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EAN 2023 | The impact of MS treatments on PIRA

Jaume Sastre-Garriga, MD, PhD, Vall d’Hebron University Hospital, Barcelona, Spain, goes into depth about clinical trials looking at the impact of multiple sclerosis (MS) treatments on progression independent of relapse activity (PIRA). Recent trials, particularly those using high-efficacy therapies, have been able to suppress neurodegenerative atrophy when compared to placebos and alternative therapies. There is also emerging information on the impact of certain drugs, such as ocrelizumab, on PIRA. While higher efficacy therapies show potential, caution is needed when evaluating drug effectiveness against PIRA as some drugs primarily reduce disability progression by lessening relapse-associated worsening, resulting in a limited effect on PIRA. However, in most clinical trials, PIRA wasn’t a primary or secondary outcome, but just a secondary analysis after primary results. Real-world evidence is limited and diverse, yielding mixed conclusions. Further focused studies are needed for clarity, but the current evidence suggests a modest impact of therapies on PIRA in MS. This interview took place at the European Academy of Neurology (EAN) 2023 Congress in Budapest, Hungary.

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Over the last 12 months, Jaume Sastre-Garriga has engaged in consulting and/or participated as speaker/chair in events organized by Merck, BMS, Janssen, Sanofi and Roche.