{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T21:17:54Z","timestamp":1793049474787,"version":"4.5.0"},"reference-count":24,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100008486","name":"Schweizerische Multiple Sklerose Gesellschaft","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100008486","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ther Adv Neurol Disord"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Over recent decades, several high-efficacy disease-modifying therapies (DMTs) have been approved for multiple sclerosis (MS), prompting a shift from an escalation strategy toward early high-efficacy treatment. Yet, DMT initiation patterns and safety profiles remain unexplored in research relying solely on patient self-reports and have not been examined in Switzerland.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>To investigate (1) time from MS diagnosis to first DMT, (2) temporal trends in initial DMT use, (3) number of suspected adverse drug reactions (sADRs) following the first DMT, and (4) occurrence of any severe sADR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Retrospective cohort study using longitudinal, patient-reported data from the Swiss MS Registry (SMSR) between 1995 and 2024.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We analyzed data from SMSR participants with relapsing-remitting MS or clinically isolated syndrome diagnosed after 1995. Time from diagnosis to first DMT was analyzed using Kaplan\u2013Meier analysis. Temporal trends were assessed through annual distributions of first DMTs. sADR burden was modeled with a two-part zero-inflated negative-binomial model, and severe sADRs (\u2a7e1 severe sADR) were assessed with logistic regression. All models were adjusted for sex and age at DMT initiation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Median time from diagnosis to first DMT decreased from 4.5\u2009months (95% confidence interval (CI): 2\u20136) in the 1995\u20132004 diagnosis group to 2\u2009months (95% CI: 1\u20132) in more recent groups (\u2a7e2010). First DMT use shifted from predominantly low-efficacy to moderate (2013\u20132020) and, since 2020, to high-efficacy DMTs. Compared to low-efficacy DMTs, moderate (incidence risk ratio (IRR)\u2009=\u20090.63, 95% CI: 0.48\u20130.84) and high-efficacy DMTs (IRR\u2009=\u20090.55, 95% CI: 0.31\u20130.98) were associated with fewer sADRs, and high-efficacy DMTs had higher odds of reporting zero sADRs (OR\u2009=\u20098.61, 95% CI: 2.34\u201331.76). We observed signals of a higher likelihood of severe sADRs in high-efficacy DMTs (OR\u2009=\u20091.41, 95% CI: 0.55\u20133.24) compared to low-efficacy DMTs, although this was not statistically significant.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Patient self-reports can reliably capture trends in DMT use. In Switzerland, the first DMT use has evolved, with patients starting DMTs earlier and more frequently with higher-efficacy DMTs. While moderate and high-efficacy DMTs were associated with fewer sADRs, they may also carry a higher risk of severe sADRs, underscoring the need to balance personal preferences, efficacy, and safety in first-line MS treatment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17562864251398472","type":"journal-article","created":{"date-parts":[[2025,12,6]],"date-time":"2025-12-06T05:57:12Z","timestamp":1765000632000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["From diagnosis to treatment: patterns in disease-modifying therapy initiation in multiple sclerosis"],"prefix":"10.1177","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5808-9026","authenticated-orcid":false,"given":"Stefania","family":"Iaquinto","sequence":"first","affiliation":[{"name":"Epidemiology, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mina","family":"Staniki\u0107","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland"},{"name":"Institute for Implementation Science in Health Care, University of Zurich, Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enriqueta","family":"Vallejo-Yag\u00fce","sequence":"additional","affiliation":[{"name":"Epidemiology, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jens","family":"Kuhle","sequence":"additional","affiliation":[{"name":"Department of Neurology, University Hospital Basel and University of Basel, Basel, Switzerland"},{"name":"Neurology Clinic and Policlinic, Departments of Head, Spine and Neuromedicine, MS Center and Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), Clinical Research and Biomedical Engineering, University Hospital Basel and University of Basel, Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zina-Mary","family":"Manjaly","sequence":"additional","affiliation":[{"name":"Department of Neurology, Schulthess Clinic, Zurich, Switzerland"},{"name":"Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Roth","sequence":"additional","affiliation":[{"name":"Department of Neurology, University Hospital Zurich, Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pasquale","family":"Calabrese","sequence":"additional","affiliation":[{"name":"Neuropsychology and Behavioral Neurology Unit, Division of Cognitive and Molecular Neuroscience, University of Basel, Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Zecca","sequence":"additional","affiliation":[{"name":"Department of Neurology, Neurocenter of Southern Switzerland, Ospedale Regionale di Lugano, EOC, Lugano, Switzerland"},{"name":"Faculty of Biomedical Sciences, Universit\u00e0 della Svizzera Italiana, Lugano, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Milo A.","family":"Puhan","sequence":"additional","affiliation":[{"name":"Epidemiology, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8754-9797","authenticated-orcid":false,"given":"Viktor","family":"von Wyl","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Hirschengraben 84, Zurich 8001, Switzerland Institute for Implementation Science in Health Care, University of Zurich, Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,12,5]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.2217\/nmt-2021-0058"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.neurol.2022.09.006"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2018.4905"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-021-10673-9"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-022-11193-w"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12883-018-1118-0"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.4414\/smw.2018.14623"},{"key":"e_1_3_4_9_2","unstructured":"Renate Bonifer. 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