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Jouvenot G, Courbon G, Lefort M, Rollot F, Casey R, Le Page E, Michel L, Edan G, de Seze J, Kremer L, Bigaut K, Vukusic S, Mathey G, Ciron J, Ruet A, Maillart E, Labauge P, Zephir H, Papeix C, Defer G, Lebrun-Frenay C, Moreau T, Laplaud DA, Berger E, Stankoff B, Clavelou P, Thouvenot E, Heinzlef O, Pelletier J, Al-Khedr A, Casez O, Bourre B, Cabre P, Wahab A, Magy L, Camdessanché JP, Doghri I, Moulin S, Ben-Nasr H, Labeyrie C, Hankiewicz K, Neau JP, Pottier C, Nifle C, Collongues N, Kerbrat A. High-Efficacy Therapy Discontinuation vs Continuation in Patients 50 Years and Older With Nonactive MS. JAMA Neurol 2024; 81:490-498. [PMID: 38526462 PMCID: PMC10964164 DOI: 10.1001/jamaneurol.2024.0395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 01/05/2024] [Indexed: 03/26/2024]
Abstract
Importance A recent randomized clinical trial concluded that discontinuing medium-efficacy therapy might be a reasonable option for older patients with nonactive multiple sclerosis (MS), but there is a lack of data on discontinuing high-efficacy therapy (HET). In younger patients, the discontinuation of natalizumab and fingolimod is associated with a risk of rebound of disease activity. Objective To determine whether discontinuing HET in patients 50 years and older with nonactive MS is associated with an increased risk of relapse compared with continuing HET. Design, Setting, and Participants This observational cohort study used data from 38 referral centers from the French MS registry (Observatoire Français de la Sclérose en Plaques [OFSEP] database). Among 84704 patients in the database, data were extracted for 1857 patients 50 years and older with relapsing-remitting MS treated by HET and with no relapse or magnetic resonance imaging activity for at least 2 years. After verification of the medical records, 1620 patients were classified as having discontinued HET or having remained taking treatment and were matched 1:1 using a dynamic propensity score (including age, sex, disease phenotype, disability, treatment of interest, and time since last inflammatory activity). Patients were included from February 2008 to November 2021, with a mean (SD) follow-up of 5.1 (2.9) years. Data were extracted in June 2022. Exposures Natalizumab, fingolimod, rituximab, and ocrelizumab. Main Outcomes and Measures Time to first relapse. Results Of 1620 included patients, 1175 (72.5%) were female, and the mean (SD) age was 54.7 (4.8) years. Among the 1452 in the HET continuation group and 168 in the HET discontinuation group, 154 patients in each group were matched using propensity scores (mean [SD] age, 57.7 [5.5] years; mean [SD] delay since the last inflammatory activity, 5.6 [3.8] years; mean [SD] follow-up duration after propensity score matching, 2.5 [2.1] years). Time to first relapse was significantly reduced in the HET discontinuation group compared with the HET continuation group (hazard ratio, 4.1; 95% CI, 2.0-8.5; P < .001) but differed between HETs, with a hazard ratio of 7.2 (95% CI, 2.1-24.5; P = .001) for natalizumab, 4.5 (95% CI, 1.3-15.5; P = .02) for fingolimod, and 1.1 (95% CI, 0.3-4.8; P = .85) for anti-CD20 therapy. Conclusion and Relevance As in younger patients, in patients 50 years and older with nonactive MS, the risk of relapse increased significantly after stopping HETs that impact immune cell trafficking (natalizumab and fingolimod). There was no significant increase in risk after stopping HETs that deplete B-cells (anti-CD20 therapy). This result may inform decisions about stopping HETs in clinical practice.
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Affiliation(s)
- Guillaume Jouvenot
- Center for Clinical Investigation, INSERM U1434, Strasbourg, France
- Biopathology of Myelin, Neuroprotection and Therapeutic Strategy, INSERM U1119, Strasbourg, France
| | - Guilhem Courbon
- Department of Neurology, University Hospital of Rennes, Rennes, France
| | - Mathilde Lefort
- University of Rennes, EHESP, CNRS, INSERM, Arènes—UMR 6051, RSMS (Recherche sur les Services et Management en Santé)—U 1309, Rennes, France
| | - Fabien Rollot
- Université de Lyon, Université Claude Bernard, Lyon, France
- Department of Neurology, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Sclérose en Plaques, Pathologies de la Myéline et Neuro-Inflammation, Bron, France
- Centre de Recherche en Neurosciences de Lyon, Observatoire Français de La Sclérose en Plaques, INSERM 1028 and CNRS UMR 5292, Lyon, France
- Eugène Devic EDMUS Foundation Against Multiple Sclerosis, State-Approved Foundation, Bron, France
| | - Romain Casey
- Université de Lyon, Université Claude Bernard, Lyon, France
- Department of Neurology, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Sclérose en Plaques, Pathologies de la Myéline et Neuro-Inflammation, Bron, France
- Centre de Recherche en Neurosciences de Lyon, Observatoire Français de La Sclérose en Plaques, INSERM 1028 and CNRS UMR 5292, Lyon, France
- Eugène Devic EDMUS Foundation Against Multiple Sclerosis, State-Approved Foundation, Bron, France
| | - Emmanuelle Le Page
- Department of Neurology, University Hospital of Rennes, Rennes, France
- CIC-P 1414 INSERM, University Hospital of Rennes, Rennes, France
| | - Laure Michel
- Department of Neurology, University Hospital of Rennes, Rennes, France
- CIC-P 1414 INSERM, University Hospital of Rennes, Rennes, France
| | - Gilles Edan
- Department of Neurology, University Hospital of Rennes, Rennes, France
- CIC-P 1414 INSERM, University Hospital of Rennes, Rennes, France
| | - Jérome de Seze
- Center for Clinical Investigation, INSERM U1434, Strasbourg, France
- Biopathology of Myelin, Neuroprotection and Therapeutic Strategy, INSERM U1119, Strasbourg, France
- Department of Neurology, University Hospital of Strasbourg, Strasbourg, France
| | - Laurent Kremer
- Biopathology of Myelin, Neuroprotection and Therapeutic Strategy, INSERM U1119, Strasbourg, France
- Department of Neurology, University Hospital of Strasbourg, Strasbourg, France
| | - Kevin Bigaut
- Biopathology of Myelin, Neuroprotection and Therapeutic Strategy, INSERM U1119, Strasbourg, France
- Department of Neurology, University Hospital of Strasbourg, Strasbourg, France
| | - Sandra Vukusic
- Université de Lyon, Université Claude Bernard, Lyon, France
- Department of Neurology, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Sclérose en Plaques, Pathologies de la Myéline et Neuro-Inflammation, Bron, France
- Centre de Recherche en Neurosciences de Lyon, Observatoire Français de La Sclérose en Plaques, INSERM 1028 and CNRS UMR 5292, Lyon, France
- Eugène Devic EDMUS Foundation Against Multiple Sclerosis, State-Approved Foundation, Bron, France
| | - Guillaume Mathey
- Department of Neurology, Nancy University Hospital, Nancy, France
- Université de Lorraine, APEMAC, Nancy, France
| | - Jonathan Ciron
- CRC-SEP, Department of Neurology, CHU de Toulouse, Toulouse, France
| | - Aurélie Ruet
- Department of Neurology, CHU de Bordeaux, CIC Bordeaux CIC1401, Bordeaux, France
| | - Elisabeth Maillart
- Département de Neurologie, Hôpital Pitié-Salpêtrière, APHP, Centre de Ressources et de Compétences SEP, Paris, France
| | | | | | - Caroline Papeix
- Department of Neurology, Fondation Rothschild, Paris, France
| | - Gilles Defer
- Department of Neurology, MS Expert Centre, CHU de Caen, Caen, France
| | - Christine Lebrun-Frenay
- Neurology, UR2CA-URRIS, Centre Hospitalier Universitaire Pasteur2, Université Nice Côte d’Azur, Nice, France
| | | | - David Axel Laplaud
- Department of Neurology, CHU de Nantes, Nantes, France
- Nantes Université, CHU Nantes, INSERM, CIC 14131413, Center for Research in Translational Immunology, UMR 1064, Nantes, France
| | - Eric Berger
- Service de Neurologie, CHU de Besançon, Besançon, France
| | - Bruno Stankoff
- Department of Neurology, AP-HP, Saint-Antoine Hospital, Paris, France
| | - Pierre Clavelou
- Department of Neurology, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Eric Thouvenot
- Department of Neurology, Nimes University Hospital, Nimes, France
| | | | - Jean Pelletier
- Service de Neurologie, APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Marseille, France
| | | | - Olivier Casez
- CHU Grenoble Alpes, Department of Neurology, Neurology MS Clinic Grenoble, Grenoble Alpes University Hospital, Grenoble, France
| | | | - Philippe Cabre
- Department of Neurology, CHU de la Martinique, Fort-de-France, France
| | - Abir Wahab
- Department of Neurology, APHP, Hôpital Henri Mondor, Créteil, France
| | - Laurent Magy
- Department of Neurology, CHU de Limoges, Hôpital Dupuytren, Limoges, France
| | | | - Ines Doghri
- Department of Neurology, CHU de Tours, Hôpital Bretonneau, Tours, France
| | - Solène Moulin
- Department of Neurology, CHU de Reims, CRC-SEP, Reims, France
| | - Haifa Ben-Nasr
- Hôpital Sud Francilien, Department of Neurology, Corbeil-Essonnes, France
| | - Céline Labeyrie
- Department of Neurology, CHU Bicêtre, Le Kremlin-Bicêtre, France
| | - Karolina Hankiewicz
- Department of Neurology, Hôpital Pierre Delafontaine, Centre Hospitalier de Saint-Denis, Saint-Denis, France
| | - Jean-Philippe Neau
- Department of Neurology, CHU La Milétrie, Hôpital Jean Bernard, Poitiers, France
| | - Corinne Pottier
- Department of Neurology, CH de Pontoise, Hôpital René Dubos, Pontoise, France
| | - Chantal Nifle
- Departement of Neurology, Centre Hospitalier de Versailles, Le Chesnay, France
| | - Nicolas Collongues
- Center for Clinical Investigation, INSERM U1434, Strasbourg, France
- Biopathology of Myelin, Neuroprotection and Therapeutic Strategy, INSERM U1119, Strasbourg, France
- Department of Neurology, University Hospital of Strasbourg, Strasbourg, France
- Department of Pharmacology, Addictology, Toxicology and Therapeutics, Strasbourg University, Strasbourg, France
| | - Anne Kerbrat
- Department of Neurology, University Hospital of Rennes, Rennes, France
- CIC-P 1414 INSERM, University Hospital of Rennes, Rennes, France
- Empenn U1228, University of Rennes, Inria, CNRS, INSERM, IRISA UMR 6074, Rennes, France
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Benallegue N, Rollot F, Wiertlewski S, Casey R, Debouverie M, Kerbrat A, De Seze J, Ciron J, Ruet A, Labauge P, Maillart E, Zephir H, Papeix C, Defer G, Lebrun-Frenay C, Moreau T, Berger E, Stankoff B, Clavelou P, Heinzlef O, Pelletier J, Thouvenot E, Al Khedr A, Bourre B, Casez O, Cabre P, Wahab A, Magy L, Vukusic S, Laplaud DA. Highly Effective Therapies as First-Line Treatment for Pediatric-Onset Multiple Sclerosis. JAMA Neurol 2024; 81:273-282. [PMID: 38345791 PMCID: PMC10862269 DOI: 10.1001/jamaneurol.2023.5566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 12/07/2023] [Indexed: 02/15/2024]
Abstract
Importance Moderately effective therapies (METs) have been the main treatment in pediatric-onset multiple sclerosis (POMS) for years. Despite the expanding use of highly effective therapies (HETs), treatment strategies for POMS still lack consensus. Objective To assess the real-world association of HET as an index treatment compared with MET with disease activity. Design, Setting, and Participants This was a retrospective cohort study conducted from January 1, 2010, to December 8, 2022, until the last recorded visit. The median follow-up was 5.8 years. A total of 36 French MS centers participated in the Observatoire Français de la Sclérose en Plaques (OFSEP) cohort. Of the total participants in OFSEP, only treatment-naive children with relapsing-remitting POMS who received a first HET or MET before adulthood and at least 1 follow-up clinical visit were included in the study. All eligible participants were included in the study, and none declined to participate. Exposure HET or MET at treatment initiation. Main Outcomes and Measures The primary outcome was the time to first relapse after treatment. Secondary outcomes were annualized relapse rate (ARR), magnetic resonance imaging (MRI) activity, time to Expanded Disability Status Scale (EDSS) progression, tertiary education attainment, and treatment safety/tolerability. An adapted statistical method was used to model the logarithm of event rate by penalized splines of time, allowing adjustment for effects of covariates that is sensitive to nonlinearity and interactions. Results Of the 3841 children (5.2% of 74 367 total participants in OFSEP), 530 patients (mean [SD] age, 16.0 [1.8] years; 364 female [68.7%]) were included in the study. In study patients, both treatment strategies were associated with a reduced risk of first relapse within the first 2 years. HET dampened disease activity with a 54% reduction in first relapse risk (adjusted hazard ratio [HR], 0.46; 95% CI, 0.31-0.67; P < .001) sustained over 5 years, confirmed on MRI activity (adjusted odds ratio [OR], 0.34; 95% CI, 0.18-0.66; P = .001), and with a better tolerability pattern than MET. The risk of discontinuation at 2 years was 6 times higher with MET (HR, 5.97; 95% CI, 2.92-12.20). The primary reasons for treatment discontinuation were lack of efficacy and intolerance. Index treatment was not associated with EDSS progression or tertiary education attainment (adjusted OR, 0.51; 95% CI, 0.24-1.10; P = .09). Conclusions and Relevance Results of this cohort study suggest that compared with MET, initial HET in POMS was associated with a reduction in the risk of first relapse with an optimal outcome within the first 2 years and was associated with a lower rate of treatment switching and a better midterm tolerance in children. These findings suggest prioritizing initial HET in POMS, although long-term safety studies are needed.
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Affiliation(s)
- Nail Benallegue
- Department of Paediatric Neurology, Universitaire Angers, CHU Angers, Angers, France
- Nantes Université, CHU Nantes, Inserm, CIC 14131413, Center for Research in Transplantation and Translational Immunology, UMR 1064, Nantes, France
| | - Fabien Rollot
- Université de Lyon, Université Claude Bernard, Lyon 1, Lyon, France
- Department of Neurology, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Sclérose en Plaques, Pathologies de la Myéline et Neuro-Infammation, Bron, France
- Centre de Recherche en Neurosciences de Lyon, Observatoire Français de La Sclérose en Plaques, Inserm 1028 et CNRS UMR 5292, Lyon, France
- EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis, State-Approved Foundation, Bron, France
| | - Sandrine Wiertlewski
- Nantes Université, CHU Nantes, Inserm, CIC 14131413, Center for Research in Transplantation and Translational Immunology, UMR 1064, Nantes, France
- Department of Neurology, CHU Nantes, Nantes, France
| | - Romain Casey
- Université de Lyon, Université Claude Bernard, Lyon 1, Lyon, France
- Department of Neurology, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Sclérose en Plaques, Pathologies de la Myéline et Neuro-Infammation, Bron, France
- Centre de Recherche en Neurosciences de Lyon, Observatoire Français de La Sclérose en Plaques, Inserm 1028 et CNRS UMR 5292, Lyon, France
- EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis, State-Approved Foundation, Bron, France
| | - Marc Debouverie
- Department of Neurology, Centre Hospitalier Régional Et Universitaire de Nancy, Université de Lorraine, 4360 APEMAC Vandoeuvre-Lès-Nancy, EA, France
| | - Anne Kerbrat
- Rennes University, CHU Rennes, CRC-SEP Neurology Department, and EMPENN U 1228, Inserm, INRIA, CNRS, Rennes, France
| | - Jérôme De Seze
- Department of Neurology Et Centre d’Investigation Clinique, CHU de Strasbourg, INSERM 1434, Strasbourg, France
| | - Jonathan Ciron
- Department of Neurology, CRC-SEP, CHU de Toulouse, Hôpital Pierre-Paul Riquet, Toulouse, France
- Institut Toulousain Des Maladies Infectieuses Et Inflammatoires (Infinity), Inserm UMR 1291, CNRS UMR 5051, Université Toulouse III, Toulouse, France
| | - Aurelie Ruet
- Department of Neurology, CHU de Bordeaux, Bordeaux, France
- Université de Bordeaux, Inserm, Neurocentre Magendie, U1215 Bordeaux, France
| | - Pierre Labauge
- CRC SEP, Department of Neurology, Montpellier Universitary Hospital, Montpellier, France
| | | | - Helene Zephir
- Pôle Des Neurosciences Et de L’appareil Locomoteur, CRC-SEP, Hôpital Roger Salengro, Université de Lille, Inserm U1172, Lille, France
| | - Caroline Papeix
- Département of Neurology, Hôpital Fondation A.de Rothschild, Paris, France
| | - Gilles Defer
- Department of Neurology, Centre Expert SEP, CHU de Caen, Université Normandie, Caen, France
| | - Christine Lebrun-Frenay
- CRC-SEP Neurologie Pasteur 2, CHU de Nice, Université Cote d’Azur, UMR2CA (URRIS), Nice, France
| | | | - Eric Berger
- Department of Neurology, CHU de Besançon, Besançon, France
| | - Bruno Stankoff
- Department of Neurology, CHU Saint-Antoine, Paris, France
| | - Pierre Clavelou
- Department of Neurology, CHU de Clermont-Ferrand, Clermont-Ferrand, France
| | - Olivier Heinzlef
- Département de Neurologie, Centre Hospitalier de Poissy, St Germain, France
| | - Jean Pelletier
- Aix Marseille Univ, APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie – MICeME, CRMBM CEMEREM UMR7339, Marseille, France
| | - Eric Thouvenot
- Department of Neurology, CHU de Nîmes, Nîmes, France
- IGF, University Montpellier, CNRS, Inserm, Montpellier, France
| | | | | | - Olivier Casez
- Department of Neurology, CHU de Grenoble, Grenoble, France
| | - Philippe Cabre
- Department of Neurology, CHU de Fort de France, Fort de France, France
| | - Abir Wahab
- Department of Neurology, Assistance Publique des Hôpitaux de Paris, Hôpital Henri Mondor, Université Paris Est, Créteil, France
| | - Laurent Magy
- Department of Neurology, CHU de Limoges, Limoges, France
| | - Sandra Vukusic
- Université de Lyon, Université Claude Bernard, Lyon 1, Lyon, France
- Department of Neurology, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Sclérose en Plaques, Pathologies de la Myéline et Neuro-Infammation, Bron, France
- Centre de Recherche en Neurosciences de Lyon, Observatoire Français de La Sclérose en Plaques, Inserm 1028 et CNRS UMR 5292, Lyon, France
- EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis, State-Approved Foundation, Bron, France
| | - David-Axel Laplaud
- Nantes Université, CHU Nantes, Inserm, CIC 14131413, Center for Research in Transplantation and Translational Immunology, UMR 1064, Nantes, France
- Department of Neurology, CHU Nantes, Nantes, France
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Federau C, Hainc N, Edjlali M, Zhu G, Mastilovic M, Nierobisch N, Uhlemann JP, Paganucci S, Granziera C, Heinzlef O, Kipp LB, Wintermark M. Evaluation of the quality and the productivity of neuroradiological reading of multiple sclerosis follow-up MRI scans using an intelligent automation software. Neuroradiology 2024; 66:361-369. [PMID: 38265684 PMCID: PMC10859335 DOI: 10.1007/s00234-024-03293-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Accepted: 01/10/2024] [Indexed: 01/25/2024]
Abstract
PURPOSE The assessment of multiple sclerosis (MS) lesions on follow-up magnetic resonance imaging (MRI) is tedious, time-consuming, and error-prone. Automation of low-level tasks could enhance the radiologist in this work. We evaluate the intelligent automation software Jazz in a blinded three centers study, for the assessment of new, slowly expanding, and contrast-enhancing MS lesions. METHODS In three separate centers, 117 MS follow-up MRIs were blindly analyzed on fluid attenuated inversion recovery (FLAIR), pre- and post-gadolinium T1-weighted images using Jazz by 2 neuroradiologists in each center. The reading time was recorded. The ground truth was defined in a second reading by side-by-side comparison of both reports from Jazz and the standard clinical report. The number of described new, slowly expanding, and contrast-enhancing lesions described with Jazz was compared to the lesions described in the standard clinical report. RESULTS A total of 96 new lesions from 41 patients and 162 slowly expanding lesions (SELs) from 61 patients were described in the ground truth reading. A significantly larger number of new lesions were described using Jazz compared to the standard clinical report (63 versus 24). No SELs were reported in the standard clinical report, while 95 SELs were reported on average using Jazz. A total of 4 new contrast-enhancing lesions were found in all reports. The reading with Jazz was very time efficient, taking on average 2min33s ± 1min0s per case. Overall inter-reader agreement for new lesions between the readers using Jazz was moderate for new lesions (Cohen kappa = 0.5) and slight for SELs (0.08). CONCLUSION The quality and the productivity of neuroradiological reading of MS follow-up MRI scans can be significantly improved using the dedicated software Jazz.
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Affiliation(s)
- Christian Federau
- AI Medical AG, Goldhaldenstr 22a, 8702, Zollikon, Switzerland.
- University of Zürich, Zürich, Switzerland.
| | - Nicolin Hainc
- University of Zürich, Zürich, Switzerland
- Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zürich, University of Zürich, Zürich, Switzerland
| | - Myriam Edjlali
- Department of Radiology, APHP, Hôpitaux Raymond-Poincaré & Ambroise Paré, Paris, France
- Laboratoire d'imagerie Biomédicale Multimodale (BioMaps), Université Paris-Saclay, CEA, CNRS, Inserm, Service Hopsitalier Frédéric Joliot, Orsay, France
| | | | - Milica Mastilovic
- Department of Radiology, APHP, Hôpitaux Raymond-Poincaré & Ambroise Paré, Paris, France
- Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - Nathalie Nierobisch
- University of Zürich, Zürich, Switzerland
- Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zürich, University of Zürich, Zürich, Switzerland
| | - Jan-Philipp Uhlemann
- University of Zürich, Zürich, Switzerland
- Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zürich, University of Zürich, Zürich, Switzerland
| | | | | | - Olivier Heinzlef
- Department of Neurology, Poissy-Saint-Germain-en-Laye Hospital, Poissy, France
- CRC SEP IDF Ouest, Poissy-Garches, France
| | - Lucas B Kipp
- Department of Neurology & Neurological Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Max Wintermark
- Stanford University, Stanford, USA
- MD Anderson Cancer Center, Houston, USA
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4
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Jeantin L, Januel E, Labauge P, Maillart E, de Seze J, Zéphir H, Pelletier J, Kerschen P, Biotti D, Heinzlef O, Guilloton L, Bensa C, Théaudin M, Vukusic S, Casez O, Maurousset A, Laplaud D, Berger E, Lebrun-Frenay C, Bourre B, Branger P, Stankoff B, Clavelou P, Thouvenot E, Manchon E, Moreau T, Sellal F, Zedet M, Papeix C, Louapre C. COVID-19 outcomes in patients with multiple sclerosis: Understanding changes from 2020 to 2022. Mult Scler 2024; 30:381-395. [PMID: 38247113 DOI: 10.1177/13524585231218149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
Abstract
BACKGROUND Epidemiologic studies on coronavirus disease 2019 (COVID-19) in patients with multiple sclerosis (pwMS) have focused on the first waves of the pandemic until early 2021. OBJECTIVES We aimed to extend these data from the onset of the pandemic to the global coverage by vaccination in summer 2022. METHODS This retrospective, multicenter observational study analyzed COVISEP registry data on reported COVID-19 cases in pwMS between January 2020 and July 2022. Severe COVID-19 was defined as hospitalization or higher severity. RESULTS Among 2584 pwMS with confirmed/highly suspected COVID-19, severe infection rates declined from 14.6% preomicron wave to 5.7% during omicron wave (p < 0.001). Multivariate analysis identified age (odds ratio (OR) = 1.43, 95% confidence interval (CI) = [1.25-1.64] per 10 years), male sex (OR = 2.01, 95% CI = [1.51-2.67]), obesity (OR = 2.36, 95% CI = [1.52-3.68]), cardiac comorbidities (OR = 2.36, 95% CI = [1.46-3.83]), higher Expanded Disability Status Scale (EDSS) scores (OR = 2.09, 95% CI = [1.43-3.06] for EDSS 3-5.5 and OR = 4.53, 95% CI = [3.04-6.75] for EDSS ⩾6), and anti-CD20 therapies (OR = 2.67, 95% CI = [1.85-3.87]) as risk factors for COVID-19 severity. Vaccinated individuals experienced less severe COVID-19, whether on (risk ratio (RR) = 0.64, 95% CI = [0.60-0.69]) or off (RR = 0.32, 95% CI = [0.30-0.33]) anti-CD20. DISCUSSION In pwMS, consistent risk factors were anti-CD20 therapies and neurological disability, emerging as vital drivers of COVID-19 severity regardless of wave, period, or vaccination status.
