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Multiple sclerosis outcomes after cancer diagnosis in people with recorded chemotherapy exposure: A real-world MSBase study
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DOI：10.1177/13524585261460658.png)
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Abstract
En 中文
<jats:sec>
<jats:title>Background and objective:</jats:title>
<jats:p>As more people with multiple sclerosis (MS) survive cancer, questions about MS management after cancer are increasingly relevant. This study aimed to describe post-cancer treatment patterns and MS outcomes in people with recorded chemotherapy exposure.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Methods:</jats:title>
<jats:p>Using MSBase, we identified people with MS with cancer and chemotherapy exposure. Time to first relapse and 6-month confirmed disability progression (CDP) were analysed using Cox models with disease-modifying therapy (DMT) as a time-varying covariate. Outcomes were contextualised using 1:2 propensity-matched MS controls without cancer or chemotherapy.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Results:</jats:title>
<jats:p>
In total, 363 individuals were followed for 2.8 years (median) after cancer. Older age at cancer was associated with lower relapse hazard (hazard ratio (HR) = 0.96 per year,
<jats:italic toggle="yes">p</jats:italic>
= 0.008), while DMT category was not. The DMT category was not associated with CDP. In matched analysis (256 vs. 505), relapse hazard was lower during the first year after cancer (HR = 0.30,
<jats:italic toggle="yes">p</jats:italic>
= 0.015) with no difference thereafter; CDP risk was similar (HR = 1.13,
<jats:italic toggle="yes">p</jats:italic>
= 0.60).
</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Conclusion:</jats:title>
<jats:p>Post-cancer DMT category was not associated with relapse or CDP. Lower first-year relapse hazard, together with lower relapse hazard at older age, may provide cautious reassurance regarding early post-cancer inflammatory activity in similar clinical contexts, although the drivers of the first-year signal remain uncertain.</jats:p>
</jats:sec>
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