; Service de Neurologie (D.-A.L., S.W., L. Michel), CHU Nantes; Centre des Neurosciences de Lyon (R.C., F.R., S.V.), Observatoire Français de la Sclérose en Plaques, INSERM 1028 and CNRS UMR5292, Lyon; Université Claude Bernard Lyon 1 (R.C., F.R., S.V.), Université de Lyon; Department of Neurology (M.D.), Nancy University Hospital; Université de Lorraine (M.D.), EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology and Clinical Investigation Center (J.D.S.), CHU de Strasbourg, INSERM 1434; Department of Neurology (D.B.), CHU de Toulouse; Service de Neurologie (B. Brochet), CHU de Bordeaux; Service de Neurologie (J.P.), Hôpital de la Timone, CRMBM, CNRS, APHM, Aix Marseille Univ, Marseille; Univ Lille (P.V.), CHU Lille, LIRIC (Lille Inflammation Research International Center), INSERM UMR995; Service de Neurologie (G.E., L. Michel), CHU de Rennes; CRCSEP Nice (C.L.-F.), Neurologie Pasteur 2, Université Nice Cote d'Azur, Nice; Service de Neurologie (P. Clavelou), CHU de Clermont-Ferrand; Service de Neurologie (E.T.), CHU de Nîmes; Department of Neurology (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; Service de Neurologie et Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; Service de Neurologie (B.S.), CHU Saint-Antoine; Service de Neurologie (A.A.K.), CHU d'Amiens; Service de Neurologie (P. Cabre), CHU de Fort de France; Service de Neurologie (C. Lubetzki, C.P.), CHU Pitié-Salpêtrière; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (T.D.), CH de Saint-Denis; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (O.G.), Fondation Rothschild; Service de Neurologie (B. Bourre), CHU de Rouen; Department of Neurology (A.W.), Hôpital Henri Mondor, Créteil; Service de Neurologie (P.L.), CHU de Montpellier; Service de Neurologie (L. Magy), CHU de Limoges; Service de Neurologie (G.D.), CHU de Caen; CRC SEP and Department of Neurology (A.-M.G.), CHU Bretonneau, Tours; Department of Neurology (N.M.), CHU La Milétrie, Poitiers; Department of Neurology (C. Labeyrie), CHU Bicêtre, Le Kremlin Bicêtre; Department of Neurology (I.P.), Hôpital Sud Francilien, Corbeil Essonnes; Department of Neurology (C.N.), CHU Versailles; Department of Neurology (O.C.), CHU de Grenoble; Ecole des Hautes Etudes en Santé Publique (E.L.), Rennes; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation (S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon/Bron; and INSERM (Y.F.), UMR 1246-SPHERE, Nantes University, Tours University, Nantes, France
| | - Ivania Patry
- From INSERM (D.-A.L., L.B.), CIC 0004, Nantes; CRTI-INSERM UMR U1064 (D.-A.L.), Université de Nantes; Service de Neurologie (D.-A.L., S.W., L. Michel), CHU Nantes; Centre des Neurosciences de Lyon (R.C., F.R., S.V.), Observatoire Français de la Sclérose en Plaques, INSERM 1028 and CNRS UMR5292, Lyon; Université Claude Bernard Lyon 1 (R.C., F.R., S.V.), Université de Lyon; Department of Neurology (M.D.), Nancy University Hospital; Université de Lorraine (M.D.), EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology and Clinical Investigation Center (J.D.S.), CHU de Strasbourg, INSERM 1434; Department of Neurology (D.B.), CHU de Toulouse; Service de Neurologie (B. Brochet), CHU de Bordeaux; Service de Neurologie (J.P.), Hôpital de la Timone, CRMBM, CNRS, APHM, Aix Marseille Univ, Marseille; Univ Lille (P.V.), CHU Lille, LIRIC (Lille Inflammation Research International Center), INSERM UMR995; Service de Neurologie (G.E., L. Michel), CHU de Rennes; CRCSEP Nice (C.L.-F.), Neurologie Pasteur 2, Université Nice Cote d'Azur, Nice; Service de Neurologie (P. Clavelou), CHU de Clermont-Ferrand; Service de Neurologie (E.T.), CHU de Nîmes; Department of Neurology (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; Service de Neurologie et Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; Service de Neurologie (B.S.), CHU Saint-Antoine; Service de Neurologie (A.A.K.), CHU d'Amiens; Service de Neurologie (P. Cabre), CHU de Fort de France; Service de Neurologie (C. Lubetzki, C.P.), CHU Pitié-Salpêtrière; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (T.D.), CH de Saint-Denis; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (O.G.), Fondation Rothschild; Service de Neurologie (B. Bourre), CHU de Rouen; Department of Neurology (A.W.), Hôpital Henri Mondor, Créteil; Service de Neurologie (P.L.), CHU de Montpellier; Service de Neurologie (L. Magy), CHU de Limoges; Service de Neurologie (G.D.), CHU de Caen; CRC SEP and Department of Neurology (A.