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Affiliation(s)
- Lina Jeantin
- Sorbonne University, Paris Brain Institute-ICM, Assistance Publique-Hôpitaux de Paris (AP-HP), Inserm, CNRS, Hôpital de la Pitié Salpêtrière, CIC Neurosciences, FCRIN4MS, Paris, France
| | - Edouard Januel
- Sorbonne University, Paris Brain Institute-ICM, Assistance Publique-Hôpitaux de Paris (AP-HP), Inserm, CNRS, Hôpital de la Pitié Salpêtrière, CIC Neurosciences, FCRIN4MS, Paris, France/Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Pitié-Salpêtrière, Département de Santé Publique, Centre de Pharmacoépidémiologie (Cephepi), Unité de Recherche Clinique PSL-CFX, CIC-1901, Paris, France
| | - Pierre Labauge
- Department of Neurology, CRC-SEP, Montpellier University Hospital, Montpellier, France/ Institute for Neurosciences of Montpellier (INM), INSERM and University of Montpellier, Montpellier, France
| | - Elisabeth Maillart
- Sorbonne University, Paris Brain Institute-ICM, Assistance Publique-Hôpitaux de Paris (AP-HP), Inserm, CNRS, Hôpital de la Pitié Salpêtrière, CIC Neurosciences, FCRIN4MS, Paris, France
| | - Jérôme de Seze
- Department of Neurology and Clinical Investigation Center, CIC 1434, INSERM 1434, CHU de Strasbourg, Strasbourg, France
| | - Hélène Zéphir
- Department of Neurology, CHU Lille, INSERM U1172, University of Lille, Lille, France
| | - Jean Pelletier
- Aix-Marseille Universite, APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, Marseille, France
| | - Philippe Kerschen
- Department of Neurology, Luxembourg Hospital Center, Luxembourg City, Luxembourg
| | - Damien Biotti
- Centre Ressources et Compétences sclérose en plaques (CRC-SEP) et Service de Neurologie B4, Hôpital Pierre-Paul Riquet, CHU Toulouse Purpan, Toulouse, France/ INSERM UMR1291-CNRS UMR5051, Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity), Université Toulouse 3, Toulouse, France
| | - Olivier Heinzlef
- Département de Neurologie, CRC SEP, Centre Hospitalier intercommunal de Poissy-Saint-Germain-en-Laye, Poissy, France
| | - Laurent Guilloton
- Association des Neurologues Libéraux de Langue Française, Rambouillet, France
| | - Caroline Bensa
- Département de Neurologie, Hôpital Fondation Adolphe de Rothschild, Paris, France
| | - Marie Théaudin
- Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Sandra Vukusic
- Hospices Civils de Lyon, Hôpital Neurologique Pierre Wertheimer, Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-Inflammation, Bron, France
| | - Olivier Casez
- Neurologie, Pathologies Inflammatoires du Système Nerveux, CHU Grenoble Alpes, Grenoble, France/ TIMC-IMAG, Translational Research in Autoimmunity and Inflammation Group (T-RAIG), Université Grenoble Alpes, Grenoble, France
| | - Aude Maurousset
- CRC SEP and Department of Neurology, CHU de Tours, Hôpital Bretonneau, Tours, France
| | - David Laplaud
- CR2TI UMR1064, Service de Neurologie and CIC0004 INSERM, CHU de Nantes, Nantes, France
| | - Eric Berger
- Service de Neurologie, CHU de Besançon, Besançon, France
| | - Christine Lebrun-Frenay
- CRCSEP Cote d'Azur, CHU de Nice Pasteur2, Université Nice Cote d'Azur, UR2CA-URRIS, Nice, France
| | | | - Pierre Branger
- Service de Neurologie, CHU de Caen Normandie, Caen, France
| | - Bruno Stankoff
- Assistance Publique-Hôpitaux de Paris (AP-HP), Sorbonne Université, Department of Neurology, Saint Antoine Hospital, CRCSEP, Paris, France
| | - Pierre Clavelou
- CRCSEP, Department of Neurology, CHU Clermont-Ferrand, Inserm, Neuro-Dol, Clermont-Ferrand, France
| | - Eric Thouvenot
- Department of Neurology, Nimes University Hospital, Nimes Cedex 9 F-30029, France; Institut de Génomique Fonctionnelle, UMR5203, INSERM 1191, Université de Montpellier, Montpellier, France
| | - Eric Manchon
- Department of Neurology, Gonesse Hospital, Gonesse, France
| | - Thibault Moreau
- EA4184, Department of Neurology, CHU de Dijon, Dijon, France
| | - François Sellal
- Département de Neurologie, Hôpitaux Civils de Colmar, Colmar, France; Unité INSERM U-1118, Faculté de Médecine, Université de Strasbourg, Strasbourg, France
| | - Mickaël Zedet
- Department of Neurology, AP-HP, Henri Mondor University Hospital, Université Paris Est Créteil, Creteil, France
| | - Caroline Papeix
- Département de Neurologie, Hôpital Fondation Adolphe de Rothschild, Paris, France
| | - Céline Louapre
- Sorbonne University, Paris Brain Institute-ICM, Assistance Publique-Hôpitaux de Paris (AP-HP), Inserm, CNRS, Hôpital de la Pitié Salpêtrière, CIC Neurosciences, FCRIN4MS, Paris, France
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5
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Gay MC, Cassedanne F, Barbot F, Vaugier I, Thomas S, Manchon E, Bensmail D, Blanchere M, Heinzlef O. Long-term effectiveness of a cognitive behavioural therapy (CBT) in the management of fatigue in patients with relapsing remitting multiple sclerosis (RRMS): a multicentre, randomised, open-label, controlled trial versus standard care. J Neurol Neurosurg Psychiatry 2024; 95:158-166. [PMID: 37648439 PMCID: PMC10850683 DOI: 10.1136/jnnp-2023-331537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 07/18/2023] [Indexed: 09/01/2023]
Abstract
BACKGROUND Fatigue is a disabling symptom of multiple sclerosis (MS). The lack of effective therapeutics has promoted the development of cognitive behavioural therapy (CBT)-based fatigue management programmes. However, their efficacy does not sustain over time. We proposed to test the long-term effectiveness of a 6-week fatigue programme supplemented with four booster sessions ('FACETS+') in patients with relapsing remitting MS (RRMS) and fatigue. METHODS This multicentre, randomised, controlled, open-label, parallel-group trial versus standard care enrolled patients with RRMS and fatigue. Participants were randomised to either FACETS+ plus standard care or standard care alone. The primary outcome measure was fatigue impact (Modified Fatigue Impact Scale (MFIS) at 12 months) based on intention-to-treat analyses. RESULTS From May 2017 to September 2020, 162 patients were screened; 105 were randomly assigned to FACETS+ (n=57) or standard care (n=48) and 88 completed the primary outcome assessment for the MFIS. At month 12, participants showed improved MFIS compared with baseline in the intervention group (mean difference (MD)=14.0 points; (95% CI 6.45 to 21.5)) and the control group (MD=6.1 points; (95% CI -0.30 to 12.5)) with a significant between-group difference in favour of the intervention group (adjusted MD=7.89 points; (95% CI 1.26 to 14.52), standardised effect size=0.52, p=0.021). No trial-related serious adverse events were reported. CONCLUSIONS A 6-week CBT-based programme with four booster sessions is superior to standard care alone to treat MS-related fatigue in the long term (12 months follow-up). The results support the use of the FACETS+ programme for the treatment of MS-related fatigue. TRIAL REGISTRATION NUMBER NCT03758820.
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Affiliation(s)
- Marie Claire Gay
- Psychology UR CLIPSYD 4430, Paris-Nanterre University, Nanterre, France
| | | | - Frederic Barbot
- Inserm CIC 1429, APHP, Hôpital Raymond-Poincare, Garches, France
| | - Isabelle Vaugier
- Inserm CIC 1429, APHP, Hôpital Raymond-Poincare, Garches, France
| | - Sarah Thomas
- Clinical Research Unit, Faculty of Health and Social Sciences, Bournemouth University, Poole, Dorset, UK
| | - Eric Manchon
- Neurologie, Centre Hospitalier de Gonesse, Gonesse, France
| | - Djamel Bensmail
- Service de Médecine Physique et de Réadaptation, Hôpital Raymond-Poincare, APHP, Garches, France
- Inserm UMR 1179, Universite Versailles Saint-Quentin-en-Yvelines, Versailles, France
- CRC SEP IDF Ouest, Poissy-Garches, France
| | - Marie Blanchere
- CRC SEP IDF Ouest, Poissy-Garches, France
- Neurologie, CHIPS Site Hospitalier de Poissy, Poissy Cedex, France
| | - Olivier Heinzlef
- CRC SEP IDF Ouest, Poissy-Garches, France
- Neurologie, CHIPS Site Hospitalier de Poissy, Poissy Cedex, France
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6
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Rollot F, Uhry Z, Dantony E, Vukusic S, Debouverie M, Le Page E, Ciron J, Ruet A, De Sèze J, Zéphir H, Labauge P, Defer G, Lebrun-Frenay C, Moreau T, Laplaud DA, Berger E, Clavelou P, Pelletier J, Thouvenot E, Heinzlef O, Camdessanche JP, Fauvernier M, Remontet L, Leray E. Comparison of 2 Methods for Estimating Multiple Sclerosis-Related Mortality. Neurology 2023; 101:e2483-e2496. [PMID: 37827849 PMCID: PMC10791051 DOI: 10.1212/wnl.0000000000207925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 09/11/2023] [Indexed: 10/14/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Determining whether multiple sclerosis (MS) causes death is challenging. Our objective was to contrast 2 frameworks to estimate probabilities of death attributed to MS (PMS) and other causes (Pother): the cause-specific framework (CSF), which requires the causes of death, and the excess mortality framework (EMF), which does not. METHODS We used data from the Observatoire Français de la Sclérose en Plaques (OFSEP, n = 37,524) and from a comparative subset where causes of death were available (4,004 women with relapsing-onset MS [R-MS]). In CSF, the probabilities were estimated using the Aalen-Johansen method. In EMF, they were estimated from the excess mortality hazard, which is the additional mortality among patients with MS as compared with the expected mortality in the matched general population. PMS values were estimated at 30 years of follow-up, (1) with both frameworks in the comparative subset, by age group at onset, and (2) with EMF only in the OFSEP population, by initial phenotype, sex, and age at onset. RESULTS In the comparative subset, the estimated 30-year PMS values were greater using EMF than CSF: 10.9% (95% CI 8.3-13.6) vs 8.7% (6.4-11.8) among the youngest and 20.4% (11.3-29.5) vs 16.2% (8.7-30.2) for the oldest groups, respectively. In the CSF, probabilities of death from unknown causes ranged from 1.5% (0.7-3.0) to 6.4% (2.5-16.4), and even after their reallocation, PMS values remained lower with CSF than with EMF. The estimated probabilities of being alive were close using the 2 frameworks, and the estimated POther (EMF vs CSF) was 2.6% (2.5-2.6) vs 2.1% (1.2-3.9) and 18.1% (16.9-19.3) vs 26.4% (16.5-42.2), respectively, for the youngest and oldest groups. In the OFSEP population, the estimated 30-year PMS values ranged from 7.5% (6.4-8.7) to 24.0% (19.1-28.9) in patients with R-MS and from 25.4% (21.1-29.7) to 36.8% (28.3-45.3) in primary progressive patients, depending on sex and age. DISCUSSION EMF has the great advantage of not requiring death certificates, their quality being less than optimal. Conceptually, it also seems more relevant because it avoids having to state, for each individual, whether death was directly or indirectly caused by MS or whether it would have occurred anyway, which is especially difficult in such chronic diseases.
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Affiliation(s)
- Fabien Rollot
- From the Université de Lyon (F.R., S.V.), Université Claude Bernard Lyon 1; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuroinflammation (F.R., S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron; Observatoire Français de la Sclérose en Plaques (F.R., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR 5292; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., S.V.), State-Approved Foundation, Bron; Direction des Maladies non Transmissible et des Traumatismes (Z.U.), Santé Publique France, Saint-Maurice; Service de Biostatistique-Bioinformatique (Z.U., E.D., M.F., L.R.), Pôle Santé Publique, Hospices Civils de Lyon; Laboratoire de Biométrie et Biologie Evolutive UMR 5558 (E.D., M.F., L.R.), Université Lyon 1 and CNRS, Villeurbanne; Service de Neurologie (M.D.), Centre Hospitalier Régional et Universitaire de Nancy, Université de Lorraine, EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Neurology Department (E.L.P.), CRCSEP Rennes, Clinical Investigation Centre CIC-P 1414, Rennes University Hospital; Service de Neurologie (J.C.), CHU de Toulouse, Hôpital Pierre-Paul Riquet, CRC-SEP; Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity) (J.C.), INSERM UMR 1291, CNRS UMR 5051, Université Toulouse III; Service de Neurologie (A.R.), CRC SEP, CHU de Bordeaux; U1215 INSERM (A.R.), Neurocentre Magendie, Université de Bordeaux; Service de Neurologie et Centre d'Investigation Clinique (J.D.S.), CHU de Strasbourg, INSERM 1434; Pôle des Neurosciences et de l'Appareil Locomoteur (H.Z.), CRC-SEP, Hôpital Roger Salengro, Université de Lille, Inserm U1172; CRC SEP (P.L.), Service de Neurologie, CHU de Montpellier; Service de Neurologie (G.D.), CRC-SEP Normandie, CHU de Caen, Université Normandie; Service de Neurologie (C.L.-F.), Neurologie Pasteur 2, CHU de Nice, Université Nice Cote d'Azur UR2CA-URRIS; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (D.A.L.), CHU Nantes; INSERM (D.A.L.), CIC 0004, CRTI-INSERM UMR U1064, Nantes; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (P.C.), CHU de Clermont-Ferrand, INSERM 1107 NeuroDol, Clermont-Ferrand; Aix Marseille University (J.P.), APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, CEMEREM; Service de Neurologie (E.T.), CHU de Nîmes; Institut de Génomique Fonctionnelle (E.T.), Université de Montpellier, CNRS, INSERM; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; and Univ Rennes (E.L.), EHESP, CNRS, Inserm, ARENES UMR 6051, RSMS U 1309, France
| | - Zoé Uhry
- From the Université de Lyon (F.R., S.V.), Université Claude Bernard Lyon 1; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuroinflammation (F.R., S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron; Observatoire Français de la Sclérose en Plaques (F.R., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR 5292; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., S.V.), State-Approved Foundation, Bron; Direction des Maladies non Transmissible et des Traumatismes (Z.U.), Santé Publique France, Saint-Maurice; Service de Biostatistique-Bioinformatique (Z.U., E.D., M.F., L.R.), Pôle Santé Publique, Hospices Civils de Lyon; Laboratoire de Biométrie et Biologie Evolutive UMR 5558 (E.D., M.F., L.R.), Université Lyon 1 and CNRS, Villeurbanne; Service de Neurologie (M.D.), Centre Hospitalier Régional et Universitaire de Nancy, Université de Lorraine, EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Neurology Department (E.L.P.), CRCSEP Rennes, Clinical Investigation Centre CIC-P 1414, Rennes University Hospital; Service de Neurologie (J.C.), CHU de Toulouse, Hôpital Pierre-Paul Riquet, CRC-SEP; Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity) (J.C.), INSERM UMR 1291, CNRS UMR 5051, Université Toulouse III; Service de Neurologie (A.R.), CRC SEP, CHU de Bordeaux; U1215 INSERM (A.R.), Neurocentre Magendie, Université de Bordeaux; Service de Neurologie et Centre d'Investigation Clinique (J.D.S.), CHU de Strasbourg, INSERM 1434; Pôle des Neurosciences et de l'Appareil Locomoteur (H.Z.), CRC-SEP, Hôpital Roger Salengro, Université de Lille, Inserm U1172; CRC SEP (P.L.), Service de Neurologie, CHU de Montpellier; Service de Neurologie (G.D.), CRC-SEP Normandie, CHU de Caen, Université Normandie; Service de Neurologie (C.L.-F.), Neurologie Pasteur 2, CHU de Nice, Université Nice Cote d'Azur UR2CA-URRIS; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (D.A.L.), CHU Nantes; INSERM (D.A.L.), CIC 0004, CRTI-INSERM UMR U1064, Nantes; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (P.C.), CHU de Clermont-Ferrand, INSERM 1107 NeuroDol, Clermont-Ferrand; Aix Marseille University (J.P.), APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, CEMEREM; Service de Neurologie (E.T.), CHU de Nîmes; Institut de Génomique Fonctionnelle (E.T.), Université de Montpellier, CNRS, INSERM; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; and Univ Rennes (E.L.), EHESP, CNRS, Inserm, ARENES UMR 6051, RSMS U 1309, France
| | - Emmanuelle Dantony
- From the Université de Lyon (F.R., S.V.), Université Claude Bernard Lyon 1; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuroinflammation (F.R., S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron; Observatoire Français de la Sclérose en Plaques (F.R., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR 5292; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., S.V.), State-Approved Foundation, Bron; Direction des Maladies non Transmissible et des Traumatismes (Z.U.), Santé Publique France, Saint-Maurice; Service de Biostatistique-Bioinformatique (Z.U., E.D., M.F., L.R.), Pôle Santé Publique, Hospices Civils de Lyon; Laboratoire de Biométrie et Biologie Evolutive UMR 5558 (E.D., M.F., L.R.), Université Lyon 1 and CNRS, Villeurbanne; Service de Neurologie (M.D.), Centre Hospitalier Régional et Universitaire de Nancy, Université de Lorraine, EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Neurology Department (E.L.P.), CRCSEP Rennes, Clinical Investigation Centre CIC-P 1414, Rennes University Hospital; Service de Neurologie (J.C.), CHU de Toulouse, Hôpital Pierre-Paul Riquet, CRC-SEP; Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity) (J.C.), INSERM UMR 1291, CNRS UMR 5051, Université Toulouse III; Service de Neurologie (A.R.), CRC SEP, CHU de Bordeaux; U1215 INSERM (A.R.), Neurocentre Magendie, Université de Bordeaux; Service de Neurologie et Centre d'Investigation Clinique (J.D.S.), CHU de Strasbourg, INSERM 1434; Pôle des Neurosciences et de l'Appareil Locomoteur (H.Z.), CRC-SEP, Hôpital Roger Salengro, Université de Lille, Inserm U1172; CRC SEP (P.L.), Service de Neurologie, CHU de Montpellier; Service de Neurologie (G.D.), CRC-SEP Normandie, CHU de Caen, Université Normandie; Service de Neurologie (C.L.-F.), Neurologie Pasteur 2, CHU de Nice, Université Nice Cote d'Azur UR2CA-URRIS; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (D.A.L.), CHU Nantes; INSERM (D.A.L.), CIC 0004, CRTI-INSERM UMR U1064, Nantes; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (P.C.), CHU de Clermont-Ferrand, INSERM 1107 NeuroDol, Clermont-Ferrand; Aix Marseille University (J.P.), APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, CEMEREM; Service de Neurologie (E.T.), CHU de Nîmes; Institut de Génomique Fonctionnelle (E.T.), Université de Montpellier, CNRS, INSERM; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; and Univ Rennes (E.L.), EHESP, CNRS, Inserm, ARENES UMR 6051, RSMS U 1309, France
| | - Sandra Vukusic
- From the Université de Lyon (F.R., S.V.), Université Claude Bernard Lyon 1; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuroinflammation (F.R., S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron; Observatoire Français de la Sclérose en Plaques (F.R., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR 5292; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., S.V.), State-Approved Foundation, Bron; Direction des Maladies non Transmissible et des Traumatismes (Z.U.), Santé Publique France, Saint-Maurice; Service de Biostatistique-Bioinformatique (Z.U., E.D., M.F., L.R.), Pôle Santé Publique, Hospices Civils de Lyon; Laboratoire de Biométrie et Biologie Evolutive UMR 5558 (E.D., M.F., L.R.), Université Lyon 1 and CNRS, Villeurbanne; Service de Neurologie (M.D.), Centre Hospitalier Régional et Universitaire de Nancy, Université de Lorraine, EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Neurology Department (E.L.P.), CRCSEP Rennes, Clinical Investigation Centre CIC-P 1414, Rennes University Hospital; Service de Neurologie (J.C.), CHU de Toulouse, Hôpital Pierre-Paul Riquet, CRC-SEP; Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity) (J.C.), INSERM UMR 1291, CNRS UMR 5051, Université Toulouse III; Service de Neurologie (A.R.), CRC SEP, CHU de Bordeaux; U1215 INSERM (A.R.), Neurocentre Magendie, Université de Bordeaux; Service de Neurologie et Centre d'Investigation Clinique (J.D.S.), CHU de Strasbourg, INSERM 1434; Pôle des Neurosciences et de l'Appareil Locomoteur (H.Z.), CRC-SEP, Hôpital Roger Salengro, Université de Lille, Inserm U1172; CRC SEP (P.L.), Service de Neurologie, CHU de Montpellier; Service de Neurologie (G.D.), CRC-SEP Normandie, CHU de Caen, Université Normandie; Service de Neurologie (C.L.-F.), Neurologie Pasteur 2, CHU de Nice, Université Nice Cote d'Azur UR2CA-URRIS; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (D.A.L.), CHU Nantes; INSERM (D.A.L.), CIC 0004, CRTI-INSERM UMR U1064, Nantes; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (P.C.), CHU de Clermont-Ferrand, INSERM 1107 NeuroDol, Clermont-Ferrand; Aix Marseille University (J.P.), APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, CEMEREM; Service de Neurologie (E.T.), CHU de Nîmes; Institut de Génomique Fonctionnelle (E.T.), Université de Montpellier, CNRS, INSERM; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; and Univ Rennes (E.L.), EHESP, CNRS, Inserm, ARENES UMR 6051, RSMS U 1309, France
| | - Marc Debouverie
- From the Université de Lyon (F.R., S.V.), Université Claude Bernard Lyon 1; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuroinflammation (F.R., S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron; Observatoire Français de la Sclérose en Plaques (F.R., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR 5292; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., S.V.), State-Approved Foundation, Bron; Direction des Maladies non Transmissible et des Traumatismes (Z.U.), Santé Publique France, Saint-Maurice; Service de Biostatistique-Bioinformatique (Z.U., E.D., M.F., L.R.), Pôle Santé Publique, Hospices Civils de Lyon; Laboratoire de Biométrie et Biologie Evolutive UMR 5558 (E.D., M.F., L.R.), Université Lyon 1 and CNRS, Villeurbanne; Service de Neurologie (M.D.), Centre Hospitalier Régional et Universitaire de Nancy, Université de Lorraine, EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Neurology Department (E.L.P.), CRCSEP Rennes, Clinical Investigation Centre CIC-P 1414, Rennes University Hospital; Service de Neurologie (J.C.), CHU de Toulouse, Hôpital Pierre-Paul Riquet, CRC-SEP; Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity) (J.C.), INSERM UMR 1291, CNRS UMR 5051, Université Toulouse III; Service de Neurologie (A.R.), CRC SEP, CHU de Bordeaux; U1215 INSERM (A.R.), Neurocentre Magendie, Université de Bordeaux; Service de Neurologie et Centre d'Investigation Clinique (J.D.S.), CHU de Strasbourg, INSERM 1434; Pôle des Neurosciences et de l'Appareil Locomoteur (H.Z.), CRC-SEP, Hôpital Roger Salengro, Université de Lille, Inserm U1172; CRC SEP (P.L.), Service de Neurologie, CHU de Montpellier; Service de Neurologie (G.D.), CRC-SEP Normandie, CHU de Caen, Université Normandie; Service de Neurologie (C.L.-F.), Neurologie Pasteur 2, CHU de Nice, Université Nice Cote d'Azur UR2CA-URRIS; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (D.A.L.), CHU Nantes; INSERM (D.A.L.), CIC 0004, CRTI-INSERM UMR U1064, Nantes; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (P.C.), CHU de Clermont-Ferrand, INSERM 1107 NeuroDol, Clermont-Ferrand; Aix Marseille University (J.P.), APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, CEMEREM; Service de Neurologie (E.T.), CHU de Nîmes; Institut de Génomique Fonctionnelle (E.T.), Université de Montpellier, CNRS, INSERM; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; and Univ Rennes (E.L.), EHESP, CNRS, Inserm, ARENES UMR 6051, RSMS U 1309, France
| | - Emmanuelle Le Page
- From the Université de Lyon (F.R., S.V.), Université Claude Bernard Lyon 1; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuroinflammation (F.R., S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron; Observatoire Français de la Sclérose en Plaques (F.R., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR 5292; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., S.V.), State-Approved Foundation, Bron; Direction des Maladies non Transmissible et des Traumatismes (Z.U.), Santé Publique France, Saint-Maurice; Service de Biostatistique-Bioinformatique (Z.U., E.D., M.F., L.R.), Pôle Santé Publique, Hospices Civils de Lyon; Laboratoire de Biométrie et Biologie Evolutive UMR 5558 (E.D., M.F., L.R.), Université Lyon 1 and CNRS, Villeurbanne; Service de Neurologie (M.D.), Centre Hospitalier Régional et Universitaire de Nancy, Université de Lorraine, EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Neurology Department (E.L.P.), CRCSEP Rennes, Clinical Investigation Centre CIC-P 1414, Rennes University Hospital; Service de Neurologie (J.C.), CHU de Toulouse, Hôpital Pierre-Paul Riquet, CRC-SEP; Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity) (J.C.), INSERM UMR 1291, CNRS UMR 5051, Université Toulouse III; Service de Neurologie (A.R.), CRC SEP, CHU de Bordeaux; U1215 INSERM (A.R.), Neurocentre Magendie, Université de Bordeaux; Service de Neurologie et Centre d'Investigation Clinique (J.D.S.), CHU de Strasbourg, INSERM 1434; Pôle des Neurosciences et de l'Appareil Locomoteur (H.Z.), CRC-SEP, Hôpital Roger Salengro, Université de Lille, Inserm U1172; CRC SEP (P.L.), Service de Neurologie, CHU de Montpellier; Service de Neurologie (G.D.), CRC-SEP Normandie, CHU de Caen, Université Normandie; Service de Neurologie (C.L.-F.), Neurologie Pasteur 2, CHU de Nice, Université Nice Cote d'Azur UR2CA-URRIS; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (D.A.L.), CHU Nantes; INSERM (D.A.L.), CIC 0004, CRTI-INSERM UMR U1064, Nantes; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (P.C.), CHU de Clermont-Ferrand, INSERM 1107 NeuroDol, Clermont-Ferrand; Aix Marseille University (J.P.), APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, CEMEREM; Service de Neurologie (E.T.), CHU de Nîmes; Institut de Génomique Fonctionnelle (E.T.), Université de Montpellier, CNRS, INSERM; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; and Univ Rennes (E.L.), EHESP, CNRS, Inserm, ARENES UMR 6051, RSMS U 1309, France
| | - Jonathan Ciron
- From the Université de Lyon (F.R., S.V.), Université Claude Bernard Lyon 1; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuroinflammation (F.R., S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron; Observatoire Français de la Sclérose en Plaques (F.R., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR 5292; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., S.V.), State-Approved Foundation, Bron; Direction des Maladies non Transmissible et des Traumatismes (Z.U.), Santé Publique France, Saint-Maurice; Service de Biostatistique-Bioinformatique (Z.U., E.D., M.F., L.R.), Pôle Santé Publique, Hospices Civils de Lyon; Laboratoire de Biométrie et Biologie Evolutive UMR 5558 (E.D., M.F., L.R.), Université Lyon 1 and CNRS, Villeurbanne; Service de Neurologie (M.D.), Centre Hospitalier Régional et Universitaire de Nancy, Université de Lorraine, EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Neurology Department (E.L.P.), CRCSEP Rennes, Clinical Investigation Centre CIC-P 1414, Rennes University Hospital; Service de Neurologie (J.C.), CHU de Toulouse, Hôpital Pierre-Paul Riquet, CRC-SEP; Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity) (J.C.), INSERM UMR 1291, CNRS UMR 5051, Université Toulouse III; Service de Neurologie (A.R.), CRC SEP, CHU de Bordeaux; U1215 INSERM (A.R.), Neurocentre Magendie, Université de Bordeaux; Service de Neurologie et Centre d'Investigation Clinique (J.D.S.), CHU de Strasbourg, INSERM 1434; Pôle des Neurosciences et de l'Appareil Locomoteur (H.Z.), CRC-SEP, Hôpital Roger Salengro, Université de Lille, Inserm U1172; CRC SEP (P.L.), Service de Neurologie, CHU de Montpellier; Service de Neurologie (G.D.), CRC-SEP Normandie, CHU de Caen, Université Normandie; Service de Neurologie (C.L.-F.), Neurologie Pasteur 2, CHU de Nice, Université Nice Cote d'Azur UR2CA-URRIS; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (D.A.L.), CHU Nantes; INSERM (D.A.L.), CIC 0004, CRTI-INSERM UMR U1064, Nantes; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (P.C.), CHU de Clermont-Ferrand, INSERM 1107 NeuroDol, Clermont-Ferrand; Aix Marseille University (J.P.), APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, CEMEREM; Service de Neurologie (E.T.), CHU de Nîmes; Institut de Génomique Fonctionnelle (E.T.), Université de Montpellier, CNRS, INSERM; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; and Univ Rennes (E.L.), EHESP, CNRS, Inserm, ARENES UMR 6051, RSMS U 1309, France
