{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T05:22:33Z","timestamp":1793510553066,"version":"4.5.0"},"reference-count":33,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,4,17]],"date-time":"2025-04-17T00:00:00Z","timestamp":1744848000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,4,17]],"date-time":"2025-04-17T00:00:00Z","timestamp":1744848000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ther Adv Neurol Disord"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Early use of high-efficacy therapies (EHT) in multiple sclerosis (MS) is a promising but novel treatment strategy. Its adoption in Germany\u2019s MS care warrants further research.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>This study assessed treatment initiation patterns among newly diagnosed MS patients in Germany (2017\u20132022).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>This is a retrospective observational study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Claims data from 4.5 million individuals insured by German statutory health insurance included 1448 newly diagnosed MS patients from 2017 to 2022. Patients were identified by International Statistical Classification of Diseases and Related Health Problems, 10th revision, German modification (ICD-10-GM) code G35 \u2013 in two different quarters of the same year, and a disease-modifying therapy (DMT) prescription, with no prior MS diagnosis or DMT prescription in the preceding 2\u2009years. DMTs were categorized according to German Society of Neurology S2k guidelines: category 1 (low-efficacy), category 2 (moderate-efficacy) and category 3 (high-efficacy).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Of patients initiating treatment, 77.1% started with category 1, 8.1% with category 2 and 14.8% with category 3 DMTs. From 2017 to 2022, category 1 initiations declined by 7.6% points (pp), while categories 2 and 3 initiations increased by 2.8 and 4.8 pp, respectively. Escalation to category 3 occurred in 10.5% of category 1\/2 starters, with 31.5% taking over 2\u2009years. De-escalation to category 1\/2 occurred in 3.3% of category 3 starters.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Real-world data highlight a shift towards EHT in MS care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17562864251328576","type":"journal-article","created":{"date-parts":[[2025,4,17]],"date-time":"2025-04-17T06:32:41Z","timestamp":1744871561000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Shifts in treatment initiation patterns among newly diagnosed multiple sclerosis patients in Germany: a claims data analysis from 2017 to 2022"],"prefix":"10.1177","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8977-6731","authenticated-orcid":false,"given":"Ann-Sophie","family":"Stratil","sequence":"first","affiliation":[{"name":"Temedica GmbH, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steffeni","family":"Papukchieva","sequence":"additional","affiliation":[{"name":"Temedica GmbH, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalie","family":"Joschko","sequence":"additional","affiliation":[{"name":"Roche Pharma AG, Grenzach-Wyhlen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sven Guenther","family":"Meuth","sequence":"additional","affiliation":[{"name":"Department of Neurology, Heinrich-Heine-University, D\u00fcsseldorf, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2198-9925","authenticated-orcid":false,"given":"Benjamin","family":"Friedrich","sequence":"additional","affiliation":[{"name":"Temedica GmbH, Landsberger Str. 300, Munich 80687, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,4,17]]},"reference":[{"key":"e_1_3_4_2_2","unstructured":"Hemmer B Bayas A Berthele A et al. 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Leitlinien f\u00fcr Diagnostik und Therapie in der Neurologie: Deutsche Gesellschaft f\u00fcr Neurologie www.dgn.org\/leitlinien (2023 accessed 7 October 2024)."},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11940-021-00677-1"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-023-11969-8"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-510X(09)70012-7"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s13311-017-0548-5"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1177\/17562864211039648"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.3390\/jpm12010119"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph192114549"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2018.20588"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000010135"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(20)30067-3"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2020-323472"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1007\/s13311-020-00847-0"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2021.693017"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2021.2738"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.1177\/17562864241237857"},{"key":"e_1_3_4_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.msard.2024.105751"},{"key":"e_1_3_4_19_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0030-1249688"},{"key":"e_1_3_4_20_2","unstructured":"European Medicines Agency. 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