-M.G.), CHU Bretonneau, Tours; Department of Neurology (N.M.), CHU La Milétrie, Poitiers; Department of Neurology (C. Labeyrie), CHU Bicêtre, Le Kremlin Bicêtre; Department of Neurology (I.P.), Hôpital Sud Francilien, Corbeil Essonnes; Department of Neurology (C.N.), CHU Versailles; Department of Neurology (O.C.), CHU de Grenoble; Ecole des Hautes Etudes en Santé Publique (E.L.), Rennes; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation (S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon/Bron; and INSERM (Y.F.), UMR 1246-SPHERE, Nantes University, Tours University, Nantes, France
| | - Chantal Nifle
- From INSERM (D.-A.L., L.B.), CIC 0004, Nantes; CRTI-INSERM UMR U1064 (D.-A.L.), Université de Nantes; Service de Neurologie (D.-A.L., S.W., L. Michel), CHU Nantes; Centre des Neurosciences de Lyon (R.C., F.R., S.V.), Observatoire Français de la Sclérose en Plaques, INSERM 1028 and CNRS UMR5292, Lyon; Université Claude Bernard Lyon 1 (R.C., F.R., S.V.), Université de Lyon; Department of Neurology (M.D.), Nancy University Hospital; Université de Lorraine (M.D.), EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology and Clinical Investigation Center (J.D.S.), CHU de Strasbourg, INSERM 1434; Department of Neurology (D.B.), CHU de Toulouse; Service de Neurologie (B. Brochet), CHU de Bordeaux; Service de Neurologie (J.P.), Hôpital de la Timone, CRMBM, CNRS, APHM, Aix Marseille Univ, Marseille; Univ Lille (P.V.), CHU Lille, LIRIC (Lille Inflammation Research International Center), INSERM UMR995; Service de Neurologie (G.E., L. Michel), CHU de Rennes; CRCSEP Nice (C.L.-F.), Neurologie Pasteur 2, Université Nice Cote d'Azur, Nice; Service de Neurologie (P. Clavelou), CHU de Clermont-Ferrand; Service de Neurologie (E.T.), CHU de Nîmes; Department of Neurology (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; Service de Neurologie et Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; Service de Neurologie (B.S.), CHU Saint-Antoine; Service de Neurologie (A.A.K.), CHU d'Amiens; Service de Neurologie (P. Cabre), CHU de Fort de France; Service de Neurologie (C. Lubetzki, C.P.), CHU Pitié-Salpêtrière; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (T.D.), CH de Saint-Denis; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (O.G.), Fondation Rothschild; Service de Neurologie (B. Bourre), CHU de Rouen; Department of Neurology (A.W.), Hôpital Henri Mondor, Créteil; Service de Neurologie (P.L.), CHU de Montpellier; Service de Neurologie (L. Magy), CHU de Limoges; Service de Neurologie (G.D.), CHU de Caen; CRC SEP and Department of Neurology (A.-M.G.), CHU Bretonneau, Tours; Department of Neurology (N.M.), CHU La Milétrie, Poitiers; Department of Neurology (C. Labeyrie), CHU Bicêtre, Le Kremlin Bicêtre; Department of Neurology (I.P.), Hôpital Sud Francilien, Corbeil Essonnes; Department of Neurology (C.N.), CHU Versailles; Department of Neurology (O.C.), CHU de Grenoble; Ecole des Hautes Etudes en Santé Publique (E.L.), Rennes; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation (S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon/Bron; and INSERM (Y.F.), UMR 1246-SPHERE, Nantes University, Tours University, Nantes, France
| | - Olivier Casez
- From INSERM (D.-A.L., L.B.), CIC 0004, Nantes; CRTI-INSERM UMR U1064 (D.-A.L.), Université de Nantes; Service de Neurologie (D.-A.L., S.W., L. Michel), CHU Nantes; Centre des Neurosciences de Lyon (R.C., F.R., S.V.), Observatoire Français de la Sclérose en Plaques, INSERM 1028 and CNRS UMR5292, Lyon; Université Claude Bernard Lyon 1 (R.C., F.R., S.V.), Université de Lyon; Department of Neurology (M.D.), Nancy University Hospital; Université de Lorraine (M.D.), EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology and Clinical Investigation Center (J.D.S.), CHU de Strasbourg, INSERM 1434; Department of Neurology (D.B.), CHU de Toulouse; Service de Neurologie (B. Brochet), CHU de Bordeaux; Service de Neurologie (J.P.), Hôpital de la Timone, CRMBM, CNRS, APHM, Aix Marseille Univ, Marseille; Univ Lille (P.V.), CHU Lille, LIRIC (Lille Inflammation Research International Center), INSERM UMR995; Service de Neurologie (G.E., L. Michel), CHU de Rennes; CRCSEP Nice (C.L.