| | - Aurélie Ruet
- From the Université de Lyon (F.R., S.V.), Université Claude Bernard Lyon 1; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuroinflammation (F.R., S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron; Observatoire Français de la Sclérose en Plaques (F.R., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR 5292; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., S.V.), State-Approved Foundation, Bron; Direction des Maladies non Transmissible et des Traumatismes (Z.U.), Santé Publique France, Saint-Maurice; Service de Biostatistique-Bioinformatique (Z.U., E.D., M.F., L.R.), Pôle Santé Publique, Hospices Civils de Lyon; Laboratoire de Biométrie et Biologie Evolutive UMR 5558 (E.D., M.F., L.R.), Université Lyon 1 and CNRS, Villeurbanne; Service de Neurologie (M.D.), Centre Hospitalier Régional et Universitaire de Nancy, Université de Lorraine, EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Neurology Department (E.L.P.), CRCSEP Rennes, Clinical Investigation Centre CIC-P 1414, Rennes University Hospital; Service de Neurologie (J.C.), CHU de Toulouse, Hôpital Pierre-Paul Riquet, CRC-SEP; Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity) (J.C.), INSERM UMR 1291, CNRS UMR 5051, Université Toulouse III; Service de Neurologie (A.R.), CRC SEP, CHU de Bordeaux; U1215 INSERM (A.R.), Neurocentre Magendie, Université de Bordeaux; Service de Neurologie et Centre d'Investigation Clinique (J.D.S.), CHU de Strasbourg, INSERM 1434; Pôle des Neurosciences et de l'Appareil Locomoteur (H.Z.), CRC-SEP, Hôpital Roger Salengro, Université de Lille, Inserm U1172; CRC SEP (P.L.), Service de Neurologie, CHU de Montpellier; Service de Neurologie (G.D.), CRC-SEP Normandie, CHU de Caen, Université Normandie; Service de Neurologie (C.L.-F.), Neurologie Pasteur 2, CHU de Nice, Université Nice Cote d'Azur UR2CA-URRIS; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (D.A.L.), CHU Nantes; INSERM (D.A.L.), CIC 0004, CRTI-INSERM UMR U1064, Nantes; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (P.C.), CHU de Clermont-Ferrand, INSERM 1107 NeuroDol, Clermont-Ferrand; Aix Marseille University (J.P.), APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, CEMEREM; Service de Neurologie (E.T.), CHU de Nîmes; Institut de Génomique Fonctionnelle (E.T.), Université de Montpellier, CNRS, INSERM; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; and Univ Rennes (E.L.), EHESP, CNRS, Inserm, ARENES UMR 6051, RSMS U 1309, France
| | - Jérome De Sèze
- From the Université de Lyon (F.R., S.V.), Université Claude Bernard Lyon 1; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuroinflammation (F.R., S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron; Observatoire Français de la Sclérose en Plaques (F.R., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR 5292; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., S.V.), State-Approved Foundation, Bron; Direction des Maladies non Transmissible et des Traumatismes (Z.U.), Santé Publique France, Saint-Maurice; Service de Biostatistique-Bioinformatique (Z.U., E.D., M.F., L.R.), Pôle Santé Publique, Hospices Civils de Lyon; Laboratoire de Biométrie et Biologie Evolutive UMR 5558 (E.D., M.F., L.R.), Université Lyon 1 and CNRS, Villeurbanne; Service de Neurologie (M.D.), Centre Hospitalier Régional et Universitaire de Nancy, Université de Lorraine, EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Neurology Department (E.L.P.), CRCSEP Rennes, Clinical Investigation Centre CIC-P 1414, Rennes University Hospital; Service de Neurologie (J.C.), CHU de Toulouse, Hôpital Pierre-Paul Riquet, CRC-SEP; Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity) (J.C.), INSERM UMR 1291, CNRS UMR 5051, Université Toulouse III; Service de Neurologie (A.R.), CRC SEP, CHU de Bordeaux; U1215 INSERM (A.R.), Neurocentre Magendie, Université de Bordeaux; Service de Neurologie et Centre d'Investigation Clinique (J.D.S.), CHU de Strasbourg, INSERM 1434; Pôle des Neurosciences et de l'Appareil Locomoteur (H.Z.), CRC-SEP, Hôpital Roger Salengro, Université de Lille, Inserm U1172; CRC SEP (P.L.), Service de Neurologie, CHU de Montpellier; Service de Neurologie (G.D.), CRC-SEP Normandie, CHU de Caen, Université Normandie; Service de Neurologie (C.L.-F.), Neurologie Pasteur 2, CHU de Nice, Université Nice Cote d'Azur UR2CA-URRIS; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (D.A.L.), CHU Nantes; INSERM (D.A.L.), CIC 0004, CRTI-INSERM UMR U1064, Nantes; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (P.C.), CHU de Clermont-Ferrand, INSERM 1107 NeuroDol, Clermont-Ferrand; Aix Marseille University (J.P.), APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, CEMEREM; Service de Neurologie (E.T.), CHU de Nîmes; Institut de Génomique Fonctionnelle (E.T.), Université de Montpellier, CNRS, INSERM; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; and Univ Rennes (E.L.), EHESP, CNRS, Inserm, ARENES UMR 6051, RSMS U 1309, France
| | - Hélène Zéphir
- From the Université de Lyon (F.R., S.V.), Université Claude Bernard Lyon 1; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuroinflammation (F.R., S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron; Observatoire Français de la Sclérose en Plaques (F.R., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR 5292; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., S.V.), State-Approved Foundation, Bron; Direction des Maladies non Transmissible et des Traumatismes (Z.U.), Santé Publique France, Saint-Maurice; Service de Biostatistique-Bioinformatique (Z.U., E.D., M.F., L.R.), Pôle Santé Publique, Hospices Civils de Lyon; Laboratoire de Biométrie et Biologie Evolutive UMR 5558 (E.D., M.F., L.R.), Université Lyon 1 and CNRS, Villeurbanne; Service de Neurologie (M.D.), Centre Hospitalier Régional et Universitaire de Nancy, Université de Lorraine, EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Neurology Department (E.L.P.), CRCSEP Rennes, Clinical Investigation Centre CIC-P 1414, Rennes University Hospital; Service de Neurologie (J.C.), CHU de Toulouse, Hôpital Pierre-Paul Riquet, CRC-SEP; Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity) (J.C.), INSERM UMR 1291, CNRS UMR 5051, Université Toulouse III; Service de Neurologie (A.R.), CRC SEP, CHU de Bordeaux; U1215 INSERM (A.R.), Neurocentre Magendie, Université de Bordeaux; Service de Neurologie et Centre d'Investigation Clinique (J.D.S.), CHU de Strasbourg, INSERM 1434; Pôle des Neurosciences et de l'Appareil Locomoteur (H.Z.), CRC-SEP, Hôpital Roger Salengro, Université de Lille, Inserm U1172; CRC SEP (P.L.), Service de Neurologie, CHU de Montpellier; Service de Neurologie (G.D.), CRC-SEP Normandie, CHU de Caen, Université Normandie; Service de Neurologie (C.L.-F.), Neurologie Pasteur 2, CHU de Nice, Université Nice Cote d'Azur UR2CA-URRIS; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (D.A.L.), CHU Nantes; INSERM (D.A.L.), CIC 0004, CRTI-INSERM UMR U1064, Nantes; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (P.C.), CHU de Clermont-Ferrand, INSERM 1107 NeuroDol, Clermont-Ferrand; Aix Marseille University (J.P.), APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, CEMEREM; Service de Neurologie (E.T.), CHU de Nîmes; Institut de Génomique Fonctionnelle (E.T.), Université de Montpellier, CNRS, INSERM; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; and Univ Rennes (E.L.), EHESP, CNRS, Inserm, ARENES UMR 6051, RSMS U 1309, France
| | - Pierre Labauge
- From the Université de Lyon (F.R., S.V.), Université Claude Bernard Lyon 1; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuroinflammation (F.R., S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron; Observatoire Français de la Sclérose en Plaques (F.R., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR 5292; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., S.V.), State-Approved Foundation, Bron; Direction des Maladies non Transmissible et des Traumatismes (Z.U.), Santé Publique France, Saint-Maurice; Service de Biostatistique-Bioinformatique (Z.U., E.D., M.F., L.R.), Pôle Santé Publique, Hospices Civils de Lyon; Laboratoire de Biométrie et Biologie Evolutive UMR 5558 (E.D., M.F., L.R.), Université Lyon 1 and CNRS, Villeurbanne; Service de Neurologie (M.D.), Centre Hospitalier Régional et Universitaire de Nancy, Université de Lorraine, EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Neurology Department (E.L.P.), CRCSEP Rennes, Clinical Investigation Centre CIC-P 1414, Rennes University Hospital; Service de Neurologie (J.C.), CHU de Toulouse, Hôpital Pierre-Paul Riquet, CRC-SEP; Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity) (J.C.), INSERM UMR 1291, CNRS UMR 5051, Université Toulouse III; Service de Neurologie (A.R.), CRC SEP, CHU de Bordeaux; U1215 INSERM (A.R.), Neurocentre Magendie, Université de Bordeaux; Service de Neurologie et Centre d'Investigation Clinique (J.D.S.), CHU de Strasbourg, INSERM 1434; Pôle des Neurosciences et de l'Appareil Locomoteur (H.Z.), CRC-SEP, Hôpital Roger Salengro, Université de Lille, Inserm U1172; CRC SEP (P.L.), Service de Neurologie, CHU de Montpellier; Service de Neurologie (G.D.), CRC-SEP Normandie, CHU de Caen, Université Normandie; Service de Neurologie (C.L.-F.), Neurologie Pasteur 2, CHU de Nice, Université Nice Cote d'Azur UR2CA-URRIS; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (D.A.L.), CHU Nantes; INSERM (D.A.L.), CIC 0004, CRTI-INSERM UMR U1064, Nantes; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (P.C.), CHU de Clermont-Ferrand, INSERM 1107 NeuroDol, Clermont-Ferrand; Aix Marseille University (J.P.), APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, CEMEREM; Service de Neurologie (E.T.), CHU de Nîmes; Institut de Génomique Fonctionnelle (E.T.), Université de Montpellier, CNRS, INSERM; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; and Univ Rennes (E.L.), EHESP, CNRS, Inserm, ARENES UMR 6051, RSMS U 1309, France
| | - Gilles Defer
- From the Université de Lyon (F.R., S.V.), Université Claude Bernard Lyon 1; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuroinflammation (F.R., S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron; Observatoire Français de la Sclérose en Plaques (F.R., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR 5292; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., S.V.), State-Approved Foundation, Bron; Direction des Maladies non Transmissible et des Traumatismes (Z.U.), Santé Publique France, Saint-Maurice; Service de Biostatistique-Bioinformatique (Z.U., E.D., M.F., L.R.), Pôle Santé Publique, Hospices Civils de Lyon; Laboratoire de Biométrie et Biologie Evolutive UMR 5558 (E.D., M.F., L.R.), Université Lyon 1 and CNRS, Villeurbanne; Service de Neurologie (M.D.), Centre Hospitalier Régional et Universitaire de Nancy, Université de Lorraine, EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Neurology Department (E.L.P.), CRCSEP Rennes, Clinical Investigation Centre CIC-P 1414, Rennes University Hospital; Service de Neurologie (J.C.), CHU de Toulouse, Hôpital Pierre-Paul Riquet, CRC-SEP; Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity) (J.C.), INSERM UMR 1291, CNRS UMR 5051, Université Toulouse III; Service de Neurologie (A.R.), CRC SEP, CHU de Bordeaux; U1215 INSERM (A.R.), Neurocentre Magendie, Université de Bordeaux; Service de Neurologie et Centre d'Investigation Clinique (J.D.S.), CHU de Strasbourg, INSERM 1434; Pôle des Neurosciences et de l'Appareil Locomoteur (H.Z.), CRC-SEP, Hôpital Roger Salengro, Université de Lille, Inserm U1172; CRC SEP (P.L.), Service de Neurologie, CHU de Montpellier; Service de Neurologie (G.D.), CRC-SEP Normandie, CHU de Caen, Université Normandie; Service de Neurologie (C.L.-F.), Neurologie Pasteur 2, CHU de Nice, Université Nice Cote d'Azur UR2CA-URRIS; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (D.A.L.), CHU Nantes; INSERM (D.A.L.), CIC 0004, CRTI-INSERM UMR U1064, Nantes; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (P.C.), CHU de Clermont-Ferrand, INSERM 1107 NeuroDol, Clermont-Ferrand; Aix Marseille University (J.P.), APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, CEMEREM; Service de Neurologie (E.T.), CHU de Nîmes; Institut de Génomique Fonctionnelle (E.T.), Université de Montpellier, CNRS, INSERM; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; and Univ Rennes (E.L.), EHESP, CNRS, Inserm, ARENES UMR 6051, RSMS U 1309, France
| | - Christine Lebrun-Frenay
- From the Université de Lyon (F.R., S.V.), Université Claude Bernard Lyon 1; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuroinflammation (F.R., S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron; Observatoire Français de la Sclérose en Plaques (F.R., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR 5292; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., S.V.), State-Approved Foundation, Bron; Direction des Maladies non Transmissible et des Traumatismes (Z.U.), Santé Publique France, Saint-Maurice; Service de Biostatistique-Bioinformatique (Z.U., E.D., M.F., L.R.), Pôle Santé Publique, Hospices Civils de Lyon; Laboratoire de Biométrie et Biologie Evolutive UMR 5558 (E.D., M.F., L.R.), Université Lyon 1 and CNRS, Villeurbanne; Service de Neurologie (M.D.), Centre Hospitalier Régional et Universitaire de Nancy, Université de Lorraine, EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Neurology Department (E.L.P.), CRCSEP Rennes, Clinical Investigation Centre CIC-P 1414, Rennes University Hospital; Service de Neurologie (J.C.), CHU de Toulouse, Hôpital Pierre-Paul Riquet, CRC-SEP; Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity) (J.C.), INSERM UMR 1291, CNRS UMR 5051, Université Toulouse III; Service de Neurologie (A.R.), CRC SEP, CHU de Bordeaux; U1215 INSERM (A.R.), Neurocentre Magendie, Université de Bordeaux; Service de Neurologie et Centre d'Investigation Clinique (J.D.S.), CHU de Strasbourg, INSERM 1434; Pôle des Neurosciences et de l'Appareil Locomoteur (H.Z.), CRC-SEP, Hôpital Roger Salengro, Université de Lille, Inserm U1172; CRC SEP (P.L.), Service de Neurologie, CHU de Montpellier; Service de Neurologie (G.D.), CRC-SEP Normandie, CHU de Caen, Université Normandie; Service de Neurologie (C.L.-F.), Neurologie Pasteur 2, CHU de Nice, Université Nice Cote d'Azur UR2CA-URRIS; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (D.A.L.), CHU Nantes; INSERM (D.A.L.), CIC 0004, CRTI-INSERM UMR U1064, Nantes; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (P.C.), CHU de Clermont-Ferrand, INSERM 1107 NeuroDol, Clermont-Ferrand; Aix Marseille University (J.P.), APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, CEMEREM; Service de Neurologie (E.T.), CHU de Nîmes; Institut de Génomique Fonctionnelle (E.T.), Université de Montpellier, CNRS, INSERM; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; and Univ Rennes (E.L.), EHESP, CNRS, Inserm, ARENES UMR 6051, RSMS U 1309, France
| | - Thibault Moreau
- From the Université de Lyon (F.R., S.V.), Université Claude Bernard Lyon 1; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuroinflammation (F.R., S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron; Observatoire Français de la Sclérose en Plaques (F.R., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR 5292; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., S.V.), State-Approved Foundation, Bron; Direction des Maladies non Transmissible et des Traumatismes (Z.U.), Santé Publique France, Saint-Maurice; Service de Biostatistique-Bioinformatique (Z.U., E.D., M.F., L.R.), Pôle Santé Publique, Hospices Civils de Lyon; Laboratoire de Biométrie et Biologie Evolutive UMR 5558 (E.D., M.F., L.R.), Université Lyon 1 and CNRS, Villeurbanne; Service de Neurologie (M.D.), Centre Hospitalier Régional et Universitaire de Nancy, Université de Lorraine, EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Neurology Department (E.L.P.), CRCSEP Rennes, Clinical Investigation Centre CIC-P 1414, Rennes University Hospital; Service de Neurologie (J.C.), CHU de Toulouse, Hôpital Pierre-Paul Riquet, CRC-SEP; Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity) (J.C.), INSERM UMR 1291, CNRS UMR 5051, Université Toulouse III; Service de Neurologie (A.R.), CRC SEP, CHU de Bordeaux; U1215 INSERM (A.R.), Neurocentre Magendie, Université de Bordeaux; Service de Neurologie et Centre d'Investigation Clinique (J.D.S.), CHU de Strasbourg, INSERM 1434; Pôle des Neurosciences et de l'Appareil Locomoteur (H.Z.), CRC-SEP, Hôpital Roger Salengro, Université de Lille, Inserm U1172; CRC SEP (P.L.), Service de Neurologie, CHU de Montpellier; Service de Neurologie (G.D.), CRC-SEP Normandie, CHU de Caen, Université Normandie; Service de Neurologie (C.L.-F.), Neurologie Pasteur 2, CHU de Nice, Université Nice Cote d'Azur UR2CA-URRIS; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (D.A.L.), CHU Nantes; INSERM (D.A.L.), CIC 0004, CRTI-INSERM UMR U1064, Nantes; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (P.C.), CHU de Clermont-Ferrand, INSERM 1107 NeuroDol, Clermont-Ferrand; Aix Marseille University (J.P.), APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, CEMEREM; Service de Neurologie (E.T.), CHU de Nîmes; Institut de Génomique Fonctionnelle (E.T.), Université de Montpellier, CNRS, INSERM; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; and Univ Rennes (E.L.), EHESP, CNRS, Inserm, ARENES UMR 6051, RSMS U 1309, France
| | - David A Laplaud
- From the Université de Lyon (F.R., S.V.), Université Claude Bernard Lyon 1; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuroinflammation (F.R., S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron; Observatoire Français de la Sclérose en Plaques (F.R., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR 5292; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., S.V.), State-Approved Foundation, Bron; Direction des Maladies non Transmissible et des Traumatismes (Z.U.), Santé Publique France, Saint-Maurice; Service de Biostatistique-Bioinformatique (Z.U., E.D., M.F., L.R.), Pôle Santé Publique, Hospices Civils de Lyon; Laboratoire de Biométrie et Biologie Evolutive UMR 5558 (E.D., M.F., L.R.), Université Lyon 1 and CNRS, Villeurbanne; Service de Neurologie (M.D.), Centre Hospitalier Régional et Universitaire de Nancy, Université de Lorraine, EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Neurology Department (E.L.P.), CRCSEP Rennes, Clinical Investigation Centre CIC-P 1414, Rennes University Hospital; Service de Neurologie (J.C.), CHU de Toulouse, Hôpital Pierre-Paul Riquet, CRC-SEP; Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity) (J.C.), INSERM UMR 1291, CNRS UMR 5051, Université Toulouse III; Service de Neurologie (A.R.), CRC SEP, CHU de Bordeaux; U1215 INSERM (A.R.), Neurocentre Magendie, Université de Bordeaux; Service de Neurologie et Centre d'Investigation Clinique (J.D.S.), CHU de Strasbourg, INSERM 1434; Pôle des Neurosciences et de l'Appareil Locomoteur (H.Z.), CRC-SEP, Hôpital Roger Salengro, Université de Lille, Inserm U1172; CRC SEP (P.L.), Service de Neurologie, CHU de Montpellier; Service de Neurologie (G.D.), CRC-SEP Normandie, CHU de Caen, Université Normandie; Service de Neurologie (C.L.-F.), Neurologie Pasteur 2, CHU de Nice, Université Nice Cote d'Azur UR2CA-URRIS; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (D.A.L.), CHU Nantes; INSERM (D.A.L.), CIC 0004, CRTI-INSERM UMR U1064, Nantes; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (P.C.), CHU de Clermont-Ferrand, INSERM 1107 NeuroDol, Clermont-Ferrand; Aix Marseille University (J.P.), APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, CEMEREM; Service de Neurologie (E.T.), CHU de Nîmes; Institut de Génomique Fonctionnelle (E.T.), Université de Montpellier, CNRS, INSERM; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; and Univ Rennes (E.L.), EHESP, CNRS, Inserm, ARENES UMR 6051, RSMS U 1309, France
| | - Eric Berger
- From the Université de Lyon (F.R., S.V.), Université Claude Bernard Lyon 1; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuroinflammation (F.R., S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron; Observatoire Français de la Sclérose en Plaques (F.R., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR 5292; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., S.V.), State-Approved Foundation, Bron; Direction des Maladies non Transmissible et des Traumatismes (Z.U.), Santé Publique France, Saint-Maurice; Service de Biostatistique-Bioinformatique (Z.U., E.D., M.F., L.R.), Pôle Santé Publique, Hospices Civils de Lyon; Laboratoire de Biométrie et Biologie Evolutive UMR 5558 (E.D., M.F., L.R.), Université Lyon 1 and CNRS, Villeurbanne; Service de Neurologie (M.D.), Centre Hospitalier Régional et Universitaire de Nancy, Université de Lorraine, EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Neurology Department (E.L.P.), CRCSEP Rennes, Clinical Investigation Centre CIC-P 1414, Rennes University Hospital; Service de Neurologie (J.C.), CHU de Toulouse, Hôpital Pierre-Paul Riquet, CRC-SEP; Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity) (J.C.), INSERM UMR 1291, CNRS UMR 5051, Université Toulouse III; Service de Neurologie (A.R.), CRC SEP, CHU de Bordeaux; U1215 INSERM (A.R.), Neurocentre Magendie, Université de Bordeaux; Service de Neurologie et Centre d'Investigation Clinique (J.D.S.), CHU de Strasbourg, INSERM 1434; Pôle des Neurosciences et de l'Appareil Locomoteur (H.Z.), CRC-SEP, Hôpital Roger Salengro, Université de Lille, Inserm U1172; CRC SEP (P.L.), Service de Neurologie, CHU de Montpellier; Service de Neurologie (G.D.), CRC-SEP Normandie, CHU de Caen, Université Normandie; Service de Neurologie (C.L.-F.), Neurologie Pasteur 2, CHU de Nice, Université Nice Cote d'Azur UR2CA-URRIS; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (D.A.L.), CHU Nantes; INSERM (D.A.L.), CIC 0004, CRTI-INSERM UMR U1064, Nantes; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (P.C.), CHU de Clermont-Ferrand, INSERM 1107 NeuroDol, Clermont-Ferrand; Aix Marseille University (J.P.), APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, CEMEREM; Service de Neurologie (E.T.), CHU de Nîmes; Institut de Génomique Fonctionnelle (E.T.), Université de Montpellier, CNRS, INSERM; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; and Univ Rennes (E.L.), EHESP, CNRS, Inserm, ARENES UMR 6051, RSMS U 1309, France
| | - Pierre Clavelou
- From the Université de Lyon (F.R., S.V.), Université Claude Bernard Lyon 1; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuroinflammation (F.R., S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron; Observatoire Français de la Sclérose en Plaques (F.R., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR 5292; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., S.V.), State-Approved Foundation, Bron; Direction des Maladies non Transmissible et des Traumatismes (Z.U.), Santé Publique France, Saint-Maurice; Service de Biostatistique-Bioinformatique (Z.U., E.D., M.F., L.R.), Pôle Santé Publique, Hospices Civils de Lyon; Laboratoire de Biométrie et Biologie Evolutive UMR 5558 (E.D., M.F., L.R.), Université Lyon 1 and CNRS, Villeurbanne; Service de Neurologie (M.D.), Centre Hospitalier Régional et Universitaire de Nancy, Université de Lorraine, EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Neurology Department (E.L.P.), CRCSEP Rennes, Clinical Investigation Centre CIC-P 1414, Rennes University Hospital; Service de Neurologie (J.C.), CHU de Toulouse, Hôpital Pierre-Paul Riquet, CRC-SEP; Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity) (J.C.), INSERM UMR 1291, CNRS UMR 5051, Université Toulouse III; Service de Neurologie (A.R.), CRC SEP, CHU de Bordeaux; U1215 INSERM (A.R.), Neurocentre Magendie, Université de Bordeaux; Service de Neurologie et Centre d'Investigation Clinique (J.D.S.), CHU de Strasbourg, INSERM 1434; Pôle des Neurosciences et de l'Appareil Locomoteur (H.Z.), CRC-SEP, Hôpital Roger Salengro, Université de Lille, Inserm U1172; CRC SEP (P.L.), Service de Neurologie, CHU de Montpellier; Service de Neurologie (G.D.), CRC-SEP Normandie, CHU de Caen, Université Normandie; Service de Neurologie (C.L.-F.), Neurologie Pasteur 2, CHU de Nice, Université Nice Cote d'Azur UR2CA-URRIS; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (D.A.L.), CHU Nantes; INSERM (D.A.L.), CIC 0004, CRTI-INSERM UMR U1064, Nantes; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (P.C.), CHU de Clermont-Ferrand, INSERM 1107 NeuroDol, Clermont-Ferrand; Aix Marseille University (J.P.), APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, CEMEREM; Service de Neurologie (E.T.), CHU de Nîmes; Institut de Génomique Fonctionnelle (E.T.), Université de Montpellier, CNRS, INSERM; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; and Univ Rennes (E.L.), EHESP, CNRS, Inserm, ARENES UMR 6051, RSMS U 1309, France
| | - Jean Pelletier
- From the Université de Lyon (F.R., S.V.), Université Claude Bernard Lyon 1; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuroinflammation (F.R., S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron; Observatoire Français de la Sclérose en Plaques (F.R., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR 5292; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., S.V.), State-Approved Foundation, Bron; Direction des Maladies non Transmissible et des Traumatismes (Z.U.), Santé Publique France, Saint-Maurice; Service de Biostatistique-Bioinformatique (Z.U., E.D., M.F., L.R.), Pôle Santé Publique, Hospices Civils de Lyon; Laboratoire de Biométrie et Biologie Evolutive UMR 5558 (E.D., M.F., L.R.), Université Lyon 1 and CNRS, Villeurbanne; Service de Neurologie (M.D.), Centre Hospitalier Régional et Universitaire de Nancy, Université de Lorraine, EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Neurology Department (E.L.P.), CRCSEP Rennes, Clinical Investigation Centre CIC-P 1414, Rennes University Hospital; Service de Neurologie (J.C.), CHU de Toulouse, Hôpital Pierre-Paul Riquet, CRC-SEP; Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity) (J.C.), INSERM UMR 1291, CNRS UMR 5051, Université Toulouse III; Service de Neurologie (A.R.), CRC SEP, CHU de Bordeaux; U1215 INSERM (A.R.), Neurocentre Magendie, Université de Bordeaux; Service de Neurologie et Centre d'Investigation Clinique (J.D.S.), CHU de Strasbourg, INSERM 1434; Pôle des Neurosciences et de l'Appareil Locomoteur (H.Z.), CRC-SEP, Hôpital Roger Salengro, Université de Lille, Inserm U1172; CRC SEP (P.L.), Service de Neurologie, CHU de Montpellier; Service de Neurologie (G.D.), CRC-SEP Normandie, CHU de Caen, Université Normandie; Service de Neurologie (C.L.-F.), Neurologie Pasteur 2, CHU de Nice, Université Nice Cote d'Azur UR2CA-URRIS; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (D.A.L.), CHU Nantes; INSERM (D.A.L.), CIC 0004, CRTI-INSERM UMR U1064, Nantes; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (P.C.), CHU de Clermont-Ferrand, INSERM 1107 NeuroDol, Clermont-Ferrand; Aix Marseille University (J.P.), APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, CEMEREM; Service de Neurologie (E.T.), CHU de Nîmes; Institut de Génomique Fonctionnelle (E.T.), Université de Montpellier, CNRS, INSERM; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; and Univ Rennes (E.L.), EHESP, CNRS, Inserm, ARENES UMR 6051, RSMS U 1309, France
