Characteristics of Switchers to Newer Therapies in the NARCOMS Registry (P3.282)
Bibliographic record
Abstract
Background: The North American Research Committee on Multiple Sclerosis Registry (NARCOMS) captures self-reported disease modifying therapy (DMT) information and patient-reported outcomes from persons with MS. Previous reports show that those who remain on the same DMT report less disease worsening than those who switch. Objective: Assess characteristics of persons with MS who switch from an parenteral DMT [interferon beta (-1a IM, -1a SC, -1b), glatiramer acetate, natalizumab] to an oral DMT [dimethyl fumarate (DMF), fingolimod (FIN), teriflunomide (TF)]. Methods: US residents who reported a switch from a parenteral DMT to an oral DMT in Spring or Fall survey in 2011-2013 were included in the analysis. Switching to DMF/TF was not captured until Fall 2012. We compared socio-demographic factors, Patient Determined Disease Steps (PDDS) as a measure of disability, and relapse activity as reported at the time of the switch and 6 months later. Results are reported as mean (SD), median (IQR) or [percnt], as applicable. Results: 595 registry participants indicated switching to FIN (n=278), DMF (n=238) or TF (n=79) from a parenteral DMT from 2011-2013. Switchers were 81.7[percnt] female, 51.6(9.8) years old, with mean disease duration of 14.6(8.4) years and 97.9[percnt] had health insurance. Median PDDS of switchers was 3(1, 5), with only 16.8[percnt] reporting PDDS worsening of at least 1 point as compared to 6 months before the switch. Relapse during the 6 months before the switch was reported by 26.1[percnt] and symptom worsening by 35.0[percnt] of the switchers, while 4.7[percnt] (23/486) reported a relapse in the prior 6 months. Conclusion: Follow-up on those taking the oral DMTs provides important information on switching behavior. Most participants that switched reported worsening in PDDS, symptom worsening, and/or switched following relapses. Patient-reported outcomes provide a practical way of describing disease activity and comparing switchers with those remaining on an established DMT.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.007 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".