-F.), Neurologie Pasteur 2, Université Nice Cote d'Azur, Nice; Service de Neurologie (P. Clavelou), CHU de Clermont-Ferrand; Service de Neurologie (E.T.), CHU de Nîmes; Department of Neurology (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; Service de Neurologie et Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; Service de Neurologie (B.S.), CHU Saint-Antoine; Service de Neurologie (A.A.K.), CHU d'Amiens; Service de Neurologie (P. Cabre), CHU de Fort de France; Service de Neurologie (C. Lubetzki, C.P.), CHU Pitié-Salpêtrière; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (T.D.), CH de Saint-Denis; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (O.G.), Fondation Rothschild; Service de Neurologie (B. Bourre), CHU de Rouen; Department of Neurology (A.W.), Hôpital Henri Mondor, Créteil; Service de Neurologie (P.L.), CHU de Montpellier; Service de Neurologie (L. Magy), CHU de Limoges; Service de Neurologie (G.D.), CHU de Caen; CRC SEP and Department of Neurology (A.-M.G.), CHU Bretonneau, Tours; Department of Neurology (N.M.), CHU La Milétrie, Poitiers; Department of Neurology (C. Labeyrie), CHU Bicêtre, Le Kremlin Bicêtre; Department of Neurology (I.P.), Hôpital Sud Francilien, Corbeil Essonnes; Department of Neurology (C.N.), CHU Versailles; Department of Neurology (O.C.), CHU de Grenoble; Ecole des Hautes Etudes en Santé Publique (E.L.), Rennes; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation (S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon/Bron; and INSERM (Y.F.), UMR 1246-SPHERE, Nantes University, Tours University, Nantes, France
| | - Laure Michel
- From INSERM (D.-A.L., L.B.), CIC 0004, Nantes; CRTI-INSERM UMR U1064 (D.-A.L.), Université de Nantes; Service de Neurologie (D.-A.L., S.W., L. Michel), CHU Nantes; Centre des Neurosciences de Lyon (R.C., F.R., S.V.), Observatoire Français de la Sclérose en Plaques, INSERM 1028 and CNRS UMR5292, Lyon; Université Claude Bernard Lyon 1 (R.C., F.R., S.V.), Université de Lyon; Department of Neurology (M.D.), Nancy University Hospital; Université de Lorraine (M.D.), EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology and Clinical Investigation Center (J.D.S.), CHU de Strasbourg, INSERM 1434; Department of Neurology (D.B.), CHU de Toulouse; Service de Neurologie (B. Brochet), CHU de Bordeaux; Service de Neurologie (J.P.), Hôpital de la Timone, CRMBM, CNRS, APHM, Aix Marseille Univ, Marseille; Univ Lille (P.V.), CHU Lille, LIRIC (Lille Inflammation Research International Center), INSERM UMR995; Service de Neurologie (G.E., L. Michel), CHU de Rennes; CRCSEP Nice (C.L.-F.), Neurologie Pasteur 2, Université Nice Cote d'Azur, Nice; Service de Neurologie (P. Clavelou), CHU de Clermont-Ferrand; Service de Neurologie (E.T.), CHU de Nîmes; Department of Neurology (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; Service de Neurologie et Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; Service de Neurologie (B.S.), CHU Saint-Antoine; Service de Neurologie (A.A.K.), CHU d'Amiens; Service de Neurologie (P. Cabre), CHU de Fort de France; Service de Neurologie (C. Lubetzki, C.P.), CHU Pitié-Salpêtrière; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (T.D.), CH de Saint-Denis; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (O.G.), Fondation Rothschild; Service de Neurologie (B. Bourre), CHU de Rouen; Department of Neurology (A.W.), Hôpital Henri Mondor, Créteil; Service de Neurologie (P.L.), CHU de Montpellier; Service de Neurologie (L. Magy), CHU de Limoges; Service de Neurologie (G.D.), CHU de Caen; CRC SEP and Department of Neurology (A.-M.G.), CHU Bretonneau, Tours; Department of Neurology (N.M.), CHU La Milétrie, Poitiers; Department of Neurology (C. Labeyrie), CHU Bicêtre, Le Kremlin Bicêtre; Department of Neurology (I.P.), Hôpital Sud Francilien, Corbeil Essonnes; Department of Neurology (C.N.), CHU Versailles; Department of Neurology (O.C.), CHU de Grenoble; Ecole des Hautes Etudes en Santé Publique (E.L.), Rennes; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation (S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon/Bron; and INSERM (Y.F.), UMR 1246-SPHERE, Nantes University, Tours University, Nantes, France
| | - Fabien Rollot