| | - Eric Thouvenot
- From the Université de Lyon (F.R., S.V.), Université Claude Bernard Lyon 1; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuroinflammation (F.R., S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron; Observatoire Français de la Sclérose en Plaques (F.R., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR 5292; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., S.V.), State-Approved Foundation, Bron; Direction des Maladies non Transmissible et des Traumatismes (Z.U.), Santé Publique France, Saint-Maurice; Service de Biostatistique-Bioinformatique (Z.U., E.D., M.F., L.R.), Pôle Santé Publique, Hospices Civils de Lyon; Laboratoire de Biométrie et Biologie Evolutive UMR 5558 (E.D., M.F., L.R.), Université Lyon 1 and CNRS, Villeurbanne; Service de Neurologie (M.D.), Centre Hospitalier Régional et Universitaire de Nancy, Université de Lorraine, EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Neurology Department (E.L.P.), CRCSEP Rennes, Clinical Investigation Centre CIC-P 1414, Rennes University Hospital; Service de Neurologie (J.C.), CHU de Toulouse, Hôpital Pierre-Paul Riquet, CRC-SEP; Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity) (J.C.), INSERM UMR 1291, CNRS UMR 5051, Université Toulouse III; Service de Neurologie (A.R.), CRC SEP, CHU de Bordeaux; U1215 INSERM (A.R.), Neurocentre Magendie, Université de Bordeaux; Service de Neurologie et Centre d'Investigation Clinique (J.D.S.), CHU de Strasbourg, INSERM 1434; Pôle des Neurosciences et de l'Appareil Locomoteur (H.Z.), CRC-SEP, Hôpital Roger Salengro, Université de Lille, Inserm U1172; CRC SEP (P.L.), Service de Neurologie, CHU de Montpellier; Service de Neurologie (G.D.), CRC-SEP Normandie, CHU de Caen, Université Normandie; Service de Neurologie (C.L.-F.), Neurologie Pasteur 2, CHU de Nice, Université Nice Cote d'Azur UR2CA-URRIS; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (D.A.L.), CHU Nantes; INSERM (D.A.L.), CIC 0004, CRTI-INSERM UMR U1064, Nantes; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (P.C.), CHU de Clermont-Ferrand, INSERM 1107 NeuroDol, Clermont-Ferrand; Aix Marseille University (J.P.), APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, CEMEREM; Service de Neurologie (E.T.), CHU de Nîmes; Institut de Génomique Fonctionnelle (E.T.), Université de Montpellier, CNRS, INSERM; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; and Univ Rennes (E.L.), EHESP, CNRS, Inserm, ARENES UMR 6051, RSMS U 1309, France
| | - Olivier Heinzlef
- From the Université de Lyon (F.R., S.V.), Université Claude Bernard Lyon 1; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuroinflammation (F.R., S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron; Observatoire Français de la Sclérose en Plaques (F.R., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR 5292; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., S.V.), State-Approved Foundation, Bron; Direction des Maladies non Transmissible et des Traumatismes (Z.U.), Santé Publique France, Saint-Maurice; Service de Biostatistique-Bioinformatique (Z.U., E.D., M.F., L.R.), Pôle Santé Publique, Hospices Civils de Lyon; Laboratoire de Biométrie et Biologie Evolutive UMR 5558 (E.D., M.F., L.R.), Université Lyon 1 and CNRS, Villeurbanne; Service de Neurologie (M.D.), Centre Hospitalier Régional et Universitaire de Nancy, Université de Lorraine, EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Neurology Department (E.L.P.), CRCSEP Rennes, Clinical Investigation Centre CIC-P 1414, Rennes University Hospital; Service de Neurologie (J.C.), CHU de Toulouse, Hôpital Pierre-Paul Riquet, CRC-SEP; Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity) (J.C.), INSERM UMR 1291, CNRS UMR 5051, Université Toulouse III; Service de Neurologie (A.R.), CRC SEP, CHU de Bordeaux; U1215 INSERM (A.R.), Neurocentre Magendie, Université de Bordeaux; Service de Neurologie et Centre d'Investigation Clinique (J.D.S.), CHU de Strasbourg, INSERM 1434; Pôle des Neurosciences et de l'Appareil Locomoteur (H.Z.), CRC-SEP, Hôpital Roger Salengro, Université de Lille, Inserm U1172; CRC SEP (P.L.), Service de Neurologie, CHU de Montpellier; Service de Neurologie (G.D.), CRC-SEP Normandie, CHU de Caen, Université Normandie; Service de Neurologie (C.L.-F.), Neurologie Pasteur 2, CHU de Nice, Université Nice Cote d'Azur UR2CA-URRIS; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (D.A.L.), CHU Nantes; INSERM (D.A.L.), CIC 0004, CRTI-INSERM UMR U1064, Nantes; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (P.C.), CHU de Clermont-Ferrand, INSERM 1107 NeuroDol, Clermont-Ferrand; Aix Marseille University (J.P.), APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, CEMEREM; Service de Neurologie (E.T.), CHU de Nîmes; Institut de Génomique Fonctionnelle (E.T.), Université de Montpellier, CNRS, INSERM; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; and Univ Rennes (E.L.), EHESP, CNRS, Inserm, ARENES UMR 6051, RSMS U 1309, France
| | - Jean-Philippe Camdessanche
- From the Université de Lyon (F.R., S.V.), Université Claude Bernard Lyon 1; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuroinflammation (F.R., S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron; Observatoire Français de la Sclérose en Plaques (F.R., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR 5292; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., S.V.), State-Approved Foundation, Bron; Direction des Maladies non Transmissible et des Traumatismes (Z.U.), Santé Publique France, Saint-Maurice; Service de Biostatistique-Bioinformatique (Z.U., E.D., M.F., L.R.), Pôle Santé Publique, Hospices Civils de Lyon; Laboratoire de Biométrie et Biologie Evolutive UMR 5558 (E.D., M.F., L.R.), Université Lyon 1 and CNRS, Villeurbanne; Service de Neurologie (M.D.), Centre Hospitalier Régional et Universitaire de Nancy, Université de Lorraine, EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Neurology Department (E.L.P.), CRCSEP Rennes, Clinical Investigation Centre CIC-P 1414, Rennes University Hospital; Service de Neurologie (J.C.), CHU de Toulouse, Hôpital Pierre-Paul Riquet, CRC-SEP; Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity) (J.C.), INSERM UMR 1291, CNRS UMR 5051, Université Toulouse III; Service de Neurologie (A.R.), CRC SEP, CHU de Bordeaux; U1215 INSERM (A.R.), Neurocentre Magendie, Université de Bordeaux; Service de Neurologie et Centre d'Investigation Clinique (J.D.S.), CHU de Strasbourg, INSERM 1434; Pôle des Neurosciences et de l'Appareil Locomoteur (H.Z.), CRC-SEP, Hôpital Roger Salengro, Université de Lille, Inserm U1172; CRC SEP (P.L.), Service de Neurologie, CHU de Montpellier; Service de Neurologie (G.D.), CRC-SEP Normandie, CHU de Caen, Université Normandie; Service de Neurologie (C.L.-F.), Neurologie Pasteur 2, CHU de Nice, Université Nice Cote d'Azur UR2CA-URRIS; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (D.A.L.), CHU Nantes; INSERM (D.A.L.), CIC 0004, CRTI-INSERM UMR U1064, Nantes; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (P.C.), CHU de Clermont-Ferrand, INSERM 1107 NeuroDol, Clermont-Ferrand; Aix Marseille University (J.P.), APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, CEMEREM; Service de Neurologie (E.T.), CHU de Nîmes; Institut de Génomique Fonctionnelle (E.T.), Université de Montpellier, CNRS, INSERM; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; and Univ Rennes (E.L.), EHESP, CNRS, Inserm, ARENES UMR 6051, RSMS U 1309, France
| | - Mathieu Fauvernier
- From the Université de Lyon (F.R., S.V.), Université Claude Bernard Lyon 1; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuroinflammation (F.R., S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron; Observatoire Français de la Sclérose en Plaques (F.R., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR 5292; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., S.V.), State-Approved Foundation, Bron; Direction des Maladies non Transmissible et des Traumatismes (Z.U.), Santé Publique France, Saint-Maurice; Service de Biostatistique-Bioinformatique (Z.U., E.D., M.F., L.R.), Pôle Santé Publique, Hospices Civils de Lyon; Laboratoire de Biométrie et Biologie Evolutive UMR 5558 (E.D., M.F., L.R.), Université Lyon 1 and CNRS, Villeurbanne; Service de Neurologie (M.D.), Centre Hospitalier Régional et Universitaire de Nancy, Université de Lorraine, EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Neurology Department (E.L.P.), CRCSEP Rennes, Clinical Investigation Centre CIC-P 1414, Rennes University Hospital; Service de Neurologie (J.C.), CHU de Toulouse, Hôpital Pierre-Paul Riquet, CRC-SEP; Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity) (J.C.), INSERM UMR 1291, CNRS UMR 5051, Université Toulouse III; Service de Neurologie (A.R.), CRC SEP, CHU de Bordeaux; U1215 INSERM (A.R.), Neurocentre Magendie, Université de Bordeaux; Service de Neurologie et Centre d'Investigation Clinique (J.D.S.), CHU de Strasbourg, INSERM 1434; Pôle des Neurosciences et de l'Appareil Locomoteur (H.Z.), CRC-SEP, Hôpital Roger Salengro, Université de Lille, Inserm U1172; CRC SEP (P.L.), Service de Neurologie, CHU de Montpellier; Service de Neurologie (G.D.), CRC-SEP Normandie, CHU de Caen, Université Normandie; Service de Neurologie (C.L.-F.), Neurologie Pasteur 2, CHU de Nice, Université Nice Cote d'Azur UR2CA-URRIS; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (D.A.L.), CHU Nantes; INSERM (D.A.L.), CIC 0004, CRTI-INSERM UMR U1064, Nantes; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (P.C.), CHU de Clermont-Ferrand, INSERM 1107 NeuroDol, Clermont-Ferrand; Aix Marseille University (J.P.), APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, CEMEREM; Service de Neurologie (E.T.), CHU de Nîmes; Institut de Génomique Fonctionnelle (E.T.), Université de Montpellier, CNRS, INSERM; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; and Univ Rennes (E.L.), EHESP, CNRS, Inserm, ARENES UMR 6051, RSMS U 1309, France
| | - Laurent Remontet
- From the Université de Lyon (F.R., S.V.), Université Claude Bernard Lyon 1; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuroinflammation (F.R., S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron; Observatoire Français de la Sclérose en Plaques (F.R., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR 5292; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., S.V.), State-Approved Foundation, Bron; Direction des Maladies non Transmissible et des Traumatismes (Z.U.), Santé Publique France, Saint-Maurice; Service de Biostatistique-Bioinformatique (Z.U., E.D., M.F., L.R.), Pôle Santé Publique, Hospices Civils de Lyon; Laboratoire de Biométrie et Biologie Evolutive UMR 5558 (E.D., M.F., L.R.), Université Lyon 1 and CNRS, Villeurbanne; Service de Neurologie (M.D.), Centre Hospitalier Régional et Universitaire de Nancy, Université de Lorraine, EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Neurology Department (E.L.P.), CRCSEP Rennes, Clinical Investigation Centre CIC-P 1414, Rennes University Hospital; Service de Neurologie (J.C.), CHU de Toulouse, Hôpital Pierre-Paul Riquet, CRC-SEP; Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity) (J.C.), INSERM UMR 1291, CNRS UMR 5051, Université Toulouse III; Service de Neurologie (A.R.), CRC SEP, CHU de Bordeaux; U1215 INSERM (A.R.), Neurocentre Magendie, Université de Bordeaux; Service de Neurologie et Centre d'Investigation Clinique (J.D.S.), CHU de Strasbourg, INSERM 1434; Pôle des Neurosciences et de l'Appareil Locomoteur (H.Z.), CRC-SEP, Hôpital Roger Salengro, Université de Lille, Inserm U1172; CRC SEP (P.L.), Service de Neurologie, CHU de Montpellier; Service de Neurologie (G.D.), CRC-SEP Normandie, CHU de Caen, Université Normandie; Service de Neurologie (C.L.-F.), Neurologie Pasteur 2, CHU de Nice, Université Nice Cote d'Azur UR2CA-URRIS; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (D.A.L.), CHU Nantes; INSERM (D.A.L.), CIC 0004, CRTI-INSERM UMR U1064, Nantes; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (P.C.), CHU de Clermont-Ferrand, INSERM 1107 NeuroDol, Clermont-Ferrand; Aix Marseille University (J.P.), APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, CEMEREM; Service de Neurologie (E.T.), CHU de Nîmes; Institut de Génomique Fonctionnelle (E.T.), Université de Montpellier, CNRS, INSERM; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; and Univ Rennes (E.L.), EHESP, CNRS, Inserm, ARENES UMR 6051, RSMS U 1309, France
| | - Emmanuelle Leray
- From the Université de Lyon (F.R., S.V.), Université Claude Bernard Lyon 1; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuroinflammation (F.R., S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron; Observatoire Français de la Sclérose en Plaques (F.R., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR 5292; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., S.V.), State-Approved Foundation, Bron; Direction des Maladies non Transmissible et des Traumatismes (Z.U.), Santé Publique France, Saint-Maurice; Service de Biostatistique-Bioinformatique (Z.U., E.D., M.F., L.R.), Pôle Santé Publique, Hospices Civils de Lyon; Laboratoire de Biométrie et Biologie Evolutive UMR 5558 (E.D., M.F., L.R.), Université Lyon 1 and CNRS, Villeurbanne; Service de Neurologie (M.D.), Centre Hospitalier Régional et Universitaire de Nancy, Université de Lorraine, EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Neurology Department (E.L.P.), CRCSEP Rennes, Clinical Investigation Centre CIC-P 1414, Rennes University Hospital; Service de Neurologie (J.C.), CHU de Toulouse, Hôpital Pierre-Paul Riquet, CRC-SEP; Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity) (J.C.), INSERM UMR 1291, CNRS UMR 5051, Université Toulouse III; Service de Neurologie (A.R.), CRC SEP, CHU de Bordeaux; U1215 INSERM (A.R.), Neurocentre Magendie, Université de Bordeaux; Service de Neurologie et Centre d'Investigation Clinique (J.D.S.), CHU de Strasbourg, INSERM 1434; Pôle des Neurosciences et de l'Appareil Locomoteur (H.Z.), CRC-SEP, Hôpital Roger Salengro, Université de Lille, Inserm U1172; CRC SEP (P.L.), Service de Neurologie, CHU de Montpellier; Service de Neurologie (G.D.), CRC-SEP Normandie, CHU de Caen, Université Normandie; Service de Neurologie (C.L.-F.), Neurologie Pasteur 2, CHU de Nice, Université Nice Cote d'Azur UR2CA-URRIS; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (D.A.L.), CHU Nantes; INSERM (D.A.L.), CIC 0004, CRTI-INSERM UMR U1064, Nantes; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (P.C.), CHU de Clermont-Ferrand, INSERM 1107 NeuroDol, Clermont-Ferrand; Aix Marseille University (J.P.), APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, CEMEREM; Service de Neurologie (E.T.), CHU de Nîmes; Institut de Génomique Fonctionnelle (E.T.), Université de Montpellier, CNRS, INSERM; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; and Univ Rennes (E.L.), EHESP, CNRS, Inserm, ARENES UMR 6051, RSMS U 1309, France
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Januel E, Hajage D, Labauge P, Maillart E, De Sèze J, Zephir H, Pelletier J, Guilloton L, Bensa C, Heinzlef O, Casez O, Biotti D, Bourre B, Vukusic S, Maurousset A, Berger E, Laplaud D, Lebrun-Frénay C, Dubessy AL, Branger P, Thouvenot E, Clavelou P, Sellal F, Manchon E, Moreau T, Papeix C, Tubach F, Louapre C. Association Between Anti-CD20 Therapies and COVID-19 Severity Among Patients With Relapsing-Remitting and Progressive Multiple Sclerosis. JAMA Netw Open 2023; 6:e2319766. [PMID: 37351881 DOI: 10.1001/jamanetworkopen.2023.19766] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/24/2023] Open
Abstract
Importance In patients with multiple sclerosis (MS), factors associated with severe COVID-19 include anti-CD20 therapies and neurologic disability, but it is still unclear whether these 2 variables are independently associated with severe COVID-19 or whether the association depends on MS clinical course. Objective To assess the association between anti-CD20 therapies and COVID-19 severity in patients with relapsing-remitting MS (RRMS) and progressive MS (PMS). Design, Setting, and Participants This multicenter, retrospective cohort study used data from the COVISEP study, which included patients with MS and COVID-19 from February 1, 2020, to June 30, 2022, at 46 French MS expert centers, general hospitals, and private neurology practices. Eligible patients with RRMS were those treated with high-efficacy MS therapy (ie, anti-CD20, fingolimod, or natalizumab), and eligible patients with PMS were those younger than 70 years with an Expanded Disability Status Scale (EDSS) score of 8 or lower. Patients were monitored from COVID-19 symptom onset until recovery or death. Exposures Current anti-CD20 therapy (ocrelizumab or rituximab). Main Outcomes and Measures The main outcome was severe COVID-19 (ie, hospitalization with any mode of oxygenation or death). All analyses were conducted separately in patients with RRMS and PMS using propensity score-weighted logistic regression. Subgroup analyses were performed according to COVID-19 vaccine status, sex, EDSS score, and age. Results A total of 1400 patients, 971 with RRMS (median age, 39.14 years [IQR, 31.38-46.80 years]; 737 [76.1%] female) and 429 with PMS (median age, 54.21 years [IQR, 48.42-60.14 years]; 250 [58.3%] female) were included in the study. A total of 418 patients with RRMS (43.0%) and 226 with PMS (52.7%) were treated with anti-CD20 therapies. In weighted analysis, 13.4% and 2.9% of patients with RRMS treated and not treated with anti-CD20 had severe COVID-19, respectively, and anti-CD20 treatment was associated with increased risk of severe COVID-19 (odds ratio [OR], 5.20; 95% CI, 2.78-9.71); this association persisted among vaccinated patients (7.0% vs 0.9%; OR, 8.85; 95% CI, 1.26-62.12). Among patients with PMS, 19.0% and 15.5% of patients treated and not treated with anti-CD20 had severe COVID-19, respectively, and there was no association between anti-CD20 treatment and severe COVID-19 (OR, 1.28; 95% CI, 0.76-2.16). In PMS subgroup analysis, anti-CD20 exposure interacted negatively with EDSS score (P = .009 for interaction) and age (P = .03 for interaction); anti-CD20 therapies were associated with risk of severe COVID-19 only in patients with less neurologic disability and younger patients with PMS. Conclusions and Relevance In this cohort study, risk of severe COVID-19 was higher in patients with PMS than in those with RRMS. Use of anti-CD20 therapies was associated with an increased risk of severe COVID-19 among patients with RRMS. In patients with PMS, there was no association between anti-CD20 therapies and risk of severe COVID-19.
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Affiliation(s)
- Edouard Januel
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Assistance Publique Hôpitaux de Paris, Hôpital Pitié Salpêtrière, Département de Santé Publique, Centre de Pharmacoépidémiologie (Cephepi), Unité de Recherche Clinique PSL-CFX, Paris, France
- Sorbonne Université, Assistance Publique des Hôpitaux de Paris, Hôpital de la Pitié Salpêtrière, Institut National de la Santé et de la Recherche Médicale, Centre National de la Recherche Scientifique, Neuroscience Clinical Investigation Center, Paris Brain Institute, Paris, France
| | - David Hajage
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Assistance Publique Hôpitaux de Paris, Hôpital Pitié Salpêtrière, Département de Santé Publique, Centre de Pharmacoépidémiologie (Cephepi), Unité de Recherche Clinique PSL-CFX, Paris, France
| | - Pierre Labauge
- Department of Neurology, CRC-SEP, Montpellier University Hospital, Montpellier, France/Institute for Neurosciences of Montpellier, INSERM and University of Montpellier, Montpellier, France
| | - Elisabeth Maillart
- Sorbonne Université, Assistance Publique des Hôpitaux de Paris, Hôpital de la Pitié Salpêtrière, Institut National de la Santé et de la Recherche Médicale, Centre National de la Recherche Scientifique, Neuroscience Clinical Investigation Center, Paris Brain Institute, Paris, France
| | - Jérome De Sèze
- Department of Neurology and Clinical Investigation Center, CHU de Strasbourg, CIC 1434, INSERM 1434, Strasbourg, France
| | - Hélène Zephir
- Department of Neurology, CHU Lille, INSERM U1172, University of Lille, Lille, France
| | - Jean Pelletier
- Aix Marseille University, Assistance Publique Hopitaux de Marseille, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, Marseille, France
| | - Laurent Guilloton
- Association des Neurologues Libéraux de Langue Française, Bergerac, France
| | - Caroline Bensa
- Département de Neurologie, Hôpital Fondation Adolphe de Rothschild, Paris, France
| | - Olivier Heinzlef
- Département de Neurologie, CRC-SEP, Centre Hospitalier de Poissy-St Germain-en-Laye, France
| | - Olivier Casez
- Neurologie, Pathologies Inflammatoires du Système Nerveux, CHU Grenoble Alpes, Grenoble, France / Techniques de l'Ingénierie Médicale et de la Complexité-Informatique, Mathématiques et Applications, Grenoble, Translational Research in Autoimmunity and Inflammation Group, Université de Grenoble Alpes, Grenoble, France
| | - Damien Biotti
- Centre Ressources et Compétences Sclérose en Plaques (CRC-SEP) et Service de Neurologie B4, Hôpital Pierre-Paul Riquet, CHU Toulouse Purpan, Toulouse, France INSERM UMR1291-CNRS UMR5051, Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity), Université Toulouse 3, Toulouse, France
| | | | - Sandra Vukusic
- Hospices Civils de Lyon, Hôpital Neurologique, Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-Inflammation, Bron, France
| | - Aude Maurousset
- CRC-SEP and Department of Neurology, CHU de Tours, Hôpital Bretonneau, Tours, France
| | - Eric Berger
- CHU de Besançon, Service de Neurologie, Besançon, France
| | - David Laplaud
- CHU de Nantes, Service de Neurologie & CIC015 INSERM, Nantes, France
| | | | - Anne-Laure Dubessy
- Assistance Publique Hôpitaux de Paris, Sorbonne Université, Department of Neurology, Saint-Antoine Hospital, CRC-SEP Paris, Paris, France
| | - Pierre Branger
- Service de Neurologie, CHU de Caen Normandie, Caen, France
| | - Eric Thouvenot
- Department of Neurology, Nimes University Hospital, Nimes, France
- Institut de Génomique Fonctionnelle, UMR5203, INSERM 1191, Université de Montpellier, Montpellier, France
| | - Pierre Clavelou
- Department of Neurology, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - François Sellal
- Département de Neurologie, Hôpitaux Civils de Colmar, Unité INSERM U-1118, Faculté de Médecine, Université de Strasbourg, Strasbourg, France
| | - Eric Manchon
- Department of Neurology, Gonesse Hospital, Gonesse, France
| | | | - Caroline Papeix
- Département de Neurologie, Hôpital Fondation Adolphe de Rothschild, Paris, France
| | - Florence Tubach
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Assistance Publique Hôpitaux de Paris, Hôpital Pitié Salpêtrière, Département de Santé Publique, Centre de Pharmacoépidémiologie (Cephepi), Unité de Recherche Clinique PSL-CFX, Paris, France
| | - Céline Louapre
- Sorbonne Université, Assistance Publique des Hôpitaux de Paris, Hôpital de la Pitié Salpêtrière, Institut National de la Santé et de la Recherche Médicale, Centre National de la Recherche Scientifique, Neuroscience Clinical Investigation Center, Paris Brain Institute, Paris, France
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Ouadika RJB, Heinzlef O. Impact de la greffe de moelle osseuse hématopoïétique sur l’évolution d’une lésion de sclérose solitaire de la jonction bulbo-médullaire. Rev Neurol (Paris) 2023. [DOI: 10.1016/j.neurol.2023.01.673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
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Gavoille A, Rollot F, Casey R, Debouverie M, Le Page E, Ciron J, De Seze J, Ruet A, Maillart E, Labauge P, Zephir H, Papeix C, Defer G, Lebrun-Frenay C, Moreau T, Laplaud DA, Berger E, Stankoff B, Clavelou P, Thouvenot E, Heinzlef O, Pelletier J, Al Khedr A, Casez O, Bourre B, Cabre P, Wahab A, Magy L, Camdessanche JP, Maurousset A, Moulin S, Ben NH, Boulos DD, Hankiewicz K, Neau JP, Pottier C, Nifle C, Rabilloud M, Subtil F, Vukusic S. Investigating the Long-term Effect of Pregnancy on the Course of Multiple Sclerosis Using Causal Inference. Neurology 2023; 100:e1296-e1308. [PMID: 36564207 PMCID: PMC10033171 DOI: 10.1212/wnl.0000000000206774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 11/17/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The question of the long-term safety of pregnancy is a major concern in patients with multiple sclerosis (MS), but its study is biased by reverse causation (women with higher disability are less likely to experience pregnancy). Using a causal inference approach, we aimed to estimate the unbiased long-term effects of pregnancy on disability and relapse risk in patients with MS and secondarily the short-term effects (during the perpartum and postpartum years) and delayed effects (occurring beyond 1 year after delivery). METHODS We conducted an observational cohort study with data from patients with MS followed in the Observatoire Français de la Sclérose en Plaques registry between 1990 and 2020. We included female patients with MS aged 18-45 years at MS onset, clinically followed up for more than 2 years, and with ≥3 Expanded Disease Status Scale (EDSS) measurements. Outcomes were the mean EDSS score at the end of follow-up and the annual probability of relapse during follow-up. Counterfactual outcomes were predicted using the longitudinal targeted maximum likelihood estimator in the entire study population. The patients exposed to at least 1 pregnancy during their follow-up were compared with the counterfactual situation in which, contrary to what was observed, they would not have been exposed to any pregnancy. Short-term and delayed effects were analyzed from the first pregnancy of early-exposed patients (who experienced it during their first 3 years of follow-up). RESULTS We included 9,100 patients, with a median follow-up duration of 7.8 years, of whom 2,125 (23.4%) patients were exposed to at least 1 pregnancy. Pregnancy had no significant long-term causal effect on the mean EDSS score at 9 years (causal mean difference [95% CI] = 0.00 [-0.16 to 0.15]) or on the annual probability of relapse (causal risk ratio [95% CI] = 0.95 [0.93-1.38]). For the 1,253 early-exposed patients, pregnancy significantly decreased the probability of relapse during the perpartum year and significantly increased it during the postpartum year, but no significant delayed effect was found on the EDSS and relapse rate. DISCUSSION Using a causal inference approach, we found no evidence of significantly deleterious or beneficial long-term effects of pregnancy on disability. The beneficial effects found in other studies were probably related to a reverse causation bias.
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Affiliation(s)
- Antoine Gavoille
- From the Service de Neurologie (A.G., F.R., R.C., S.V.), Sclérose en Plaques, Pathologies de La Myéline et Neuro-inflammation, Hôpital Neurologique Pierre-Wertheimer, Hospices Civils de Lyon, Bron; Université de Lyon (A.G., M.R., F.S.), Université Claude Bernard Lyon 1, CNRS, Laboratoire de Biométrie et Biologie Évolutive UMR 5558, Villeurbanne; Service de Biostatistique-Bioinformatique (A.G., M.R., F.S.), Hospices Civils de Lyon; Université de Lyon (F.R., R.C., S.V.), Université Claude Bernard Lyon 1; Observatoire Français de La Sclérose en Plaques (F.R., R.C., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., R.C., S.V.), State-approved Foundation, Bron; Nancy University Hospital (M.D.), Department of Neurology, Université de Lorraine, APEMAC; CHU Pontchaillou (E.L.P.), CIC1414 INSERM, Rennes; CHU de Toulouse (J.C.), Hôpital Pierre-Paul Riquet, Department of Neurology, CRC-SEP, Toulouse; Infinity (J.C.), INSERM UMR1291-CNRS UMR5051, Université Toulouse III; CHU de Strasbourg (J.D.S.), Department of Neurology and Clinical Investigation Center, CIC 1434, INSERM 1434; Univ. Bordeaux (A.R.), F-33000 Bordeaux INSERM U1215, Neurocentre Magendie, F-33000 Bordeaux CHU de Bordeaux, Department of Neurology, CIC Bordeaux CIC1401; Département de Neurologie (E.M.), Hôpital Pitié-Salpêtrière, APHP, Paris; Centre de Ressources et de Compétences SEP Paris (E.M.); CHU de Montpellier (P.L.), MS Unit; University of Montpellier (MUSE) (P.L.); CHU Lille (H.Z.), CRCSEP Lille, Univ Lille, U1172; Fondation Rotschild (C. Papeix), Department of Neurology, Paris; CHU de Caen (G.D.), MS Expert Centre, Department of Neurology, Avenue de La Côte-de-Nacre, Normandy University, Caen; Neurology (C.L.-F.), UR2CA, Centre Hospitalier Universitaire Pasteur2, Université Nice Côte d'Azur, Nice; CHU de Dijon (T.M.), Department of Neurology, EA4184; CHU de Nantes (D.A.L.), Service de Neurologie & CIC015 INSERM; CRTI-Inserm U1064 (D.A.L.), Nantes; CHU de Besançon (E.B.), Service de Neurologie; Sorbonne Universités (B.S.), UPMC Paris 06, Brain and Spine Institute, ICM, Hôpital de La Pitié Salpêtrière, Inserm UMR S 1127, CNRS UMR 7225, and Department of Neurology, AP-HP, Saint-Antoine Hospital; CHU Clermont-Ferrand (Pierre Clavelou), Department of Neurology, F-63000 Clermont-Ferrand Université Clermont Auvergne, Inserm, Neuro-Dol, F-63000 Clermont-Ferrand; Department of Neurology (E.T.), Nimes University Hospital; Institut de Génomique Fonctionnelle (E.T.), UMR5203, INSERM 1191, Univ. Montpellier; Hôpital de Poissy (O.H.), Department of Neurology; Aix Marseille Univ (J.P.), APHM, Hôpital de La Timone, Pôle de Neurosciences Cliniques, Service de Neurologie; CHU d'Amiens (A.A.K.), Department of Neurology; CHU Grenoble Alpes (O.C.), Department of Neurology, La Tronche/Grenoble; CHU de Rouen (B.B.), Department of Neurology; CHU de La Martinique (Philippe Cabre), Department of Neurology, Fort-de-France; APHP (A.W.), Hôpital Henri Mondor, Department of Neurology, Créteil; CHU de Limoges (L.M.), Hôpital Dupuytren, Department of Neurology; CHU de Saint-Étienne (J.-P.C.), Hôpital Nord, Department of Neurology; CHU de Tours (A.M.), Hôpital Bretonneau, CRC SEP and Department of Neurology; CHU de Reims (S.M.), CRC-SEP, Department of Neurology; Hôpital Sud Francilien (N.H.B.), Department of Neurology, Corbeil Essonnes; CHU Bicêtre (D.D.B.), Department of Neurology, Le Kremlin Bicêtre; Department of Neurology (K.H.), Hôpital Pierre Delafontaine, Centre Hospitalier de Saint-Denis; CHU La Milétrie (J.-P.N.), Hôpital Jean Bernard, Department of Neurology, Poitiers; CH de Pontoise (C. Pottier), Hôpital René Dubos, Department of Neurology; and Centre Hospitalier de Versailles (C.N.), Department of Neurology, F-78150 Le Chesnay, France.
| | - Fabien Rollot
- From the Service de Neurologie (A.G., F.R., R.C., S.V.), Sclérose en Plaques, Pathologies de La Myéline et Neuro-inflammation, Hôpital Neurologique Pierre-Wertheimer, Hospices Civils de Lyon, Bron; Université de Lyon (A.G., M.R., F.S.), Université Claude Bernard Lyon 1, CNRS, Laboratoire de Biométrie et Biologie Évolutive UMR 5558, Villeurbanne; Service de Biostatistique-Bioinformatique (A.G., M.R., F.S.), Hospices Civils de Lyon; Université de Lyon (F.R., R.C., S.V.), Université Claude Bernard Lyon 1; Observatoire Français de La Sclérose en Plaques (F.R., R.C., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., R.C., S.V.), State-approved Foundation, Bron; Nancy University Hospital (M.D.), Department of Neurology, Université de Lorraine, APEMAC; CHU Pontchaillou (E.L.P.), CIC1414 INSERM, Rennes; CHU de Toulouse (J.C.), Hôpital Pierre-Paul Riquet, Department of Neurology, CRC-SEP, Toulouse; Infinity (J.C.), INSERM UMR1291-CNRS UMR5051, Université Toulouse III; CHU de Strasbourg (J.D.S.), Department of Neurology and Clinical Investigation Center, CIC 1434, INSERM 1434; Univ. Bordeaux (A.R.), F-33000 Bordeaux INSERM U1215, Neurocentre Magendie, F-33000 Bordeaux CHU de Bordeaux, Department of Neurology, CIC Bordeaux CIC1401; Département de Neurologie (E.M.), Hôpital Pitié-Salpêtrière, APHP, Paris; Centre de Ressources et de Compétences SEP Paris (E.M.); CHU de Montpellier (P.L.), MS Unit; University of Montpellier (MUSE) (P.L.); CHU Lille (H.Z.), CRCSEP Lille, Univ Lille, U1172; Fondation Rotschild (C. Papeix), Department of Neurology, Paris; CHU de Caen (G.D.), MS Expert Centre, Department of Neurology, Avenue de La Côte-de-Nacre, Normandy University, Caen; Neurology (C.L.-F.), UR2CA, Centre Hospitalier Universitaire Pasteur2, Université Nice Côte d'Azur, Nice; CHU de Dijon (T.M.), Department of Neurology, EA4184; CHU de Nantes (D.A.L.), Service de Neurologie & CIC015 INSERM; CRTI-Inserm U1064 (D.A.L.), Nantes; CHU de Besançon (E.B.), Service de Neurologie; Sorbonne Universités (B.S.), UPMC Paris 06, Brain and Spine Institute, ICM, Hôpital de La Pitié Salpêtrière, Inserm UMR S 1127, CNRS UMR 7225, and Department of Neurology, AP-HP, Saint-Antoine Hospital; CHU Clermont-Ferrand (Pierre Clavelou), Department of Neurology, F-63000 Clermont-Ferrand Université Clermont Auvergne, Inserm, Neuro-Dol, F-63000 Clermont-Ferrand; Department of Neurology (E.T.), Nimes University Hospital; Institut de Génomique Fonctionnelle (E.T.), UMR5203, INSERM 1191, Univ. Montpellier; Hôpital de Poissy (O.H.), Department of Neurology; Aix Marseille Univ (J.P.), APHM, Hôpital de La Timone, Pôle de Neurosciences Cliniques, Service de Neurologie; CHU d'Amiens (A.A.K.), Department of Neurology; CHU Grenoble Alpes (O.C.), Department of Neurology, La Tronche/Grenoble; CHU de Rouen (B.B.), Department of Neurology; CHU de La Martinique (Philippe Cabre), Department of Neurology, Fort-de-France; APHP (A.W.), Hôpital Henri Mondor, Department of Neurology, Créteil; CHU de Limoges (L.M.), Hôpital Dupuytren, Department of Neurology; CHU de Saint-Étienne (J.-P.C.), Hôpital Nord, Department of Neurology; CHU de Tours (A.M.), Hôpital Bretonneau, CRC SEP and Department of Neurology; CHU de Reims (S.M.), CRC-SEP, Department of Neurology; Hôpital Sud Francilien (N.H.B.), Department of Neurology, Corbeil Essonnes; CHU Bicêtre (D.D.B.), Department of Neurology, Le Kremlin Bicêtre; Department of Neurology (K.H.), Hôpital Pierre Delafontaine, Centre Hospitalier de Saint-Denis; CHU La Milétrie (J.-P.N.), Hôpital Jean Bernard, Department of Neurology, Poitiers; CH de Pontoise (C. Pottier), Hôpital René Dubos, Department of Neurology; and Centre Hospitalier de Versailles (C.N.), Department of Neurology, F-78150 Le Chesnay, France
| | - Romain Casey
- From the Service de Neurologie (A.G., F.R., R.C., S.V.), Sclérose en Plaques, Pathologies de La Myéline et Neuro-inflammation, Hôpital Neurologique Pierre-Wertheimer, Hospices Civils de Lyon, Bron; Université de Lyon (A.G., M.R., F.S.), Université Claude Bernard Lyon 1, CNRS, Laboratoire de Biométrie et Biologie Évolutive UMR 5558, Villeurbanne; Service de Biostatistique-Bioinformatique (A.G., M.R., F.S.), Hospices Civils de Lyon; Université de Lyon (F.R., R.C., S.V.), Université Claude Bernard Lyon 1; Observatoire Français de La Sclérose en Plaques (F.R., R.C., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., R.C., S.V.), State-approved Foundation, Bron; Nancy University Hospital (M.D.), Department of Neurology, Université de Lorraine, APEMAC; CHU Pontchaillou (E.L.P.), CIC1414 INSERM, Rennes; CHU de Toulouse (J.C.), Hôpital Pierre-Paul Riquet, Department of Neurology, CRC-SEP, Toulouse; Infinity (J.C.), INSERM UMR1291-CNRS UMR5051, Université Toulouse III; CHU de Strasbourg (J.D.S.), Department of Neurology and Clinical Investigation Center, CIC 1434, INSERM 1434; Univ. Bordeaux (A.R.), F-33000 Bordeaux INSERM U1215, Neurocentre Magendie, F-33000 Bordeaux CHU de Bordeaux, Department of Neurology, CIC Bordeaux CIC1401; Département de Neurologie (E.M.), Hôpital Pitié-Salpêtrière, APHP, Paris; Centre de Ressources et de Compétences SEP Paris (E.M.); CHU de Montpellier (P.L.), MS Unit; University of Montpellier (MUSE) (P.L.); CHU Lille (H.Z.), CRCSEP Lille, Univ Lille, U1172; Fondation Rotschild (C. Papeix), Department of Neurology, Paris; CHU de Caen (G.D.), MS Expert Centre, Department of Neurology, Avenue de La Côte-de-Nacre, Normandy University, Caen; Neurology (C.L.-F.), UR2CA, Centre Hospitalier Universitaire Pasteur2, Université Nice Côte d'Azur, Nice; CHU de Dijon (T.M.), Department of Neurology, EA4184; CHU de Nantes (D.A.L.), Service de Neurologie & CIC015 INSERM; CRTI-Inserm U1064 (D.A.L.), Nantes; CHU de Besançon (E.B.), Service de Neurologie; Sorbonne Universités (B.S.), UPMC Paris 06, Brain and Spine Institute, ICM, Hôpital de La Pitié Salpêtrière, Inserm UMR S 1127, CNRS UMR 7225, and Department of Neurology, AP-HP, Saint-Antoine Hospital; CHU Clermont-Ferrand (Pierre Clavelou), Department of Neurology, F-63000 Clermont-Ferrand Université Clermont Auvergne, Inserm, Neuro-Dol, F-63000 Clermont-Ferrand; Department of Neurology (E.T.), Nimes University Hospital; Institut de Génomique Fonctionnelle (E.T.), UMR5203, INSERM 1191, Univ. Montpellier; Hôpital de Poissy (O.H.), Department of Neurology; Aix Marseille Univ (J.P.), APHM, Hôpital de La Timone, Pôle de Neurosciences Cliniques, Service de Neurologie; CHU d'Amiens (A.A.K.), Department of Neurology; CHU Grenoble Alpes (O.C.), Department of Neurology, La Tronche/Grenoble; CHU de Rouen (B.B.), Department of Neurology; CHU de La Martinique (Philippe Cabre), Department of Neurology, Fort-de-France; APHP (A.W.), Hôpital Henri Mondor, Department of Neurology, Créteil; CHU de Limoges (L.M.), Hôpital Dupuytren, Department of Neurology; CHU de Saint-Étienne (J.-P.C.), Hôpital Nord, Department of Neurology; CHU de Tours (A.M.), Hôpital Bretonneau, CRC SEP and Department of Neurology; CHU de Reims (S.M.), CRC-SEP, Department of Neurology; Hôpital Sud Francilien (N.H.B.), Department of Neurology, Corbeil Essonnes; CHU Bicêtre (D.D.B.), Department of Neurology, Le Kremlin Bicêtre; Department of Neurology (K.H.), Hôpital Pierre Delafontaine, Centre Hospitalier de Saint-Denis; CHU La Milétrie (J.-P.N.), Hôpital Jean Bernard, Department of Neurology, Poitiers; CH de Pontoise (C. Pottier), Hôpital René Dubos, Department of Neurology; and Centre Hospitalier de Versailles (C.N.), Department of Neurology, F-78150 Le Chesnay, France
| | - Marc Debouverie
- From the Service de Neurologie (A.G., F.R., R.C., S.V.), Sclérose en Plaques, Pathologies de La Myéline et Neuro-inflammation, Hôpital Neurologique Pierre-Wertheimer, Hospices Civils de Lyon, Bron; Université de Lyon (A.G., M.R., F.S.), Université Claude Bernard Lyon 1, CNRS, Laboratoire de Biométrie et Biologie Évolutive UMR 5558, Villeurbanne; Service de Biostatistique-Bioinformatique (A.G., M.R., F.S.), Hospices Civils de Lyon; Université de Lyon (F.R., R.C., S.V.), Université Claude Bernard Lyon 1; Observatoire Français de La Sclérose en Plaques (F.R., R.C., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., R.C., S.V.), State-approved Foundation, Bron; Nancy University Hospital (M.D.), Department of Neurology, Université de Lorraine, APEMAC; CHU Pontchaillou (E.L.P.), CIC1414 INSERM, Rennes; CHU de Toulouse (J.C.), Hôpital Pierre-Paul Riquet, Department of Neurology, CRC-SEP, Toulouse; Infinity (J.C.), INSERM UMR1291-CNRS UMR5051, Université Toulouse III; CHU de Strasbourg (J.D.S.), Department of Neurology and Clinical Investigation Center, CIC 1434, INSERM 1434; Univ. Bordeaux (A.R.), F-33000 Bordeaux INSERM U1215, Neurocentre Magendie, F-33000 Bordeaux CHU de Bordeaux, Department of Neurology, CIC Bordeaux CIC1401; Département de Neurologie (E.M.), Hôpital Pitié-Salpêtrière, APHP, Paris; Centre de Ressources et de Compétences SEP Paris (E.M.); CHU de Montpellier (P.L.), MS Unit; University of Montpellier (MUSE) (P.L.); CHU Lille (H.Z.), CRCSEP Lille, Univ Lille, U1172; Fondation Rotschild (C. Papeix), Department of Neurology, Paris; CHU de Caen (G.D.), MS Expert Centre, Department of Neurology, Avenue de La Côte-de-Nacre, Normandy University, Caen; Neurology (C.L.-F.), UR2CA, Centre Hospitalier Universitaire Pasteur2, Université Nice Côte d'Azur, Nice; CHU de Dijon (T.M.), Department of Neurology, EA4184; CHU de Nantes (D.A.L.), Service de Neurologie & CIC015 INSERM; CRTI-Inserm U1064 (D.A.L.), Nantes; CHU de Besançon (E.B.), Service de Neurologie; Sorbonne Universités (B.S.), UPMC Paris 06, Brain and Spine Institute, ICM, Hôpital de La Pitié Salpêtrière, Inserm UMR S 1127, CNRS UMR 7225, and Department of Neurology, AP-HP, Saint-Antoine Hospital; CHU Clermont-Ferrand (Pierre Clavelou), Department of Neurology, F-63000 Clermont-Ferrand Université Clermont Auvergne, Inserm, Neuro-Dol, F-63000 Clermont-Ferrand; Department of Neurology (E.T.), Nimes University Hospital; Institut de Génomique Fonctionnelle (E.T.), UMR5203, INSERM 1191, Univ. Montpellier; Hôpital de Poissy (O.H.), Department of Neurology; Aix Marseille Univ (J.P.), APHM, Hôpital de La Timone, Pôle de Neurosciences Cliniques, Service de Neurologie; CHU d'Amiens (A.A.K.), Department of Neurology; CHU Grenoble Alpes (O.C.), Department of Neurology, La Tronche/Grenoble; CHU de Rouen (B.B.), Department of Neurology; CHU de La Martinique (Philippe Cabre), Department of Neurology, Fort-de-France; APHP (A.W.), Hôpital Henri Mondor, Department of Neurology, Créteil; CHU de Limoges (L.M.), Hôpital Dupuytren, Department of Neurology; CHU de Saint-Étienne (J.-P.C.), Hôpital Nord, Department of Neurology; CHU de Tours (A.M.), Hôpital Bretonneau, CRC SEP and Department of Neurology; CHU de Reims (S.M.), CRC-SEP, Department of Neurology; Hôpital Sud Francilien (N.H.B.), Department of Neurology, Corbeil Essonnes; CHU Bicêtre (D.D.B.), Department of Neurology, Le Kremlin Bicêtre; Department of Neurology (K.H.), Hôpital Pierre Delafontaine, Centre Hospitalier de Saint-Denis; CHU La Milétrie (J.-P.N.), Hôpital Jean Bernard, Department of Neurology, Poitiers; CH de Pontoise (C. Pottier), Hôpital René Dubos, Department of Neurology; and Centre Hospitalier de Versailles (C.N.), Department of Neurology, F-78150 Le Chesnay, France
| | - Emmanuelle Le Page
- From the Service de Neurologie (A.G., F.R., R.C., S.V.), Sclérose en Plaques, Pathologies de La Myéline et Neuro-inflammation, Hôpital Neurologique Pierre-Wertheimer, Hospices Civils de Lyon, Bron; Université de Lyon (A.G., M.R., F.S.), Université Claude Bernard Lyon 1, CNRS, Laboratoire de Biométrie et Biologie Évolutive UMR 5558, Villeurbanne; Service de Biostatistique-Bioinformatique (A.G., M.R., F.S.), Hospices Civils de Lyon; Université de Lyon (F.R., R.C., S.V.), Université Claude Bernard Lyon 1; Observatoire Français de La Sclérose en Plaques (F.R., R.C., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., R.C., S.V.), State-approved Foundation, Bron; Nancy University Hospital (M.D.), Department of Neurology, Université de Lorraine, APEMAC; CHU Pontchaillou (E.L.P.), CIC1414 INSERM, Rennes; CHU de Toulouse (J.C.), Hôpital Pierre-Paul Riquet, Department of Neurology, CRC-SEP, Toulouse; Infinity (J.C.), INSERM UMR1291-CNRS UMR5051, Université Toulouse III; CHU de Strasbourg (J.D.S.), Department of Neurology and Clinical Investigation Center, CIC 1434, INSERM 1434; Univ. Bordeaux (A.R.), F-33000 Bordeaux INSERM U1215, Neurocentre Magendie, F-33000 Bordeaux CHU de Bordeaux, Department of Neurology, CIC Bordeaux CIC1401; Département de Neurologie (E.M.), Hôpital Pitié-Salpêtrière, APHP, Paris; Centre de Ressources et de Compétences SEP Paris (E.M.); CHU de Montpellier (P.L.), MS Unit; University of Montpellier (MUSE) (P.L.); CHU Lille (H.Z.), CRCSEP Lille, Univ Lille, U1172; Fondation Rotschild (C. Papeix), Department of Neurology, Paris; CHU de Caen (G.D.), MS Expert Centre, Department of Neurology, Avenue de La Côte-de-Nacre, Normandy University, Caen; Neurology (C.L.-F.), UR2CA, Centre Hospitalier Universitaire Pasteur2, Université Nice Côte d'Azur, Nice; CHU de Dijon (T.M.), Department of Neurology, EA4184; CHU de Nantes (D.A.L.), Service de Neurologie & CIC015 INSERM; CRTI-Inserm U1064 (D.A.L.), Nantes; CHU de Besançon (E.B.), Service de Neurologie; Sorbonne Universités (B.S.), UPMC Paris 06, Brain and Spine Institute, ICM, Hôpital de La Pitié Salpêtrière, Inserm UMR S 1127, CNRS UMR 7225, and Department of Neurology, AP-HP, Saint-Antoine Hospital; CHU Clermont-Ferrand (Pierre Clavelou), Department of Neurology, F-63000 Clermont-Ferrand Université Clermont Auvergne, Inserm, Neuro-Dol, F-63000 Clermont-Ferrand; Department of Neurology (E.T.), Nimes University Hospital; Institut de Génomique Fonctionnelle (E.T.), UMR5203, INSERM 1191, Univ. Montpellier; Hôpital de Poissy (O.H.), Department of Neurology; Aix Marseille Univ (J.P.), APHM, Hôpital de La Timone, Pôle de Neurosciences Cliniques, Service de Neurologie; CHU d'Amiens (A.A.K.), Department of Neurology; CHU Grenoble Alpes (O.C.), Department of Neurology, La Tronche/Grenoble; CHU de Rouen (B.B.), Department of Neurology; CHU de La Martinique (Philippe Cabre), Department of Neurology, Fort-de-France; APHP (A.W.), Hôpital Henri Mondor, Department of Neurology, Créteil; CHU de Limoges (L.M.), Hôpital Dupuytren, Department of Neurology; CHU de Saint-Étienne (J.-P.C.), Hôpital Nord, Department of Neurology; CHU de Tours (A.M.), Hôpital Bretonneau, CRC SEP and Department of Neurology; CHU de Reims (S.M.), CRC-SEP, Department of Neurology; Hôpital Sud Francilien (N.H.B.), Department of Neurology, Corbeil Essonnes; CHU Bicêtre (D.D.B.), Department of Neurology, Le Kremlin Bicêtre; Department of Neurology (K.H.), Hôpital Pierre Delafontaine, Centre Hospitalier de Saint-Denis; CHU La Milétrie (J.-P.N.), Hôpital Jean Bernard, Department of Neurology, Poitiers; CH de Pontoise (C. Pottier), Hôpital René Dubos, Department of Neurology; and Centre Hospitalier de Versailles (C.N.), Department of Neurology, F-78150 Le Chesnay, France
| | - Jonathan Ciron
- From the Service de Neurologie (A.G., F.R., R.C., S.V.), Sclérose en Plaques, Pathologies de La Myéline et Neuro-inflammation, Hôpital Neurologique Pierre-Wertheimer, Hospices Civils de Lyon, Bron; Université de Lyon (A.G., M.R., F.S.), Université Claude Bernard Lyon 1, CNRS, Laboratoire de Biométrie et Biologie Évolutive UMR 5558, Villeurbanne; Service de Biostatistique-Bioinformatique (A.G., M.R., F.S.), Hospices Civils de Lyon; Université de Lyon (F.R., R.C., S.V.), Université Claude Bernard Lyon 1; Observatoire Français de La Sclérose en Plaques (F.R., R.C., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., R.C., S.V.), State-approved Foundation, Bron; Nancy University Hospital (M.D.), Department of Neurology, Université de Lorraine, APEMAC; CHU Pontchaillou (E.L.P.), CIC1414 INSERM, Rennes; CHU de Toulouse (J.C.), Hôpital Pierre-Paul Riquet, Department of Neurology, CRC-SEP, Toulouse; Infinity (J.C.), INSERM UMR1291-CNRS UMR5051, Université Toulouse III; CHU de Strasbourg (J.D.S.), Department of Neurology and Clinical Investigation Center, CIC 1434, INSERM 1434; Univ. Bordeaux (A.R.), F-33000 Bordeaux INSERM U1215, Neurocentre Magendie, F-33000 Bordeaux CHU de Bordeaux, Department of Neurology, CIC Bordeaux CIC1401; Département de Neurologie (E.M.), Hôpital Pitié-Salpêtrière, APHP, Paris; Centre de Ressources et de Compétences SEP Paris (E.M.); CHU de Montpellier (P.L.), MS Unit; University of Montpellier (MUSE) (P.L.); CHU Lille (H.Z.), CRCSEP Lille, Univ Lille, U1172; Fondation Rotschild (C. Papeix), Department of Neurology, Paris; CHU de Caen (G.D.), MS Expert Centre, Department of Neurology, Avenue de La Côte-de-Nacre, Normandy University, Caen; Neurology (C.L.-F.), UR2CA, Centre Hospitalier Universitaire Pasteur2, Université Nice Côte d'Azur, Nice; CHU de Dijon (T.M.), Department of Neurology, EA4184; CHU de Nantes (D.A.L.), Service de Neurologie & CIC015 INSERM; CRTI-Inserm U1064 (D.A.L.), Nantes; CHU de Besançon (E.B.), Service de Neurologie; Sorbonne Universités (B.S.), UPMC Paris 06, Brain and Spine Institute, ICM, Hôpital de La Pitié Salpêtrière, Inserm UMR S 1127, CNRS UMR 7225, and Department of Neurology, AP-HP, Saint-Antoine Hospital; CHU Clermont-Ferrand (Pierre Clavelou), Department of Neurology, F-63000 Clermont-Ferrand Université Clermont Auvergne, Inserm, Neuro-Dol, F-63000 Clermont-Ferrand; Department of Neurology (E.T.), Nimes University Hospital; Institut de Génomique Fonctionnelle (E.T.), UMR5203, INSERM 1191, Univ. Montpellier; Hôpital de Poissy (O.H.), Department of Neurology; Aix Marseille Univ (J.P.), APHM, Hôpital de La Timone, Pôle de Neurosciences Cliniques, Service de Neurologie; CHU d'Amiens (A.A.K.), Department of Neurology; CHU Grenoble Alpes (O.C.), Department of Neurology, La Tronche/Grenoble; CHU de Rouen (B.B.), Department of Neurology; CHU de La Martinique (Philippe Cabre), Department of Neurology, Fort-de-France; APHP (A.W.), Hôpital Henri Mondor, Department of Neurology, Créteil; CHU de Limoges (L.M.), Hôpital Dupuytren, Department of Neurology; CHU de Saint-Étienne (J.-P.C.), Hôpital Nord, Department of Neurology; CHU de Tours (A.M.), Hôpital Bretonneau, CRC SEP and Department of Neurology; CHU de Reims (S.M.), CRC-SEP, Department of Neurology; Hôpital Sud Francilien (N.H.B.), Department of Neurology, Corbeil Essonnes; CHU Bicêtre (D.D.B.), Department of Neurology, Le Kremlin Bicêtre; Department of Neurology (K.H.), Hôpital Pierre Delafontaine, Centre Hospitalier de Saint-Denis; CHU La Milétrie (J.-P.N.), Hôpital Jean Bernard, Department of Neurology, Poitiers; CH de Pontoise (C. Pottier), Hôpital René Dubos, Department of Neurology; and Centre Hospitalier de Versailles (C.N.), Department of Neurology, F-78150 Le Chesnay, France