- From INSERM (D.-A.L., L.B.), CIC 0004, Nantes; CRTI-INSERM UMR U1064 (D.-A.L.), Université de Nantes; Service de Neurologie (D.-A.L., S.W., L. Michel), CHU Nantes; Centre des Neurosciences de Lyon (R.C., F.R., S.V.), Observatoire Français de la Sclérose en Plaques, INSERM 1028 and CNRS UMR5292, Lyon; Université Claude Bernard Lyon 1 (R.C., F.R., S.V.), Université de Lyon; Department of Neurology (M.D.), Nancy University Hospital; Université de Lorraine (M.D.), EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology and Clinical Investigation Center (J.D.S.), CHU de Strasbourg, INSERM 1434; Department of Neurology (D.B.), CHU de Toulouse; Service de Neurologie (B. Brochet), CHU de Bordeaux; Service de Neurologie (J.P.), Hôpital de la Timone, CRMBM, CNRS, APHM, Aix Marseille Univ, Marseille; Univ Lille (P.V.), CHU Lille, LIRIC (Lille Inflammation Research International Center), INSERM UMR995; Service de Neurologie (G.E., L. Michel), CHU de Rennes; CRCSEP Nice (C.L.-F.), Neurologie Pasteur 2, Université Nice Cote d'Azur, Nice; Service de Neurologie (P. Clavelou), CHU de Clermont-Ferrand; Service de Neurologie (E.T.), CHU de Nîmes; Department of Neurology (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; Service de Neurologie et Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; Service de Neurologie (B.S.), CHU Saint-Antoine; Service de Neurologie (A.A.K.), CHU d'Amiens; Service de Neurologie (P. Cabre), CHU de Fort de France; Service de Neurologie (C. Lubetzki, C.P.), CHU Pitié-Salpêtrière; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (T.D.), CH de Saint-Denis; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (O.G.), Fondation Rothschild; Service de Neurologie (B. Bourre), CHU de Rouen; Department of Neurology (A.W.), Hôpital Henri Mondor, Créteil; Service de Neurologie (P.L.), CHU de Montpellier; Service de Neurologie (L. Magy), CHU de Limoges; Service de Neurologie (G.D.), CHU de Caen; CRC SEP and Department of Neurology (A.-M.G.), CHU Bretonneau, Tours; Department of Neurology (N.M.), CHU La Milétrie, Poitiers; Department of Neurology (C. Labeyrie), CHU Bicêtre, Le Kremlin Bicêtre; Department of Neurology (I.P.), Hôpital Sud Francilien, Corbeil Essonnes; Department of Neurology (C.N.), CHU Versailles; Department of Neurology (O.C.), CHU de Grenoble; Ecole des Hautes Etudes en Santé Publique (E.L.), Rennes; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation (S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon/Bron; and INSERM (Y.F.), UMR 1246-SPHERE, Nantes University, Tours University, Nantes, France
| | - Emmanuelle Leray
- From INSERM (D.-A.L., L.B.), CIC 0004, Nantes; CRTI-INSERM UMR U1064 (D.-A.L.), Université de Nantes; Service de Neurologie (D.-A.L., S.W., L. Michel), CHU Nantes; Centre des Neurosciences de Lyon (R.C., F.R., S.V.), Observatoire Français de la Sclérose en Plaques, INSERM 1028 and CNRS UMR5292, Lyon; Université Claude Bernard Lyon 1 (R.C., F.R., S.V.), Université de Lyon; Department of Neurology (M.D.), Nancy University Hospital; Université de Lorraine (M.D.), EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology and Clinical Investigation Center (J.D.S.), CHU de Strasbourg, INSERM 1434; Department of Neurology (D.B.), CHU de Toulouse; Service de Neurologie (B. Brochet), CHU de Bordeaux; Service de Neurologie (J.P.), Hôpital de la Timone, CRMBM, CNRS, APHM, Aix Marseille Univ, Marseille; Univ Lille (P.V.), CHU Lille, LIRIC (Lille Inflammation Research International Center), INSERM UMR995; Service de Neurologie (G.E., L. Michel), CHU de Rennes; CRCSEP Nice (C.L.-F.), Neurologie Pasteur 2, Université Nice Cote d'Azur, Nice; Service de Neurologie (P. Clavelou), CHU de Clermont-Ferrand; Service de Neurologie (E.T.), CHU de Nîmes; Department of Neurology (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; Service de Neurologie et Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; Service de Neurologie (B.S.), CHU Saint-Antoine; Service de Neurologie (A.A.K.), CHU d'Amiens; Service de Neurologie (P. Cabre), CHU de Fort de France; Service de Neurologie (C. Lubetzki, C.P.), CHU Pitié-Salpêtrière; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (T.D.), CH de Saint-Denis; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (O.G.), Fondation Rothschild; Service de Neurologie (B. Bourre), CHU de Rouen; Department of Neurology (A.W.), Hôpital Henri Mondor, Créteil; Service de Neurologie (P.L.), CHU de Montpellier; Service de Neurologie (L. Magy), CHU de Limoges; Service de Neurologie (G.D.), CHU de Caen; CRC SEP and Department of Neurology (A.