| | - Jerome De Seze
- From the Service de Neurologie (A.G., F.R., R.C., S.V.), Sclérose en Plaques, Pathologies de La Myéline et Neuro-inflammation, Hôpital Neurologique Pierre-Wertheimer, Hospices Civils de Lyon, Bron; Université de Lyon (A.G., M.R., F.S.), Université Claude Bernard Lyon 1, CNRS, Laboratoire de Biométrie et Biologie Évolutive UMR 5558, Villeurbanne; Service de Biostatistique-Bioinformatique (A.G., M.R., F.S.), Hospices Civils de Lyon; Université de Lyon (F.R., R.C., S.V.), Université Claude Bernard Lyon 1; Observatoire Français de La Sclérose en Plaques (F.R., R.C., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., R.C., S.V.), State-approved Foundation, Bron; Nancy University Hospital (M.D.), Department of Neurology, Université de Lorraine, APEMAC; CHU Pontchaillou (E.L.P.), CIC1414 INSERM, Rennes; CHU de Toulouse (J.C.), Hôpital Pierre-Paul Riquet, Department of Neurology, CRC-SEP, Toulouse; Infinity (J.C.), INSERM UMR1291-CNRS UMR5051, Université Toulouse III; CHU de Strasbourg (J.D.S.), Department of Neurology and Clinical Investigation Center, CIC 1434, INSERM 1434; Univ. Bordeaux (A.R.), F-33000 Bordeaux INSERM U1215, Neurocentre Magendie, F-33000 Bordeaux CHU de Bordeaux, Department of Neurology, CIC Bordeaux CIC1401; Département de Neurologie (E.M.), Hôpital Pitié-Salpêtrière, APHP, Paris; Centre de Ressources et de Compétences SEP Paris (E.M.); CHU de Montpellier (P.L.), MS Unit; University of Montpellier (MUSE) (P.L.); CHU Lille (H.Z.), CRCSEP Lille, Univ Lille, U1172; Fondation Rotschild (C. Papeix), Department of Neurology, Paris; CHU de Caen (G.D.), MS Expert Centre, Department of Neurology, Avenue de La Côte-de-Nacre, Normandy University, Caen; Neurology (C.L.-F.), UR2CA, Centre Hospitalier Universitaire Pasteur2, Université Nice Côte d'Azur, Nice; CHU de Dijon (T.M.), Department of Neurology, EA4184; CHU de Nantes (D.A.L.), Service de Neurologie & CIC015 INSERM; CRTI-Inserm U1064 (D.A.L.), Nantes; CHU de Besançon (E.B.), Service de Neurologie; Sorbonne Universités (B.S.), UPMC Paris 06, Brain and Spine Institute, ICM, Hôpital de La Pitié Salpêtrière, Inserm UMR S 1127, CNRS UMR 7225, and Department of Neurology, AP-HP, Saint-Antoine Hospital; CHU Clermont-Ferrand (Pierre Clavelou), Department of Neurology, F-63000 Clermont-Ferrand Université Clermont Auvergne, Inserm, Neuro-Dol, F-63000 Clermont-Ferrand; Department of Neurology (E.T.), Nimes University Hospital; Institut de Génomique Fonctionnelle (E.T.), UMR5203, INSERM 1191, Univ. Montpellier; Hôpital de Poissy (O.H.), Department of Neurology; Aix Marseille Univ (J.P.), APHM, Hôpital de La Timone, Pôle de Neurosciences Cliniques, Service de Neurologie; CHU d'Amiens (A.A.K.), Department of Neurology; CHU Grenoble Alpes (O.C.), Department of Neurology, La Tronche/Grenoble; CHU de Rouen (B.B.), Department of Neurology; CHU de La Martinique (Philippe Cabre), Department of Neurology, Fort-de-France; APHP (A.W.), Hôpital Henri Mondor, Department of Neurology, Créteil; CHU de Limoges (L.M.), Hôpital Dupuytren, Department of Neurology; CHU de Saint-Étienne (J.-P.C.), Hôpital Nord, Department of Neurology; CHU de Tours (A.M.), Hôpital Bretonneau, CRC SEP and Department of Neurology; CHU de Reims (S.M.), CRC-SEP, Department of Neurology; Hôpital Sud Francilien (N.H.B.), Department of Neurology, Corbeil Essonnes; CHU Bicêtre (D.D.B.), Department of Neurology, Le Kremlin Bicêtre; Department of Neurology (K.H.), Hôpital Pierre Delafontaine, Centre Hospitalier de Saint-Denis; CHU La Milétrie (J.-P.N.), Hôpital Jean Bernard, Department of Neurology, Poitiers; CH de Pontoise (C. Pottier), Hôpital René Dubos, Department of Neurology; and Centre Hospitalier de Versailles (C.N.), Department of Neurology, F-78150 Le Chesnay, France
| | - Aurélie Ruet
- From the Service de Neurologie (A.G., F.R., R.C., S.V.), Sclérose en Plaques, Pathologies de La Myéline et Neuro-inflammation, Hôpital Neurologique Pierre-Wertheimer, Hospices Civils de Lyon, Bron; Université de Lyon (A.G., M.R., F.S.), Université Claude Bernard Lyon 1, CNRS, Laboratoire de Biométrie et Biologie Évolutive UMR 5558, Villeurbanne; Service de Biostatistique-Bioinformatique (A.G., M.R., F.S.), Hospices Civils de Lyon; Université de Lyon (F.R., R.C., S.V.), Université Claude Bernard Lyon 1; Observatoire Français de La Sclérose en Plaques (F.R., R.C., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., R.C., S.V.), State-approved Foundation, Bron; Nancy University Hospital (M.D.), Department of Neurology, Université de Lorraine, APEMAC; CHU Pontchaillou (E.L.P.), CIC1414 INSERM, Rennes; CHU de Toulouse (J.C.), Hôpital Pierre-Paul Riquet, Department of Neurology, CRC-SEP, Toulouse; Infinity (J.C.), INSERM UMR1291-CNRS UMR5051, Université Toulouse III; CHU de Strasbourg (J.D.S.), Department of Neurology and Clinical Investigation Center, CIC 1434, INSERM 1434; Univ. Bordeaux (A.R.), F-33000 Bordeaux INSERM U1215, Neurocentre Magendie, F-33000 Bordeaux CHU de Bordeaux, Department of Neurology, CIC Bordeaux CIC1401; Département de Neurologie (E.M.), Hôpital Pitié-Salpêtrière, APHP, Paris; Centre de Ressources et de Compétences SEP Paris (E.M.); CHU de Montpellier (P.L.), MS Unit; University of Montpellier (MUSE) (P.L.); CHU Lille (H.Z.), CRCSEP Lille, Univ Lille, U1172; Fondation Rotschild (C. Papeix), Department of Neurology, Paris; CHU de Caen (G.D.), MS Expert Centre, Department of Neurology, Avenue de La Côte-de-Nacre, Normandy University, Caen; Neurology (C.L.-F.), UR2CA, Centre Hospitalier Universitaire Pasteur2, Université Nice Côte d'Azur, Nice; CHU de Dijon (T.M.), Department of Neurology, EA4184; CHU de Nantes (D.A.L.), Service de Neurologie & CIC015 INSERM; CRTI-Inserm U1064 (D.A.L.), Nantes; CHU de Besançon (E.B.), Service de Neurologie; Sorbonne Universités (B.S.), UPMC Paris 06, Brain and Spine Institute, ICM, Hôpital de La Pitié Salpêtrière, Inserm UMR S 1127, CNRS UMR 7225, and Department of Neurology, AP-HP, Saint-Antoine Hospital; CHU Clermont-Ferrand (Pierre Clavelou), Department of Neurology, F-63000 Clermont-Ferrand Université Clermont Auvergne, Inserm, Neuro-Dol, F-63000 Clermont-Ferrand; Department of Neurology (E.T.), Nimes University Hospital; Institut de Génomique Fonctionnelle (E.T.), UMR5203, INSERM 1191, Univ. Montpellier; Hôpital de Poissy (O.H.), Department of Neurology; Aix Marseille Univ (J.P.), APHM, Hôpital de La Timone, Pôle de Neurosciences Cliniques, Service de Neurologie; CHU d'Amiens (A.A.K.), Department of Neurology; CHU Grenoble Alpes (O.C.), Department of Neurology, La Tronche/Grenoble; CHU de Rouen (B.B.), Department of Neurology; CHU de La Martinique (Philippe Cabre), Department of Neurology, Fort-de-France; APHP (A.W.), Hôpital Henri Mondor, Department of Neurology, Créteil; CHU de Limoges (L.M.), Hôpital Dupuytren, Department of Neurology; CHU de Saint-Étienne (J.-P.C.), Hôpital Nord, Department of Neurology; CHU de Tours (A.M.), Hôpital Bretonneau, CRC SEP and Department of Neurology; CHU de Reims (S.M.), CRC-SEP, Department of Neurology; Hôpital Sud Francilien (N.H.B.), Department of Neurology, Corbeil Essonnes; CHU Bicêtre (D.D.B.), Department of Neurology, Le Kremlin Bicêtre; Department of Neurology (K.H.), Hôpital Pierre Delafontaine, Centre Hospitalier de Saint-Denis; CHU La Milétrie (J.-P.N.), Hôpital Jean Bernard, Department of Neurology, Poitiers; CH de Pontoise (C. Pottier), Hôpital René Dubos, Department of Neurology; and Centre Hospitalier de Versailles (C.N.), Department of Neurology, F-78150 Le Chesnay, France
| | - Elisabeth Maillart
- From the Service de Neurologie (A.G., F.R., R.C., S.V.), Sclérose en Plaques, Pathologies de La Myéline et Neuro-inflammation, Hôpital Neurologique Pierre-Wertheimer, Hospices Civils de Lyon, Bron; Université de Lyon (A.G., M.R., F.S.), Université Claude Bernard Lyon 1, CNRS, Laboratoire de Biométrie et Biologie Évolutive UMR 5558, Villeurbanne; Service de Biostatistique-Bioinformatique (A.G., M.R., F.S.), Hospices Civils de Lyon; Université de Lyon (F.R., R.C., S.V.), Université Claude Bernard Lyon 1; Observatoire Français de La Sclérose en Plaques (F.R., R.C., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., R.C., S.V.), State-approved Foundation, Bron; Nancy University Hospital (M.D.), Department of Neurology, Université de Lorraine, APEMAC; CHU Pontchaillou (E.L.P.), CIC1414 INSERM, Rennes; CHU de Toulouse (J.C.), Hôpital Pierre-Paul Riquet, Department of Neurology, CRC-SEP, Toulouse; Infinity (J.C.), INSERM UMR1291-CNRS UMR5051, Université Toulouse III; CHU de Strasbourg (J.D.S.), Department of Neurology and Clinical Investigation Center, CIC 1434, INSERM 1434; Univ. Bordeaux (A.R.), F-33000 Bordeaux INSERM U1215, Neurocentre Magendie, F-33000 Bordeaux CHU de Bordeaux, Department of Neurology, CIC Bordeaux CIC1401; Département de Neurologie (E.M.), Hôpital Pitié-Salpêtrière, APHP, Paris; Centre de Ressources et de Compétences SEP Paris (E.M.); CHU de Montpellier (P.L.), MS Unit; University of Montpellier (MUSE) (P.L.); CHU Lille (H.Z.), CRCSEP Lille, Univ Lille, U1172; Fondation Rotschild (C. Papeix), Department of Neurology, Paris; CHU de Caen (G.D.), MS Expert Centre, Department of Neurology, Avenue de La Côte-de-Nacre, Normandy University, Caen; Neurology (C.L.-F.), UR2CA, Centre Hospitalier Universitaire Pasteur2, Université Nice Côte d'Azur, Nice; CHU de Dijon (T.M.), Department of Neurology, EA4184; CHU de Nantes (D.A.L.), Service de Neurologie & CIC015 INSERM; CRTI-Inserm U1064 (D.A.L.), Nantes; CHU de Besançon (E.B.), Service de Neurologie; Sorbonne Universités (B.S.), UPMC Paris 06, Brain and Spine Institute, ICM, Hôpital de La Pitié Salpêtrière, Inserm UMR S 1127, CNRS UMR 7225, and Department of Neurology, AP-HP, Saint-Antoine Hospital; CHU Clermont-Ferrand (Pierre Clavelou), Department of Neurology, F-63000 Clermont-Ferrand Université Clermont Auvergne, Inserm, Neuro-Dol, F-63000 Clermont-Ferrand; Department of Neurology (E.T.), Nimes University Hospital; Institut de Génomique Fonctionnelle (E.T.), UMR5203, INSERM 1191, Univ. Montpellier; Hôpital de Poissy (O.H.), Department of Neurology; Aix Marseille Univ (J.P.), APHM, Hôpital de La Timone, Pôle de Neurosciences Cliniques, Service de Neurologie; CHU d'Amiens (A.A.K.), Department of Neurology; CHU Grenoble Alpes (O.C.), Department of Neurology, La Tronche/Grenoble; CHU de Rouen (B.B.), Department of Neurology; CHU de La Martinique (Philippe Cabre), Department of Neurology, Fort-de-France; APHP (A.W.), Hôpital Henri Mondor, Department of Neurology, Créteil; CHU de Limoges (L.M.), Hôpital Dupuytren, Department of Neurology; CHU de Saint-Étienne (J.-P.C.), Hôpital Nord, Department of Neurology; CHU de Tours (A.M.), Hôpital Bretonneau, CRC SEP and Department of Neurology; CHU de Reims (S.M.), CRC-SEP, Department of Neurology; Hôpital Sud Francilien (N.H.B.), Department of Neurology, Corbeil Essonnes; CHU Bicêtre (D.D.B.), Department of Neurology, Le Kremlin Bicêtre; Department of Neurology (K.H.), Hôpital Pierre Delafontaine, Centre Hospitalier de Saint-Denis; CHU La Milétrie (J.-P.N.), Hôpital Jean Bernard, Department of Neurology, Poitiers; CH de Pontoise (C. Pottier), Hôpital René Dubos, Department of Neurology; and Centre Hospitalier de Versailles (C.N.), Department of Neurology, F-78150 Le Chesnay, France
| | - Pierre Labauge
- From the Service de Neurologie (A.G., F.R., R.C., S.V.), Sclérose en Plaques, Pathologies de La Myéline et Neuro-inflammation, Hôpital Neurologique Pierre-Wertheimer, Hospices Civils de Lyon, Bron; Université de Lyon (A.G., M.R., F.S.), Université Claude Bernard Lyon 1, CNRS, Laboratoire de Biométrie et Biologie Évolutive UMR 5558, Villeurbanne; Service de Biostatistique-Bioinformatique (A.G., M.R., F.S.), Hospices Civils de Lyon; Université de Lyon (F.R., R.C., S.V.), Université Claude Bernard Lyon 1; Observatoire Français de La Sclérose en Plaques (F.R., R.C., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., R.C., S.V.), State-approved Foundation, Bron; Nancy University Hospital (M.D.), Department of Neurology, Université de Lorraine, APEMAC; CHU Pontchaillou (E.L.P.), CIC1414 INSERM, Rennes; CHU de Toulouse (J.C.), Hôpital Pierre-Paul Riquet, Department of Neurology, CRC-SEP, Toulouse; Infinity (J.C.), INSERM UMR1291-CNRS UMR5051, Université Toulouse III; CHU de Strasbourg (J.D.S.), Department of Neurology and Clinical Investigation Center, CIC 1434, INSERM 1434; Univ. Bordeaux (A.R.), F-33000 Bordeaux INSERM U1215, Neurocentre Magendie, F-33000 Bordeaux CHU de Bordeaux, Department of Neurology, CIC Bordeaux CIC1401; Département de Neurologie (E.M.), Hôpital Pitié-Salpêtrière, APHP, Paris; Centre de Ressources et de Compétences SEP Paris (E.M.); CHU de Montpellier (P.L.), MS Unit; University of Montpellier (MUSE) (P.L.); CHU Lille (H.Z.), CRCSEP Lille, Univ Lille, U1172; Fondation Rotschild (C. Papeix), Department of Neurology, Paris; CHU de Caen (G.D.), MS Expert Centre, Department of Neurology, Avenue de La Côte-de-Nacre, Normandy University, Caen; Neurology (C.L.-F.), UR2CA, Centre Hospitalier Universitaire Pasteur2, Université Nice Côte d'Azur, Nice; CHU de Dijon (T.M.), Department of Neurology, EA4184; CHU de Nantes (D.A.L.), Service de Neurologie & CIC015 INSERM; CRTI-Inserm U1064 (D.A.L.), Nantes; CHU de Besançon (E.B.), Service de Neurologie; Sorbonne Universités (B.S.), UPMC Paris 06, Brain and Spine Institute, ICM, Hôpital de La Pitié Salpêtrière, Inserm UMR S 1127, CNRS UMR 7225, and Department of Neurology, AP-HP, Saint-Antoine Hospital; CHU Clermont-Ferrand (Pierre Clavelou), Department of Neurology, F-63000 Clermont-Ferrand Université Clermont Auvergne, Inserm, Neuro-Dol, F-63000 Clermont-Ferrand; Department of Neurology (E.T.), Nimes University Hospital; Institut de Génomique Fonctionnelle (E.T.), UMR5203, INSERM 1191, Univ. Montpellier; Hôpital de Poissy (O.H.), Department of Neurology; Aix Marseille Univ (J.P.), APHM, Hôpital de La Timone, Pôle de Neurosciences Cliniques, Service de Neurologie; CHU d'Amiens (A.A.K.), Department of Neurology; CHU Grenoble Alpes (O.C.), Department of Neurology, La Tronche/Grenoble; CHU de Rouen (B.B.), Department of Neurology; CHU de La Martinique (Philippe Cabre), Department of Neurology, Fort-de-France; APHP (A.W.), Hôpital Henri Mondor, Department of Neurology, Créteil; CHU de Limoges (L.M.), Hôpital Dupuytren, Department of Neurology; CHU de Saint-Étienne (J.-P.C.), Hôpital Nord, Department of Neurology; CHU de Tours (A.M.), Hôpital Bretonneau, CRC SEP and Department of Neurology; CHU de Reims (S.M.), CRC-SEP, Department of Neurology; Hôpital Sud Francilien (N.H.B.), Department of Neurology, Corbeil Essonnes; CHU Bicêtre (D.D.B.), Department of Neurology, Le Kremlin Bicêtre; Department of Neurology (K.H.), Hôpital Pierre Delafontaine, Centre Hospitalier de Saint-Denis; CHU La Milétrie (J.-P.N.), Hôpital Jean Bernard, Department of Neurology, Poitiers; CH de Pontoise (C. Pottier), Hôpital René Dubos, Department of Neurology; and Centre Hospitalier de Versailles (C.N.), Department of Neurology, F-78150 Le Chesnay, France
| | - Helene Zephir
- From the Service de Neurologie (A.G., F.R., R.C., S.V.), Sclérose en Plaques, Pathologies de La Myéline et Neuro-inflammation, Hôpital Neurologique Pierre-Wertheimer, Hospices Civils de Lyon, Bron; Université de Lyon (A.G., M.R., F.S.), Université Claude Bernard Lyon 1, CNRS, Laboratoire de Biométrie et Biologie Évolutive UMR 5558, Villeurbanne; Service de Biostatistique-Bioinformatique (A.G., M.R., F.S.), Hospices Civils de Lyon; Université de Lyon (F.R., R.C., S.V.), Université Claude Bernard Lyon 1; Observatoire Français de La Sclérose en Plaques (F.R., R.C., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., R.C., S.V.), State-approved Foundation, Bron; Nancy University Hospital (M.D.), Department of Neurology, Université de Lorraine, APEMAC; CHU Pontchaillou (E.L.P.), CIC1414 INSERM, Rennes; CHU de Toulouse (J.C.), Hôpital Pierre-Paul Riquet, Department of Neurology, CRC-SEP, Toulouse; Infinity (J.C.), INSERM UMR1291-CNRS UMR5051, Université Toulouse III; CHU de Strasbourg (J.D.S.), Department of Neurology and Clinical Investigation Center, CIC 1434, INSERM 1434; Univ. Bordeaux (A.R.), F-33000 Bordeaux INSERM U1215, Neurocentre Magendie, F-33000 Bordeaux CHU de Bordeaux, Department of Neurology, CIC Bordeaux CIC1401; Département de Neurologie (E.M.), Hôpital Pitié-Salpêtrière, APHP, Paris; Centre de Ressources et de Compétences SEP Paris (E.M.); CHU de Montpellier (P.L.), MS Unit; University of Montpellier (MUSE) (P.L.); CHU Lille (H.Z.), CRCSEP Lille, Univ Lille, U1172; Fondation Rotschild (C. Papeix), Department of Neurology, Paris; CHU de Caen (G.D.), MS Expert Centre, Department of Neurology, Avenue de La Côte-de-Nacre, Normandy University, Caen; Neurology (C.L.-F.), UR2CA, Centre Hospitalier Universitaire Pasteur2, Université Nice Côte d'Azur, Nice; CHU de Dijon (T.M.), Department of Neurology, EA4184; CHU de Nantes (D.A.L.), Service de Neurologie & CIC015 INSERM; CRTI-Inserm U1064 (D.A.L.), Nantes; CHU de Besançon (E.B.), Service de Neurologie; Sorbonne Universités (B.S.), UPMC Paris 06, Brain and Spine Institute, ICM, Hôpital de La Pitié Salpêtrière, Inserm UMR S 1127, CNRS UMR 7225, and Department of Neurology, AP-HP, Saint-Antoine Hospital; CHU Clermont-Ferrand (Pierre Clavelou), Department of Neurology, F-63000 Clermont-Ferrand Université Clermont Auvergne, Inserm, Neuro-Dol, F-63000 Clermont-Ferrand; Department of Neurology (E.T.), Nimes University Hospital; Institut de Génomique Fonctionnelle (E.T.), UMR5203, INSERM 1191, Univ. Montpellier; Hôpital de Poissy (O.H.), Department of Neurology; Aix Marseille Univ (J.P.), APHM, Hôpital de La Timone, Pôle de Neurosciences Cliniques, Service de Neurologie; CHU d'Amiens (A.A.K.), Department of Neurology; CHU Grenoble Alpes (O.C.), Department of Neurology, La Tronche/Grenoble; CHU de Rouen (B.B.), Department of Neurology; CHU de La Martinique (Philippe Cabre), Department of Neurology, Fort-de-France; APHP (A.W.), Hôpital Henri Mondor, Department of Neurology, Créteil; CHU de Limoges (L.M.), Hôpital Dupuytren, Department of Neurology; CHU de Saint-Étienne (J.-P.C.), Hôpital Nord, Department of Neurology; CHU de Tours (A.M.), Hôpital Bretonneau, CRC SEP and Department of Neurology; CHU de Reims (S.M.), CRC-SEP, Department of Neurology; Hôpital Sud Francilien (N.H.B.), Department of Neurology, Corbeil Essonnes; CHU Bicêtre (D.D.B.), Department of Neurology, Le Kremlin Bicêtre; Department of Neurology (K.H.), Hôpital Pierre Delafontaine, Centre Hospitalier de Saint-Denis; CHU La Milétrie (J.-P.N.), Hôpital Jean Bernard, Department of Neurology, Poitiers; CH de Pontoise (C. Pottier), Hôpital René Dubos, Department of Neurology; and Centre Hospitalier de Versailles (C.N.), Department of Neurology, F-78150 Le Chesnay, France
| | - Caroline Papeix
- From the Service de Neurologie (A.G., F.R., R.C., S.V.), Sclérose en Plaques, Pathologies de La Myéline et Neuro-inflammation, Hôpital Neurologique Pierre-Wertheimer, Hospices Civils de Lyon, Bron; Université de Lyon (A.G., M.R., F.S.), Université Claude Bernard Lyon 1, CNRS, Laboratoire de Biométrie et Biologie Évolutive UMR 5558, Villeurbanne; Service de Biostatistique-Bioinformatique (A.G., M.R., F.S.), Hospices Civils de Lyon; Université de Lyon (F.R., R.C., S.V.), Université Claude Bernard Lyon 1; Observatoire Français de La Sclérose en Plaques (F.R., R.C., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., R.C., S.V.), State-approved Foundation, Bron; Nancy University Hospital (M.D.), Department of Neurology, Université de Lorraine, APEMAC; CHU Pontchaillou (E.L.P.), CIC1414 INSERM, Rennes; CHU de Toulouse (J.C.), Hôpital Pierre-Paul Riquet, Department of Neurology, CRC-SEP, Toulouse; Infinity (J.C.), INSERM UMR1291-CNRS UMR5051, Université Toulouse III; CHU de Strasbourg (J.D.S.), Department of Neurology and Clinical Investigation Center, CIC 1434, INSERM 1434; Univ. Bordeaux (A.R.), F-33000 Bordeaux INSERM U1215, Neurocentre Magendie, F-33000 Bordeaux CHU de Bordeaux, Department of Neurology, CIC Bordeaux CIC1401; Département de Neurologie (E.M.), Hôpital Pitié-Salpêtrière, APHP, Paris; Centre de Ressources et de Compétences SEP Paris (E.M.); CHU de Montpellier (P.L.), MS Unit; University of Montpellier (MUSE) (P.L.); CHU Lille (H.Z.), CRCSEP Lille, Univ Lille, U1172; Fondation Rotschild (C. Papeix), Department of Neurology, Paris; CHU de Caen (G.D.), MS Expert Centre, Department of Neurology, Avenue de La Côte-de-Nacre, Normandy University, Caen; Neurology (C.L.-F.), UR2CA, Centre Hospitalier Universitaire Pasteur2, Université Nice Côte d'Azur, Nice; CHU de Dijon (T.M.), Department of Neurology, EA4184; CHU de Nantes (D.A.L.), Service de Neurologie & CIC015 INSERM; CRTI-Inserm U1064 (D.A.L.), Nantes; CHU de Besançon (E.B.), Service de Neurologie; Sorbonne Universités (B.S.), UPMC Paris 06, Brain and Spine Institute, ICM, Hôpital de La Pitié Salpêtrière, Inserm UMR S 1127, CNRS UMR 7225, and Department of Neurology, AP-HP, Saint-Antoine Hospital; CHU Clermont-Ferrand (Pierre Clavelou), Department of Neurology, F-63000 Clermont-Ferrand Université Clermont Auvergne, Inserm, Neuro-Dol, F-63000 Clermont-Ferrand; Department of Neurology (E.T.), Nimes University Hospital; Institut de Génomique Fonctionnelle (E.T.), UMR5203, INSERM 1191, Univ. Montpellier; Hôpital de Poissy (O.H.), Department of Neurology; Aix Marseille Univ (J.P.), APHM, Hôpital de La Timone, Pôle de Neurosciences Cliniques, Service de Neurologie; CHU d'Amiens (A.A.K.), Department of Neurology; CHU Grenoble Alpes (O.C.), Department of Neurology, La Tronche/Grenoble; CHU de Rouen (B.B.), Department of Neurology; CHU de La Martinique (Philippe Cabre), Department of Neurology, Fort-de-France; APHP (A.W.), Hôpital Henri Mondor, Department of Neurology, Créteil; CHU de Limoges (L.M.), Hôpital Dupuytren, Department of Neurology; CHU de Saint-Étienne (J.-P.C.), Hôpital Nord, Department of Neurology; CHU de Tours (A.M.), Hôpital Bretonneau, CRC SEP and Department of Neurology; CHU de Reims (S.M.), CRC-SEP, Department of Neurology; Hôpital Sud Francilien (N.H.B.), Department of Neurology, Corbeil Essonnes; CHU Bicêtre (D.D.B.), Department of Neurology, Le Kremlin Bicêtre; Department of Neurology (K.H.), Hôpital Pierre Delafontaine, Centre Hospitalier de Saint-Denis; CHU La Milétrie (J.-P.N.), Hôpital Jean Bernard, Department of Neurology, Poitiers; CH de Pontoise (C. Pottier), Hôpital René Dubos, Department of Neurology; and Centre Hospitalier de Versailles (C.N.), Department of Neurology, F-78150 Le Chesnay, France
| | - Gilles Defer
- From the Service de Neurologie (A.G., F.R., R.C., S.V.), Sclérose en Plaques, Pathologies de La Myéline et Neuro-inflammation, Hôpital Neurologique Pierre-Wertheimer, Hospices Civils de Lyon, Bron; Université de Lyon (A.G., M.R., F.S.), Université Claude Bernard Lyon 1, CNRS, Laboratoire de Biométrie et Biologie Évolutive UMR 5558, Villeurbanne; Service de Biostatistique-Bioinformatique (A.G., M.R., F.S.), Hospices Civils de Lyon; Université de Lyon (F.R., R.C., S.V.), Université Claude Bernard Lyon 1; Observatoire Français de La Sclérose en Plaques (F.R., R.C., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., R.C., S.V.), State-approved Foundation, Bron; Nancy University Hospital (M.D.), Department of Neurology, Université de Lorraine, APEMAC; CHU Pontchaillou (E.L.P.), CIC1414 INSERM, Rennes; CHU de Toulouse (J.C.), Hôpital Pierre-Paul Riquet, Department of Neurology, CRC-SEP, Toulouse; Infinity (J.C.), INSERM UMR1291-CNRS UMR5051, Université Toulouse III; CHU de Strasbourg (J.D.S.), Department of Neurology and Clinical Investigation Center, CIC 1434, INSERM 1434; Univ. Bordeaux (A.R.), F-33000 Bordeaux INSERM U1215, Neurocentre Magendie, F-33000 Bordeaux CHU de Bordeaux, Department of Neurology, CIC Bordeaux CIC1401; Département de Neurologie (E.M.), Hôpital Pitié-Salpêtrière, APHP, Paris; Centre de Ressources et de Compétences SEP Paris (E.M.); CHU de Montpellier (P.L.), MS Unit; University of Montpellier (MUSE) (P.L.); CHU Lille (H.Z.), CRCSEP Lille, Univ Lille, U1172; Fondation Rotschild (C. Papeix), Department of Neurology, Paris; CHU de Caen (G.D.), MS Expert Centre, Department of Neurology, Avenue de La Côte-de-Nacre, Normandy University, Caen; Neurology (C.L.-F.), UR2CA, Centre Hospitalier Universitaire Pasteur2, Université Nice Côte d'Azur, Nice; CHU de Dijon (T.M.), Department of Neurology, EA4184; CHU de Nantes (D.A.L.), Service de Neurologie & CIC015 INSERM; CRTI-Inserm U1064 (D.A.L.), Nantes; CHU de Besançon (E.B.), Service de Neurologie; Sorbonne Universités (B.S.), UPMC Paris 06, Brain and Spine Institute, ICM, Hôpital de La Pitié Salpêtrière, Inserm UMR S 1127, CNRS UMR 7225, and Department of Neurology, AP-HP, Saint-Antoine Hospital; CHU Clermont-Ferrand (Pierre Clavelou), Department of Neurology, F-63000 Clermont-Ferrand Université Clermont Auvergne, Inserm, Neuro-Dol, F-63000 Clermont-Ferrand; Department of Neurology (E.T.), Nimes University Hospital; Institut de Génomique Fonctionnelle (E.T.), UMR5203, INSERM 1191, Univ. Montpellier; Hôpital de Poissy (O.H.), Department of Neurology; Aix Marseille Univ (J.P.), APHM, Hôpital de La Timone, Pôle de Neurosciences Cliniques, Service de Neurologie; CHU d'Amiens (A.A.K.), Department of Neurology; CHU Grenoble Alpes (O.C.), Department of Neurology, La Tronche/Grenoble; CHU de Rouen (B.B.), Department of Neurology; CHU de La Martinique (Philippe Cabre), Department of Neurology, Fort-de-France; APHP (A.W.), Hôpital Henri Mondor, Department of Neurology, Créteil; CHU de Limoges (L.M.), Hôpital Dupuytren, Department of Neurology; CHU de Saint-Étienne (J.-P.C.), Hôpital Nord, Department of Neurology; CHU de Tours (A.M.), Hôpital Bretonneau, CRC SEP and Department of Neurology; CHU de Reims (S.M.), CRC-SEP, Department of Neurology; Hôpital Sud Francilien (N.H.B.), Department of Neurology, Corbeil Essonnes; CHU Bicêtre (D.D.B.), Department of Neurology, Le Kremlin Bicêtre; Department of Neurology (K.H.), Hôpital Pierre Delafontaine, Centre Hospitalier de Saint-Denis; CHU La Milétrie (J.-P.N.), Hôpital Jean Bernard, Department of Neurology, Poitiers; CH de Pontoise (C. Pottier), Hôpital René Dubos, Department of Neurology; and Centre Hospitalier de Versailles (C.N.), Department of Neurology, F-78150 Le Chesnay, France
| | - Christine Lebrun-Frenay
- From the Service de Neurologie (A.G., F.R., R.C., S.V.), Sclérose en Plaques, Pathologies de La Myéline et Neuro-inflammation, Hôpital Neurologique Pierre-Wertheimer, Hospices Civils de Lyon, Bron; Université de Lyon (A.G., M.R., F.S.), Université Claude Bernard Lyon 1, CNRS, Laboratoire de Biométrie et Biologie Évolutive UMR 5558, Villeurbanne; Service de Biostatistique-Bioinformatique (A.G., M.R., F.S.), Hospices Civils de Lyon; Université de Lyon (F.R., R.C., S.V.), Université Claude Bernard Lyon 1; Observatoire Français de La Sclérose en Plaques (F.R., R.C., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., R.C., S.V.), State-approved Foundation, Bron; Nancy University Hospital (M.D.), Department of Neurology, Université de Lorraine, APEMAC; CHU Pontchaillou (E.L.P.), CIC1414 INSERM, Rennes; CHU de Toulouse (J.C.), Hôpital Pierre-Paul Riquet, Department of Neurology, CRC-SEP, Toulouse; Infinity (J.C.), INSERM UMR1291-CNRS UMR5051, Université Toulouse III; CHU de Strasbourg (J.D.S.), Department of Neurology and Clinical Investigation Center, CIC 1434, INSERM 1434; Univ. Bordeaux (A.R.), F-33000 Bordeaux INSERM U1215, Neurocentre Magendie, F-33000 Bordeaux CHU de Bordeaux, Department of Neurology, CIC Bordeaux CIC1401; Département de Neurologie (E.M.), Hôpital Pitié-Salpêtrière, APHP, Paris; Centre de Ressources et de Compétences SEP Paris (E.M.); CHU de Montpellier (P.L.), MS Unit; University of Montpellier (MUSE) (P.L.); CHU Lille (H.Z.), CRCSEP Lille, Univ Lille, U1172; Fondation Rotschild (C. Papeix), Department of Neurology, Paris; CHU de Caen (G.D.), MS Expert Centre, Department of Neurology, Avenue de La Côte-de-Nacre, Normandy University, Caen; Neurology (C.L.-F.), UR2CA, Centre Hospitalier Universitaire Pasteur2, Université Nice Côte d'Azur, Nice; CHU de Dijon (T.M.), Department of Neurology, EA4184; CHU de Nantes (D.A.L.), Service de Neurologie & CIC015 INSERM; CRTI-Inserm U1064 (D.A.L.), Nantes; CHU de Besançon (E.B.), Service de Neurologie; Sorbonne Universités (B.S.), UPMC Paris 06, Brain and Spine Institute, ICM, Hôpital de La Pitié Salpêtrière, Inserm UMR S 1127, CNRS UMR 7225, and Department of Neurology, AP-HP, Saint-Antoine Hospital; CHU Clermont-Ferrand (Pierre Clavelou), Department of Neurology, F-63000 Clermont-Ferrand Université Clermont Auvergne, Inserm, Neuro-Dol, F-63000 Clermont-Ferrand; Department of Neurology (E.T.), Nimes University Hospital; Institut de Génomique Fonctionnelle (E.T.), UMR5203, INSERM 1191, Univ. Montpellier; Hôpital de Poissy (O.H.), Department of Neurology; Aix Marseille Univ (J.P.), APHM, Hôpital de La Timone, Pôle de Neurosciences Cliniques, Service de Neurologie; CHU d'Amiens (A.A.K.), Department of Neurology; CHU Grenoble Alpes (O.C.), Department of Neurology, La Tronche/Grenoble; CHU de Rouen (B.B.), Department of Neurology; CHU de La Martinique (Philippe Cabre), Department of Neurology, Fort-de-France; APHP (A.W.), Hôpital Henri Mondor, Department of Neurology, Créteil; CHU de Limoges (L.M.), Hôpital Dupuytren, Department of Neurology; CHU de Saint-Étienne (J.-P.C.), Hôpital Nord, Department of Neurology; CHU de Tours (A.M.), Hôpital Bretonneau, CRC SEP and Department of Neurology; CHU de Reims (S.M.), CRC-SEP, Department of Neurology; Hôpital Sud Francilien (N.H.B.), Department of Neurology, Corbeil Essonnes; CHU Bicêtre (D.D.B.), Department of Neurology, Le Kremlin Bicêtre; Department of Neurology (K.H.), Hôpital Pierre Delafontaine, Centre Hospitalier de Saint-Denis; CHU La Milétrie (J.-P.N.), Hôpital Jean Bernard, Department of Neurology, Poitiers; CH de Pontoise (C. Pottier), Hôpital René Dubos, Department of Neurology; and Centre Hospitalier de Versailles (C.N.), Department of Neurology, F-78150 Le Chesnay, France
| | - Thibault Moreau
- From the Service de Neurologie (A.G., F.R., R.C., S.V.), Sclérose en Plaques, Pathologies de La Myéline et Neuro-inflammation, Hôpital Neurologique Pierre-Wertheimer, Hospices Civils de Lyon, Bron; Université de Lyon (A.G., M.R., F.S.), Université Claude Bernard Lyon 1, CNRS, Laboratoire de Biométrie et Biologie Évolutive UMR 5558, Villeurbanne; Service de Biostatistique-Bioinformatique (A.G., M.R., F.S.), Hospices Civils de Lyon; Université de Lyon (F.R., R.C., S.V.), Université Claude Bernard Lyon 1; Observatoire Français de La Sclérose en Plaques (F.R., R.C., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., R.C., S.V.), State-approved Foundation, Bron; Nancy University Hospital (M.D.), Department of Neurology, Université de Lorraine, APEMAC; CHU Pontchaillou (E.L.P.), CIC1414 INSERM, Rennes; CHU de Toulouse (J.C.), Hôpital Pierre-Paul Riquet, Department of Neurology, CRC-SEP, Toulouse; Infinity (J.C.), INSERM UMR1291-CNRS UMR5051, Université Toulouse III; CHU de Strasbourg (J.D.S.), Department of Neurology and Clinical Investigation Center, CIC 1434, INSERM 1434; Univ. Bordeaux (A.R.), F-33000 Bordeaux INSERM U1215, Neurocentre Magendie, F-33000 Bordeaux CHU de Bordeaux, Department of Neurology, CIC Bordeaux CIC1401; Département de Neurologie (E.M.), Hôpital Pitié-Salpêtrière, APHP, Paris; Centre de Ressources et de Compétences SEP Paris (E.M.); CHU de Montpellier (P.L.), MS Unit; University of Montpellier (MUSE) (P.L.); CHU Lille (H.Z.), CRCSEP Lille, Univ Lille, U1172; Fondation Rotschild (C. Papeix), Department of Neurology, Paris; CHU de Caen (G.D.), MS Expert Centre, Department of Neurology, Avenue de La Côte-de-Nacre, Normandy University, Caen; Neurology (C.L.-F.), UR2CA, Centre Hospitalier Universitaire Pasteur2, Université Nice Côte d'Azur, Nice; CHU de Dijon (T.M.), Department of Neurology, EA4184; CHU de Nantes (D.A.L.), Service de Neurologie & CIC015 INSERM; CRTI-Inserm U1064 (D.A.L.), Nantes; CHU de Besançon (E.B.), Service de Neurologie; Sorbonne Universités (B.S.), UPMC Paris 06, Brain and Spine Institute, ICM, Hôpital de La Pitié Salpêtrière, Inserm UMR S 1127, CNRS UMR 7225, and Department of Neurology, AP-HP, Saint-Antoine Hospital; CHU Clermont-Ferrand (Pierre Clavelou), Department of Neurology, F-63000 Clermont-Ferrand Université Clermont Auvergne, Inserm, Neuro-Dol, F-63000 Clermont-Ferrand; Department of Neurology (E.T.), Nimes University Hospital; Institut de Génomique Fonctionnelle (E.T.), UMR5203, INSERM 1191, Univ. Montpellier; Hôpital de Poissy (O.H.), Department of Neurology; Aix Marseille Univ (J.P.), APHM, Hôpital de La Timone, Pôle de Neurosciences Cliniques, Service de Neurologie; CHU d'Amiens (A.A.K.), Department of Neurology; CHU Grenoble Alpes (O.C.), Department of Neurology, La Tronche/Grenoble; CHU de Rouen (B.B.), Department of Neurology; CHU de La Martinique (Philippe Cabre), Department of Neurology, Fort-de-France; APHP (A.W.), Hôpital Henri Mondor, Department of Neurology, Créteil; CHU de Limoges (L.M.), Hôpital Dupuytren, Department of Neurology; CHU de Saint-Étienne (J.-P.C.), Hôpital Nord, Department of Neurology; CHU de Tours (A.M.), Hôpital Bretonneau, CRC SEP and Department of Neurology; CHU de Reims (S.M.), CRC-SEP, Department of Neurology; Hôpital Sud Francilien (N.H.B.), Department of Neurology, Corbeil Essonnes; CHU Bicêtre (D.D.B.), Department of Neurology, Le Kremlin Bicêtre; Department of Neurology (K.H.), Hôpital Pierre Delafontaine, Centre Hospitalier de Saint-Denis; CHU La Milétrie (J.-P.N.), Hôpital Jean Bernard, Department of Neurology, Poitiers; CH de Pontoise (C. Pottier), Hôpital René Dubos, Department of Neurology; and Centre Hospitalier de Versailles (C.N.), Department of Neurology, F-78150 Le Chesnay, France
| | - David Axel Laplaud
- From the Service de Neurologie (A.G., F.R., R.C., S.V.), Sclérose en Plaques, Pathologies de La Myéline et Neuro-inflammation, Hôpital Neurologique Pierre-Wertheimer, Hospices Civils de Lyon, Bron; Université de Lyon (A.G., M.R., F.S.), Université Claude Bernard Lyon 1, CNRS, Laboratoire de Biométrie et Biologie Évolutive UMR 5558, Villeurbanne; Service de Biostatistique-Bioinformatique (A.G., M.R., F.S.), Hospices Civils de Lyon; Université de Lyon (F.R., R.C., S.V.), Université Claude Bernard Lyon 1; Observatoire Français de La Sclérose en Plaques (F.R., R.C., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., R.C., S.V.), State-approved Foundation, Bron; Nancy University Hospital (M.D.), Department of Neurology, Université de Lorraine, APEMAC; CHU Pontchaillou (E.L.P.), CIC1414 INSERM, Rennes; CHU de Toulouse (J.C.), Hôpital Pierre-Paul Riquet, Department of Neurology, CRC-SEP, Toulouse; Infinity (J.C.), INSERM UMR1291-CNRS UMR5051, Université Toulouse III; CHU de Strasbourg (J.D.S.), Department of Neurology and Clinical Investigation Center, CIC 1434, INSERM 1434; Univ. Bordeaux (A.R.), F-33000 Bordeaux INSERM U1215, Neurocentre Magendie, F-33000 Bordeaux CHU de Bordeaux, Department of Neurology, CIC Bordeaux CIC1401; Département de Neurologie (E.M.), Hôpital Pitié-Salpêtrière, APHP, Paris; Centre de Ressources et de Compétences SEP Paris (E.M.); CHU de Montpellier (P.L.), MS Unit; University of Montpellier (MUSE) (P.L.); CHU Lille (H.Z.), CRCSEP Lille, Univ Lille, U1172; Fondation Rotschild (C. Papeix), Department of Neurology, Paris; CHU de Caen (G.D.), MS Expert Centre, Department of Neurology, Avenue de La Côte-de-Nacre, Normandy University, Caen; Neurology (C.L.-F.), UR2CA, Centre Hospitalier Universitaire Pasteur2, Université Nice Côte d'Azur, Nice; CHU de Dijon (T.M.), Department of Neurology, EA4184; CHU de Nantes (D.A.L.), Service de Neurologie & CIC015 INSERM; CRTI-Inserm U1064 (D.A.L.), Nantes; CHU de Besançon (E.B.), Service de Neurologie; Sorbonne Universités (B.S.), UPMC Paris 06, Brain and Spine Institute, ICM, Hôpital de La Pitié Salpêtrière, Inserm UMR S 1127, CNRS UMR 7225, and Department of Neurology, AP-HP, Saint-Antoine Hospital; CHU Clermont-Ferrand (Pierre Clavelou), Department of Neurology, F-63000 Clermont-Ferrand Université Clermont Auvergne, Inserm, Neuro-Dol, F-63000 Clermont-Ferrand; Department of Neurology (E.T.), Nimes University Hospital; Institut de Génomique Fonctionnelle (E.T.), UMR5203, INSERM 1191, Univ. Montpellier; Hôpital de Poissy (O.H.), Department of Neurology; Aix Marseille Univ (J.P.), APHM, Hôpital de La Timone, Pôle de Neurosciences Cliniques, Service de Neurologie; CHU d'Amiens (A.A.K.), Department of Neurology; CHU Grenoble Alpes (O.C.), Department of Neurology, La Tronche/Grenoble; CHU de Rouen (B.B.), Department of Neurology; CHU de La Martinique (Philippe Cabre), Department of Neurology, Fort-de-France; APHP (A.W.), Hôpital Henri Mondor, Department of Neurology, Créteil; CHU de Limoges (L.M.), Hôpital Dupuytren, Department of Neurology; CHU de Saint-Étienne (J.-P.C.), Hôpital Nord, Department of Neurology; CHU de Tours (A.M.), Hôpital Bretonneau, CRC SEP and Department of Neurology; CHU de Reims (S.M.), CRC-SEP, Department of Neurology; Hôpital Sud Francilien (N.H.B.), Department of Neurology, Corbeil Essonnes; CHU Bicêtre (D.D.B.), Department of Neurology, Le Kremlin Bicêtre; Department of Neurology (K.H.), Hôpital Pierre Delafontaine, Centre Hospitalier de Saint-Denis; CHU La Milétrie (J.-P.N.), Hôpital Jean Bernard, Department of Neurology, Poitiers; CH de Pontoise (C. Pottier), Hôpital René Dubos, Department of Neurology; and Centre Hospitalier de Versailles (C.N.), Department of Neurology, F-78150 Le Chesnay, France
| | - Eric Berger
- From the Service de Neurologie (A.G., F.R., R.C., S.V.), Sclérose en Plaques, Pathologies de La Myéline et Neuro-inflammation, Hôpital Neurologique Pierre-Wertheimer, Hospices Civils de Lyon, Bron; Université de Lyon (A.G., M.R., F.S.), Université Claude Bernard Lyon 1, CNRS, Laboratoire de Biométrie et Biologie Évolutive UMR 5558, Villeurbanne; Service de Biostatistique-Bioinformatique (A.G., M.R., F.S.), Hospices Civils de Lyon; Université de Lyon (F.R., R.C., S.V.), Université Claude Bernard Lyon 1; Observatoire Français de La Sclérose en Plaques (F.R., R.C., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., R.C., S.V.), State-approved Foundation, Bron; Nancy University Hospital (M.D.), Department of Neurology, Université de Lorraine, APEMAC; CHU Pontchaillou (E.L.P.), CIC1414 INSERM, Rennes; CHU de Toulouse (J.C.), Hôpital Pierre-Paul Riquet, Department of Neurology, CRC-SEP, Toulouse; Infinity (J.C.), INSERM UMR1291-CNRS UMR5051, Université Toulouse III; CHU de Strasbourg (J.D.S.), Department of Neurology and Clinical Investigation Center, CIC 1434, INSERM 1434; Univ. Bordeaux (A.R.), F-33000 Bordeaux INSERM U1215, Neurocentre Magendie, F-33000 Bordeaux CHU de Bordeaux, Department of Neurology, CIC Bordeaux CIC1401; Département de Neurologie (E.M.), Hôpital Pitié-Salpêtrière, APHP, Paris; Centre de Ressources et de Compétences SEP Paris (E.M.); CHU de Montpellier (P.L.), MS Unit; University of Montpellier (MUSE) (P.L.); CHU Lille (H.Z.), CRCSEP Lille, Univ Lille, U1172; Fondation Rotschild (C. Papeix), Department of Neurology, Paris; CHU de Caen (G.D.), MS Expert Centre, Department of Neurology, Avenue de La Côte-de-Nacre, Normandy University, Caen; Neurology (C.L.-F.), UR2CA, Centre Hospitalier Universitaire Pasteur2, Université Nice Côte d'Azur, Nice; CHU de Dijon (T.M.), Department of Neurology, EA4184; CHU de Nantes (D.A.L.), Service de Neurologie & CIC015 INSERM; CRTI-Inserm U1064 (D.A.L.), Nantes; CHU de Besançon (E.B.), Service de Neurologie; Sorbonne Universités (B.S.), UPMC Paris 06, Brain and Spine Institute, ICM, Hôpital de La Pitié Salpêtrière, Inserm UMR S 1127, CNRS UMR 7225, and Department of Neurology, AP-HP, Saint-Antoine Hospital; CHU Clermont-Ferrand (Pierre Clavelou), Department of Neurology, F-63000 Clermont-Ferrand Université Clermont Auvergne, Inserm, Neuro-Dol, F-63000 Clermont-Ferrand; Department of Neurology (E.T.), Nimes University Hospital; Institut de Génomique Fonctionnelle (E.T.), UMR5203, INSERM 1191, Univ. Montpellier; Hôpital de Poissy (O.H.), Department of Neurology; Aix Marseille Univ (J.P.), APHM, Hôpital de La Timone, Pôle de Neurosciences Cliniques, Service de Neurologie; CHU d'Amiens (A.A.K.), Department of Neurology; CHU Grenoble Alpes (O.C.), Department of Neurology, La Tronche/Grenoble; CHU de Rouen (B.B.), Department of Neurology; CHU de La Martinique (Philippe Cabre), Department of Neurology, Fort-de-France; APHP (A.W.), Hôpital Henri Mondor, Department of Neurology, Créteil; CHU de Limoges (L.M.), Hôpital Dupuytren, Department of Neurology; CHU de Saint-Étienne (J.-P.C.), Hôpital Nord, Department of Neurology; CHU de Tours (A.M.), Hôpital Bretonneau, CRC SEP and Department of Neurology; CHU de Reims (S.M.), CRC-SEP, Department of Neurology; Hôpital Sud Francilien (N.H.B.), Department of Neurology, Corbeil Essonnes; CHU Bicêtre (D.D.B.), Department of Neurology, Le Kremlin Bicêtre; Department of Neurology (K.H.), Hôpital Pierre Delafontaine, Centre Hospitalier de Saint-Denis; CHU La Milétrie (J.-P.N.), Hôpital Jean Bernard, Department of Neurology, Poitiers; CH de Pontoise (C. Pottier), Hôpital René Dubos, Department of Neurology; and Centre Hospitalier de Versailles (C.N.), Department of Neurology, F-78150 Le Chesnay, France