-M.G.), CHU Bretonneau, Tours; Department of Neurology (N.M.), CHU La Milétrie, Poitiers; Department of Neurology (C. Labeyrie), CHU Bicêtre, Le Kremlin Bicêtre; Department of Neurology (I.P.), Hôpital Sud Francilien, Corbeil Essonnes; Department of Neurology (C.N.), CHU Versailles; Department of Neurology (O.C.), CHU de Grenoble; Ecole des Hautes Etudes en Santé Publique (E.L.), Rennes; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation (S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon/Bron; and INSERM (Y.F.), UMR 1246-SPHERE, Nantes University, Tours University, Nantes, France
| | - Sandra Vukusic
- From INSERM (D.-A.L., L.B.), CIC 0004, Nantes; CRTI-INSERM UMR U1064 (D.-A.L.), Université de Nantes; Service de Neurologie (D.-A.L., S.W., L. Michel), CHU Nantes; Centre des Neurosciences de Lyon (R.C., F.R., S.V.), Observatoire Français de la Sclérose en Plaques, INSERM 1028 and CNRS UMR5292, Lyon; Université Claude Bernard Lyon 1 (R.C., F.R., S.V.), Université de Lyon; Department of Neurology (M.D.), Nancy University Hospital; Université de Lorraine (M.D.), EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology and Clinical Investigation Center (J.D.S.), CHU de Strasbourg, INSERM 1434; Department of Neurology (D.B.), CHU de Toulouse; Service de Neurologie (B. Brochet), CHU de Bordeaux; Service de Neurologie (J.P.), Hôpital de la Timone, CRMBM, CNRS, APHM, Aix Marseille Univ, Marseille; Univ Lille (P.V.), CHU Lille, LIRIC (Lille Inflammation Research International Center), INSERM UMR995; Service de Neurologie (G.E., L. Michel), CHU de Rennes; CRCSEP Nice (C.L.-F.), Neurologie Pasteur 2, Université Nice Cote d'Azur, Nice; Service de Neurologie (P. Clavelou), CHU de Clermont-Ferrand; Service de Neurologie (E.T.), CHU de Nîmes; Department of Neurology (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; Service de Neurologie et Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; Service de Neurologie (B.S.), CHU Saint-Antoine; Service de Neurologie (A.A.K.), CHU d'Amiens; Service de Neurologie (P. Cabre), CHU de Fort de France; Service de Neurologie (C. Lubetzki, C.P.), CHU Pitié-Salpêtrière; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (T.D.), CH de Saint-Denis; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (O.G.), Fondation Rothschild; Service de Neurologie (B. Bourre), CHU de Rouen; Department of Neurology (A.W.), Hôpital Henri Mondor, Créteil; Service de Neurologie (P.L.), CHU de Montpellier; Service de Neurologie (L. Magy), CHU de Limoges; Service de Neurologie (G.D.), CHU de Caen; CRC SEP and Department of Neurology (A.-M.G.), CHU Bretonneau, Tours; Department of Neurology (N.M.), CHU La Milétrie, Poitiers; Department of Neurology (C. Labeyrie), CHU Bicêtre, Le Kremlin Bicêtre; Department of Neurology (I.P.), Hôpital Sud Francilien, Corbeil Essonnes; Department of Neurology (C.N.), CHU Versailles; Department of Neurology (O.C.), CHU de Grenoble; Ecole des Hautes Etudes en Santé Publique (E.L.), Rennes; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation (S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon/Bron; and INSERM (Y.F.), UMR 1246-SPHERE, Nantes University, Tours University, Nantes, France
| | - Yohann Foucher
- From INSERM (D.-A.L., L.B.), CIC 0004, Nantes; CRTI-INSERM UMR U1064 (D.-A.L.), Université de Nantes; Service de Neurologie (D.-A.L., S.W., L. Michel), CHU Nantes; Centre des Neurosciences de Lyon (R.C., F.R., S.V.), Observatoire Français de la Sclérose en Plaques, INSERM 1028 and CNRS UMR5292, Lyon; Université Claude Bernard Lyon 1 (R.C., F.R., S.V.), Université de Lyon; Department of Neurology (M.D.), Nancy University Hospital; Université de Lorraine (M.D.), EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology and Clinical Investigation Center (J.D.S.), CHU de Strasbourg, INSERM 1434; Department of Neurology (D.B.), CHU de Toulouse; Service de Neurologie (B. Brochet), CHU de Bordeaux; Service de Neurologie (J.P.), Hôpital de la Timone, CRMBM, CNRS, APHM, Aix Marseille Univ, Marseille; Univ Lille (P.V.), CHU Lille, LIRIC (Lille Inflammation Research International Center), INSERM UMR995; Service de Neurologie (G.E., L. Michel), CHU de Rennes; CRCSEP Nice (C.L.-F.), Neurologie Pasteur 2, Université Nice Cote d'Azur, Nice; Service de Neurologie (P. Clavelou), CHU de Clermont-Ferrand; Service de Neurologie (E.T.), CHU de Nîmes; Department of Neurology (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; Service de Neurologie et Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; Service de Neurologie (B.S.), CHU Saint-Antoine; Service de Neurologie (A.A.K.), CHU d'Amiens; Service de Neurologie (P. Cabre), CHU de Fort de France; Service de Neurologie (C. Lubetzki, C.P.), CHU Pitié-Salpêtrière; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (T.D.), CH de Saint-Denis; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (O.G.), Fondation Rothschild; Service de Neurologie (B. Bourre), CHU de Rouen; Department of Neurology (A.W.), Hôpital Henri Mondor, Créteil; Service de Neurologie (P.L.), CHU de Montpellier; Service de Neurologie (L. Magy), CHU de Limoges; Service de Neurologie (G.D.), CHU de Caen; CRC SEP and Department of Neurology (A.-M.G.), CHU Bretonneau, Tours; Department of Neurology (N.M.), CHU La Milétrie, Poitiers; Department of Neurology (C. Labeyrie), CHU Bicêtre, Le Kremlin Bicêtre; Department of Neurology (I.P.), Hôpital Sud Francilien, Corbeil Essonnes; Department of Neurology (C.N.), CHU Versailles; Department of Neurology (O.C.), CHU de Grenoble; Ecole des Hautes Etudes en Santé Publique (E.L.), Rennes; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation (S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon/Bron; and INSERM (Y.F.), UMR 1246-SPHERE, Nantes University, Tours University, Nantes, France
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Mariani LL, Doulazmi M, Chaigneau V, Brefel-Courbon C, Carrière N, Danaila T, Defebvre L, Defer G, Dellapina E, Doé de Maindreville A, Geny C, Maltête D, Meissner WG, Rascol O, Thobois S, Torny F, Tranchant C, Vidailhet M, Corvol JC, Degos B. Descriptive analysis of the French NS-Park registry: Towards a nation-wide Parkinson's disease cohort? Parkinsonism Relat Disord 2019; 64:226-234. [PMID: 31047798 DOI: 10.1016/j.parkreldis.2019.04.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 04/07/2019] [Accepted: 04/15/2019] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Parkinson's disease (PD) is the second most common neurodegenerative disorder after Alzheimer's. The French clinical research network for PD (NS-Park) has created a national patient registry to i)report medical activity of Parkinson Expert Centers (PECs) to the Ministry of Health, ii)facilitate PD patients pre-screening for clinical trials, iii) provide a source for pharmaco-epidemiology studies. OBJECTIVE Assess the French Parkinsonian population at a nation-wide level and discover new clinical characteristics. METHODS In this feasibility study, PECs prospectively collected clinical data in a standardized manner. The population main clinical characteristics are described, focusing on motor and non-motor symptoms and treatments, assessing its representativeness. By using an unbiased clustering with multiple correspondence analysis (MCA), we also investigate potential relationships between multiple variables like symptoms and treatments, as clues for future studies. RESULTS Between 2012 and 2016, among 11,157 included parkinsonian syndromes, 9454 (85%) had PD. MCA identified various profiles depending on disease duration. Occurrences of motor complications, axial signs, cognitive disorders and Levodopa use increase over time. Neurovegetative symptoms, psychiatric disorders, sleep disturbances and impulse control disorders (ICDs) seem stable over time. As expected, ICDs were associated to dopaminergic agonist use but other associations, such as ICDs and sleep disturbances for instance, or anxiety and depression, were found. CONCLUSIONS Our results report one of the biggest PD registries ever reported and demonstrate the feasibility of implementing a nation-wide registry of PD patients in France, a potent tool for future longitudinal studies and clinical trials' population selection, and for pharmaco-epidemiology and cost-effectiveness studies.
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Affiliation(s)
- Louise-Laure Mariani
- Sorbonne Université, Assistance Publique Hôpitaux de Paris, Institut du Cerveau et de la Moelle épinière, ICM, Inserm U 1127, CNRS UMR 7225, Department of Neurology, Hôpital Pitié-Salpêtrière, F-75013, Paris, France
| | - Mohamed Doulazmi
- Sorbonne University, CNRS, Institut de Biologie Paris Seine, Adaptation Biologique et Vieillissement, UMR8256, Paris, France
| | - Véronique Chaigneau
- Inserm, Université de Toulouse 3, CHU de Toulouse, NS-Park/F-CRIN Network, Toulouse, France
| | | | - Nicolas Carrière
- Lille University, Inserm 1171, Movement Disorders Department, Lille, France
| | - Teodor Danaila
- Faculté de Médecine Lyon Sud Charles Mérieux, Université Lyon 1, Université de Lyon, Department of Neurology C, Parkinson Expert Center, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon, France
| | - Luc Defebvre
- Lille University, Inserm 1171, Movement Disorders Department, Lille, France
| | - Gilles Defer
- Department of Neurology, Caen University-Hospital, Normandie University, Caen, France
| | - Estelle Dellapina
- Inserm, Université de Toulouse 3, CHU de Toulouse, NS-Park/F-CRIN Network, Toulouse, France
| | | | - Christian Geny
- EuroMov, Univ. Montpellier, Montpellier, France; Department of Neurology, CHRU Montpellier, Montpellier, France
| | - David Maltête
- Department of Neurology, Rouen University Hospital and University of Rouen, France; INSERM U1239, Laboratory of Neuronal and Neuroendocrine Differentiation and Communication, Mont-Saint-Aignan, France
| | - Wassilios G Meissner
- Department of Neurology, Hôpital Pellegrin, CHU de Bordeaux, 33000, Bordeaux, France; Univ. de Bordeaux, Institut des Maladies Neurodégénératives, CNRS UMR 5293, 33000, Bordeaux, France
| | - Olivier Rascol
- CHU de Toulouse, INSERM, Université de Toulouse3, Centre d'Investigation Clinique CIC1436, Départements de Neurosciences et de Pharmacologie Clinique, Centre Expert Parkinson de Toulouse, NS-Park/F-CRIN Network, NeuroToul CoEN Center, Toulouse, France
| | - Stéphane Thobois
- Faculté de Médecine Lyon Sud Charles Mérieux, Université Lyon 1, Université de Lyon, Department of Neurology C, Parkinson Expert Center, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon, France
| | - Frederic Torny
- Department of Neurology, Hôpital Dupuytren, CHU de Limoges, 87042, Limoges Cedex, France
| | - Christine Tranchant
- Department of Neurology, Hopitaux Universitaires, Strasbourg, France; IGBMC, INSERM-U964, CNRS- UMR 7104, Université de Strasbourg, Illkirch, France; Fédération de Médecine Translationnelle de Strasbourg, Université de Strasbourg, France
| | - Marie Vidailhet
- Sorbonne Université, Assistance Publique Hôpitaux de Paris, Institut du Cerveau et de la Moelle épinière, ICM, Inserm U 1127, CNRS UMR 7225, Department of Neurology, Hôpital Pitié-Salpêtrière, F-75013, Paris, France
| | - Jean-Christophe Corvol
- Sorbonne Université, Assistance Publique Hôpitaux de Paris, Institut du Cerveau et de la Moelle épinière, ICM, Inserm U 1127, CNRS UMR 7225, Department of Neurology, Hôpital Pitié-Salpêtrière, F-75013, Paris, France
| | - Bertrand Degos
- Sorbonne Université, Assistance Publique Hôpitaux de Paris, Institut du Cerveau et de la Moelle épinière, ICM, Inserm U 1127, CNRS UMR 7225, Department of Neurology, Hôpital Pitié-Salpêtrière, F-75013, Paris, France; Center for Interdisciplinary Research in Biology, Collège de France, INSERM U1050, CNRS UMR7241, Labex Memolife, Paris Sciences et Lettres, Paris, France; AP-HP, Department of Neurology, Hôpital Avicenne, Hôpitaux Universitaires de Paris - Seine Saint Denis, Bobigny, France.
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Defer G. Histoire de la pharmacovigilance. Rev Neurol (Paris) 2019. [DOI: 10.1016/j.neurol.2019.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Pignolet B, Biotti D, De Seze J, Brochet B, Debouverie M, Defer G, Hautecoeur P, Labauge P, Clavelou P, Pelletier J, Laplaud DA, Vermersch P, Lebrun-Frenay C, Thouvenot E, Brassat D. Existe-t-il un biomarqueur universel sanguin de réponse aux traitements dans la sclérose en plaques ? Étude UBITMUS (Universal BIomarker of Treatment in MS). Rev Neurol (Paris) 2019. [DOI: 10.1016/j.neurol.2019.01.265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Defer G, de Seze J, Bouee S, Courouve L, Longin J, Payet M, Deleglise AJ. Outcomes and treatment management of a French cohort suffering from multiple sclerosis: A retrospective epidemiological study. Mult Scler Relat Disord 2018; 25:276-281. [DOI: 10.1016/j.msard.2018.08.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Revised: 07/13/2018] [Accepted: 08/03/2018] [Indexed: 11/26/2022]
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Harand C, Mondou A, Chevanne D, Bocca ML, Defer G. Evidence of attentional impairments using virtual driving simulation in multiple sclerosis. Mult Scler Relat Disord 2018; 25:251-257. [PMID: 30144695 DOI: 10.1016/j.msard.2018.08.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Accepted: 08/03/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Detection of attentional disorders in complex situation related to daily life activities in multiple sclerosis patients needs better adapted tools than traditional cognitive assessment. OBJECTIVE To investigate the usefulness of virtual reality assessment of attention in multiple sclerosis, especially to evaluate alertness and divided attention using driving simulation. METHODS In this preliminary study, 11 relapsing-remitting patients (median EDSS: 2; mean disease duration of 10.3 years) and 11 healthy matched controls performed a driving simulation under three conditions (monotonous driving, divided attention driving and urban driving) where Standard Deviation of Lateral position (SDLP) was the main evaluated criteria. In comparison, traditional cognitive assessment of attentional functions was administered (SDMT, alertness and divided attention of TAP battery). Statistical non-parametric Mann-Whitney U tests were used to compare performances between groups in the two types of assessments. Exploratory correlational analyses were further conducted. RESULTS No significant difference was observed between groups for traditional attentional assessment except for information processing speed (SDMT; p < 0.01). Considering virtual reality, patients were less efficient than controls on the primary parameter of safe driving (SDLP; p < 0.05). They also committed more errors and omissions (p < 0.01) and speed fluctuations (p < 0.01) during the divided-attention driving condition. Urban driving did not reveal difference between groups. Lack of significant correlations between traditional and virtual reality attentional assessment suggested that they do not evaluate the same cognitive processes. CONCLUSION Patients experienced difficulties in maintaining the trajectory and the speed of the simulated vehicle which may be indicative of attentional difficulties, especially alertness and divided attention. These impairments were not revealed by the traditional cognitive assessment. Results of this preliminary study shed new light about the usefulness of virtual reality techniques and their future interest as a part of cognitive rehabilitation programs. They also highlights the need to develop driving preventive measures in MS.
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Affiliation(s)
- C Harand
- Department of Neurology, Caen University Hospital Centre, Avenue de la Côte de Nacre, CS 30001, 14033 Caen Cedex 9, France; Centre de Ressources et de Compétences SEP, 14000 Caen, France.
| | - A Mondou
- Department of Neurology, Caen University Hospital Centre, Avenue de la Côte de Nacre, CS 30001, 14033 Caen Cedex 9, France; Centre de Ressources et de Compétences SEP, 14000 Caen, France
| | - D Chevanne
- Department of Neurology, Caen University Hospital Centre, Avenue de la Côte de Nacre, CS 30001, 14033 Caen Cedex 9, France; Centre de Ressources et de Compétences SEP, 14000 Caen, France
| | - M L Bocca
- Normandie University, UNICAEN, INSERM, U1075, COMETE, 14000 Caen, France
| | - G Defer
- Department of Neurology, Caen University Hospital Centre, Avenue de la Côte de Nacre, CS 30001, 14033 Caen Cedex 9, France; Centre de Ressources et de Compétences SEP, 14000 Caen, France; Réseau Bas-Normand Pour la Prise en Charge de la SEP, 14000 Caen, France
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