| | - Bruno Stankoff
- From the Service de Neurologie (A.G., F.R., R.C., S.V.), Sclérose en Plaques, Pathologies de La Myéline et Neuro-inflammation, Hôpital Neurologique Pierre-Wertheimer, Hospices Civils de Lyon, Bron; Université de Lyon (A.G., M.R., F.S.), Université Claude Bernard Lyon 1, CNRS, Laboratoire de Biométrie et Biologie Évolutive UMR 5558, Villeurbanne; Service de Biostatistique-Bioinformatique (A.G., M.R., F.S.), Hospices Civils de Lyon; Université de Lyon (F.R., R.C., S.V.), Université Claude Bernard Lyon 1; Observatoire Français de La Sclérose en Plaques (F.R., R.C., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., R.C., S.V.), State-approved Foundation, Bron; Nancy University Hospital (M.D.), Department of Neurology, Université de Lorraine, APEMAC; CHU Pontchaillou (E.L.P.), CIC1414 INSERM, Rennes; CHU de Toulouse (J.C.), Hôpital Pierre-Paul Riquet, Department of Neurology, CRC-SEP, Toulouse; Infinity (J.C.), INSERM UMR1291-CNRS UMR5051, Université Toulouse III; CHU de Strasbourg (J.D.S.), Department of Neurology and Clinical Investigation Center, CIC 1434, INSERM 1434; Univ. Bordeaux (A.R.), F-33000 Bordeaux INSERM U1215, Neurocentre Magendie, F-33000 Bordeaux CHU de Bordeaux, Department of Neurology, CIC Bordeaux CIC1401; Département de Neurologie (E.M.), Hôpital Pitié-Salpêtrière, APHP, Paris; Centre de Ressources et de Compétences SEP Paris (E.M.); CHU de Montpellier (P.L.), MS Unit; University of Montpellier (MUSE) (P.L.); CHU Lille (H.Z.), CRCSEP Lille, Univ Lille, U1172; Fondation Rotschild (C. Papeix), Department of Neurology, Paris; CHU de Caen (G.D.), MS Expert Centre, Department of Neurology, Avenue de La Côte-de-Nacre, Normandy University, Caen; Neurology (C.L.-F.), UR2CA, Centre Hospitalier Universitaire Pasteur2, Université Nice Côte d'Azur, Nice; CHU de Dijon (T.M.), Department of Neurology, EA4184; CHU de Nantes (D.A.L.), Service de Neurologie & CIC015 INSERM; CRTI-Inserm U1064 (D.A.L.), Nantes; CHU de Besançon (E.B.), Service de Neurologie; Sorbonne Universités (B.S.), UPMC Paris 06, Brain and Spine Institute, ICM, Hôpital de La Pitié Salpêtrière, Inserm UMR S 1127, CNRS UMR 7225, and Department of Neurology, AP-HP, Saint-Antoine Hospital; CHU Clermont-Ferrand (Pierre Clavelou), Department of Neurology, F-63000 Clermont-Ferrand Université Clermont Auvergne, Inserm, Neuro-Dol, F-63000 Clermont-Ferrand; Department of Neurology (E.T.), Nimes University Hospital; Institut de Génomique Fonctionnelle (E.T.), UMR5203, INSERM 1191, Univ. Montpellier; Hôpital de Poissy (O.H.), Department of Neurology; Aix Marseille Univ (J.P.), APHM, Hôpital de La Timone, Pôle de Neurosciences Cliniques, Service de Neurologie; CHU d'Amiens (A.A.K.), Department of Neurology; CHU Grenoble Alpes (O.C.), Department of Neurology, La Tronche/Grenoble; CHU de Rouen (B.B.), Department of Neurology; CHU de La Martinique (Philippe Cabre), Department of Neurology, Fort-de-France; APHP (A.W.), Hôpital Henri Mondor, Department of Neurology, Créteil; CHU de Limoges (L.M.), Hôpital Dupuytren, Department of Neurology; CHU de Saint-Étienne (J.-P.C.), Hôpital Nord, Department of Neurology; CHU de Tours (A.M.), Hôpital Bretonneau, CRC SEP and Department of Neurology; CHU de Reims (S.M.), CRC-SEP, Department of Neurology; Hôpital Sud Francilien (N.H.B.), Department of Neurology, Corbeil Essonnes; CHU Bicêtre (D.D.B.), Department of Neurology, Le Kremlin Bicêtre; Department of Neurology (K.H.), Hôpital Pierre Delafontaine, Centre Hospitalier de Saint-Denis; CHU La Milétrie (J.-P.N.), Hôpital Jean Bernard, Department of Neurology, Poitiers; CH de Pontoise (C. Pottier), Hôpital René Dubos, Department of Neurology; and Centre Hospitalier de Versailles (C.N.), Department of Neurology, F-78150 Le Chesnay, France
| | - Pierre Clavelou
- From the Service de Neurologie (A.G., F.R., R.C., S.V.), Sclérose en Plaques, Pathologies de La Myéline et Neuro-inflammation, Hôpital Neurologique Pierre-Wertheimer, Hospices Civils de Lyon, Bron; Université de Lyon (A.G., M.R., F.S.), Université Claude Bernard Lyon 1, CNRS, Laboratoire de Biométrie et Biologie Évolutive UMR 5558, Villeurbanne; Service de Biostatistique-Bioinformatique (A.G., M.R., F.S.), Hospices Civils de Lyon; Université de Lyon (F.R., R.C., S.V.), Université Claude Bernard Lyon 1; Observatoire Français de La Sclérose en Plaques (F.R., R.C., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., R.C., S.V.), State-approved Foundation, Bron; Nancy University Hospital (M.D.), Department of Neurology, Université de Lorraine, APEMAC; CHU Pontchaillou (E.L.P.), CIC1414 INSERM, Rennes; CHU de Toulouse (J.C.), Hôpital Pierre-Paul Riquet, Department of Neurology, CRC-SEP, Toulouse; Infinity (J.C.), INSERM UMR1291-CNRS UMR5051, Université Toulouse III; CHU de Strasbourg (J.D.S.), Department of Neurology and Clinical Investigation Center, CIC 1434, INSERM 1434; Univ. Bordeaux (A.R.), F-33000 Bordeaux INSERM U1215, Neurocentre Magendie, F-33000 Bordeaux CHU de Bordeaux, Department of Neurology, CIC Bordeaux CIC1401; Département de Neurologie (E.M.), Hôpital Pitié-Salpêtrière, APHP, Paris; Centre de Ressources et de Compétences SEP Paris (E.M.); CHU de Montpellier (P.L.), MS Unit; University of Montpellier (MUSE) (P.L.); CHU Lille (H.Z.), CRCSEP Lille, Univ Lille, U1172; Fondation Rotschild (C. Papeix), Department of Neurology, Paris; CHU de Caen (G.D.), MS Expert Centre, Department of Neurology, Avenue de La Côte-de-Nacre, Normandy University, Caen; Neurology (C.L.-F.), UR2CA, Centre Hospitalier Universitaire Pasteur2, Université Nice Côte d'Azur, Nice; CHU de Dijon (T.M.), Department of Neurology, EA4184; CHU de Nantes (D.A.L.), Service de Neurologie & CIC015 INSERM; CRTI-Inserm U1064 (D.A.L.), Nantes; CHU de Besançon (E.B.), Service de Neurologie; Sorbonne Universités (B.S.), UPMC Paris 06, Brain and Spine Institute, ICM, Hôpital de La Pitié Salpêtrière, Inserm UMR S 1127, CNRS UMR 7225, and Department of Neurology, AP-HP, Saint-Antoine Hospital; CHU Clermont-Ferrand (Pierre Clavelou), Department of Neurology, F-63000 Clermont-Ferrand Université Clermont Auvergne, Inserm, Neuro-Dol, F-63000 Clermont-Ferrand; Department of Neurology (E.T.), Nimes University Hospital; Institut de Génomique Fonctionnelle (E.T.), UMR5203, INSERM 1191, Univ. Montpellier; Hôpital de Poissy (O.H.), Department of Neurology; Aix Marseille Univ (J.P.), APHM, Hôpital de La Timone, Pôle de Neurosciences Cliniques, Service de Neurologie; CHU d'Amiens (A.A.K.), Department of Neurology; CHU Grenoble Alpes (O.C.), Department of Neurology, La Tronche/Grenoble; CHU de Rouen (B.B.), Department of Neurology; CHU de La Martinique (Philippe Cabre), Department of Neurology, Fort-de-France; APHP (A.W.), Hôpital Henri Mondor, Department of Neurology, Créteil; CHU de Limoges (L.M.), Hôpital Dupuytren, Department of Neurology; CHU de Saint-Étienne (J.-P.C.), Hôpital Nord, Department of Neurology; CHU de Tours (A.M.), Hôpital Bretonneau, CRC SEP and Department of Neurology; CHU de Reims (S.M.), CRC-SEP, Department of Neurology; Hôpital Sud Francilien (N.H.B.), Department of Neurology, Corbeil Essonnes; CHU Bicêtre (D.D.B.), Department of Neurology, Le Kremlin Bicêtre; Department of Neurology (K.H.), Hôpital Pierre Delafontaine, Centre Hospitalier de Saint-Denis; CHU La Milétrie (J.-P.N.), Hôpital Jean Bernard, Department of Neurology, Poitiers; CH de Pontoise (C. Pottier), Hôpital René Dubos, Department of Neurology; and Centre Hospitalier de Versailles (C.N.), Department of Neurology, F-78150 Le Chesnay, France
| | - Eric Thouvenot
- From the Service de Neurologie (A.G., F.R., R.C., S.V.), Sclérose en Plaques, Pathologies de La Myéline et Neuro-inflammation, Hôpital Neurologique Pierre-Wertheimer, Hospices Civils de Lyon, Bron; Université de Lyon (A.G., M.R., F.S.), Université Claude Bernard Lyon 1, CNRS, Laboratoire de Biométrie et Biologie Évolutive UMR 5558, Villeurbanne; Service de Biostatistique-Bioinformatique (A.G., M.R., F.S.), Hospices Civils de Lyon; Université de Lyon (F.R., R.C., S.V.), Université Claude Bernard Lyon 1; Observatoire Français de La Sclérose en Plaques (F.R., R.C., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., R.C., S.V.), State-approved Foundation, Bron; Nancy University Hospital (M.D.), Department of Neurology, Université de Lorraine, APEMAC; CHU Pontchaillou (E.L.P.), CIC1414 INSERM, Rennes; CHU de Toulouse (J.C.), Hôpital Pierre-Paul Riquet, Department of Neurology, CRC-SEP, Toulouse; Infinity (J.C.), INSERM UMR1291-CNRS UMR5051, Université Toulouse III; CHU de Strasbourg (J.D.S.), Department of Neurology and Clinical Investigation Center, CIC 1434, INSERM 1434; Univ. Bordeaux (A.R.), F-33000 Bordeaux INSERM U1215, Neurocentre Magendie, F-33000 Bordeaux CHU de Bordeaux, Department of Neurology, CIC Bordeaux CIC1401; Département de Neurologie (E.M.), Hôpital Pitié-Salpêtrière, APHP, Paris; Centre de Ressources et de Compétences SEP Paris (E.M.); CHU de Montpellier (P.L.), MS Unit; University of Montpellier (MUSE) (P.L.); CHU Lille (H.Z.), CRCSEP Lille, Univ Lille, U1172; Fondation Rotschild (C. Papeix), Department of Neurology, Paris; CHU de Caen (G.D.), MS Expert Centre, Department of Neurology, Avenue de La Côte-de-Nacre, Normandy University, Caen; Neurology (C.L.-F.), UR2CA, Centre Hospitalier Universitaire Pasteur2, Université Nice Côte d'Azur, Nice; CHU de Dijon (T.M.), Department of Neurology, EA4184; CHU de Nantes (D.A.L.), Service de Neurologie & CIC015 INSERM; CRTI-Inserm U1064 (D.A.L.), Nantes; CHU de Besançon (E.B.), Service de Neurologie; Sorbonne Universités (B.S.), UPMC Paris 06, Brain and Spine Institute, ICM, Hôpital de La Pitié Salpêtrière, Inserm UMR S 1127, CNRS UMR 7225, and Department of Neurology, AP-HP, Saint-Antoine Hospital; CHU Clermont-Ferrand (Pierre Clavelou), Department of Neurology, F-63000 Clermont-Ferrand Université Clermont Auvergne, Inserm, Neuro-Dol, F-63000 Clermont-Ferrand; Department of Neurology (E.T.), Nimes University Hospital; Institut de Génomique Fonctionnelle (E.T.), UMR5203, INSERM 1191, Univ. Montpellier; Hôpital de Poissy (O.H.), Department of Neurology; Aix Marseille Univ (J.P.), APHM, Hôpital de La Timone, Pôle de Neurosciences Cliniques, Service de Neurologie; CHU d'Amiens (A.A.K.), Department of Neurology; CHU Grenoble Alpes (O.C.), Department of Neurology, La Tronche/Grenoble; CHU de Rouen (B.B.), Department of Neurology; CHU de La Martinique (Philippe Cabre), Department of Neurology, Fort-de-France; APHP (A.W.), Hôpital Henri Mondor, Department of Neurology, Créteil; CHU de Limoges (L.M.), Hôpital Dupuytren, Department of Neurology; CHU de Saint-Étienne (J.-P.C.), Hôpital Nord, Department of Neurology; CHU de Tours (A.M.), Hôpital Bretonneau, CRC SEP and Department of Neurology; CHU de Reims (S.M.), CRC-SEP, Department of Neurology; Hôpital Sud Francilien (N.H.B.), Department of Neurology, Corbeil Essonnes; CHU Bicêtre (D.D.B.), Department of Neurology, Le Kremlin Bicêtre; Department of Neurology (K.H.), Hôpital Pierre Delafontaine, Centre Hospitalier de Saint-Denis; CHU La Milétrie (J.-P.N.), Hôpital Jean Bernard, Department of Neurology, Poitiers; CH de Pontoise (C. Pottier), Hôpital René Dubos, Department of Neurology; and Centre Hospitalier de Versailles (C.N.), Department of Neurology, F-78150 Le Chesnay, France
| | - Olivier Heinzlef
- From the Service de Neurologie (A.G., F.R., R.C., S.V.), Sclérose en Plaques, Pathologies de La Myéline et Neuro-inflammation, Hôpital Neurologique Pierre-Wertheimer, Hospices Civils de Lyon, Bron; Université de Lyon (A.G., M.R., F.S.), Université Claude Bernard Lyon 1, CNRS, Laboratoire de Biométrie et Biologie Évolutive UMR 5558, Villeurbanne; Service de Biostatistique-Bioinformatique (A.G., M.R., F.S.), Hospices Civils de Lyon; Université de Lyon (F.R., R.C., S.V.), Université Claude Bernard Lyon 1; Observatoire Français de La Sclérose en Plaques (F.R., R.C., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., R.C., S.V.), State-approved Foundation, Bron; Nancy University Hospital (M.D.), Department of Neurology, Université de Lorraine, APEMAC; CHU Pontchaillou (E.L.P.), CIC1414 INSERM, Rennes; CHU de Toulouse (J.C.), Hôpital Pierre-Paul Riquet, Department of Neurology, CRC-SEP, Toulouse; Infinity (J.C.), INSERM UMR1291-CNRS UMR5051, Université Toulouse III; CHU de Strasbourg (J.D.S.), Department of Neurology and Clinical Investigation Center, CIC 1434, INSERM 1434; Univ. Bordeaux (A.R.), F-33000 Bordeaux INSERM U1215, Neurocentre Magendie, F-33000 Bordeaux CHU de Bordeaux, Department of Neurology, CIC Bordeaux CIC1401; Département de Neurologie (E.M.), Hôpital Pitié-Salpêtrière, APHP, Paris; Centre de Ressources et de Compétences SEP Paris (E.M.); CHU de Montpellier (P.L.), MS Unit; University of Montpellier (MUSE) (P.L.); CHU Lille (H.Z.), CRCSEP Lille, Univ Lille, U1172; Fondation Rotschild (C. Papeix), Department of Neurology, Paris; CHU de Caen (G.D.), MS Expert Centre, Department of Neurology, Avenue de La Côte-de-Nacre, Normandy University, Caen; Neurology (C.L.-F.), UR2CA, Centre Hospitalier Universitaire Pasteur2, Université Nice Côte d'Azur, Nice; CHU de Dijon (T.M.), Department of Neurology, EA4184; CHU de Nantes (D.A.L.), Service de Neurologie & CIC015 INSERM; CRTI-Inserm U1064 (D.A.L.), Nantes; CHU de Besançon (E.B.), Service de Neurologie; Sorbonne Universités (B.S.), UPMC Paris 06, Brain and Spine Institute, ICM, Hôpital de La Pitié Salpêtrière, Inserm UMR S 1127, CNRS UMR 7225, and Department of Neurology, AP-HP, Saint-Antoine Hospital; CHU Clermont-Ferrand (Pierre Clavelou), Department of Neurology, F-63000 Clermont-Ferrand Université Clermont Auvergne, Inserm, Neuro-Dol, F-63000 Clermont-Ferrand; Department of Neurology (E.T.), Nimes University Hospital; Institut de Génomique Fonctionnelle (E.T.), UMR5203, INSERM 1191, Univ. Montpellier; Hôpital de Poissy (O.H.), Department of Neurology; Aix Marseille Univ (J.P.), APHM, Hôpital de La Timone, Pôle de Neurosciences Cliniques, Service de Neurologie; CHU d'Amiens (A.A.K.), Department of Neurology; CHU Grenoble Alpes (O.C.), Department of Neurology, La Tronche/Grenoble; CHU de Rouen (B.B.), Department of Neurology; CHU de La Martinique (Philippe Cabre), Department of Neurology, Fort-de-France; APHP (A.W.), Hôpital Henri Mondor, Department of Neurology, Créteil; CHU de Limoges (L.M.), Hôpital Dupuytren, Department of Neurology; CHU de Saint-Étienne (J.-P.C.), Hôpital Nord, Department of Neurology; CHU de Tours (A.M.), Hôpital Bretonneau, CRC SEP and Department of Neurology; CHU de Reims (S.M.), CRC-SEP, Department of Neurology; Hôpital Sud Francilien (N.H.B.), Department of Neurology, Corbeil Essonnes; CHU Bicêtre (D.D.B.), Department of Neurology, Le Kremlin Bicêtre; Department of Neurology (K.H.), Hôpital Pierre Delafontaine, Centre Hospitalier de Saint-Denis; CHU La Milétrie (J.-P.N.), Hôpital Jean Bernard, Department of Neurology, Poitiers; CH de Pontoise (C. Pottier), Hôpital René Dubos, Department of Neurology; and Centre Hospitalier de Versailles (C.N.), Department of Neurology, F-78150 Le Chesnay, France
| | - Jean Pelletier
- From the Service de Neurologie (A.G., F.R., R.C., S.V.), Sclérose en Plaques, Pathologies de La Myéline et Neuro-inflammation, Hôpital Neurologique Pierre-Wertheimer, Hospices Civils de Lyon, Bron; Université de Lyon (A.G., M.R., F.S.), Université Claude Bernard Lyon 1, CNRS, Laboratoire de Biométrie et Biologie Évolutive UMR 5558, Villeurbanne; Service de Biostatistique-Bioinformatique (A.G., M.R., F.S.), Hospices Civils de Lyon; Université de Lyon (F.R., R.C., S.V.), Université Claude Bernard Lyon 1; Observatoire Français de La Sclérose en Plaques (F.R., R.C., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., R.C., S.V.), State-approved Foundation, Bron; Nancy University Hospital (M.D.), Department of Neurology, Université de Lorraine, APEMAC; CHU Pontchaillou (E.L.P.), CIC1414 INSERM, Rennes; CHU de Toulouse (J.C.), Hôpital Pierre-Paul Riquet, Department of Neurology, CRC-SEP, Toulouse; Infinity (J.C.), INSERM UMR1291-CNRS UMR5051, Université Toulouse III; CHU de Strasbourg (J.D.S.), Department of Neurology and Clinical Investigation Center, CIC 1434, INSERM 1434; Univ. Bordeaux (A.R.), F-33000 Bordeaux INSERM U1215, Neurocentre Magendie, F-33000 Bordeaux CHU de Bordeaux, Department of Neurology, CIC Bordeaux CIC1401; Département de Neurologie (E.M.), Hôpital Pitié-Salpêtrière, APHP, Paris; Centre de Ressources et de Compétences SEP Paris (E.M.); CHU de Montpellier (P.L.), MS Unit; University of Montpellier (MUSE) (P.L.); CHU Lille (H.Z.), CRCSEP Lille, Univ Lille, U1172; Fondation Rotschild (C. Papeix), Department of Neurology, Paris; CHU de Caen (G.D.), MS Expert Centre, Department of Neurology, Avenue de La Côte-de-Nacre, Normandy University, Caen; Neurology (C.L.-F.), UR2CA, Centre Hospitalier Universitaire Pasteur2, Université Nice Côte d'Azur, Nice; CHU de Dijon (T.M.), Department of Neurology, EA4184; CHU de Nantes (D.A.L.), Service de Neurologie & CIC015 INSERM; CRTI-Inserm U1064 (D.A.L.), Nantes; CHU de Besançon (E.B.), Service de Neurologie; Sorbonne Universités (B.S.), UPMC Paris 06, Brain and Spine Institute, ICM, Hôpital de La Pitié Salpêtrière, Inserm UMR S 1127, CNRS UMR 7225, and Department of Neurology, AP-HP, Saint-Antoine Hospital; CHU Clermont-Ferrand (Pierre Clavelou), Department of Neurology, F-63000 Clermont-Ferrand Université Clermont Auvergne, Inserm, Neuro-Dol, F-63000 Clermont-Ferrand; Department of Neurology (E.T.), Nimes University Hospital; Institut de Génomique Fonctionnelle (E.T.), UMR5203, INSERM 1191, Univ. Montpellier; Hôpital de Poissy (O.H.), Department of Neurology; Aix Marseille Univ (J.P.), APHM, Hôpital de La Timone, Pôle de Neurosciences Cliniques, Service de Neurologie; CHU d'Amiens (A.A.K.), Department of Neurology; CHU Grenoble Alpes (O.C.), Department of Neurology, La Tronche/Grenoble; CHU de Rouen (B.B.), Department of Neurology; CHU de La Martinique (Philippe Cabre), Department of Neurology, Fort-de-France; APHP (A.W.), Hôpital Henri Mondor, Department of Neurology, Créteil; CHU de Limoges (L.M.), Hôpital Dupuytren, Department of Neurology; CHU de Saint-Étienne (J.-P.C.), Hôpital Nord, Department of Neurology; CHU de Tours (A.M.), Hôpital Bretonneau, CRC SEP and Department of Neurology; CHU de Reims (S.M.), CRC-SEP, Department of Neurology; Hôpital Sud Francilien (N.H.B.), Department of Neurology, Corbeil Essonnes; CHU Bicêtre (D.D.B.), Department of Neurology, Le Kremlin Bicêtre; Department of Neurology (K.H.), Hôpital Pierre Delafontaine, Centre Hospitalier de Saint-Denis; CHU La Milétrie (J.-P.N.), Hôpital Jean Bernard, Department of Neurology, Poitiers; CH de Pontoise (C. Pottier), Hôpital René Dubos, Department of Neurology; and Centre Hospitalier de Versailles (C.N.), Department of Neurology, F-78150 Le Chesnay, France
| | - Abdullatif Al Khedr
- From the Service de Neurologie (A.G., F.R., R.C., S.V.), Sclérose en Plaques, Pathologies de La Myéline et Neuro-inflammation, Hôpital Neurologique Pierre-Wertheimer, Hospices Civils de Lyon, Bron; Université de Lyon (A.G., M.R., F.S.), Université Claude Bernard Lyon 1, CNRS, Laboratoire de Biométrie et Biologie Évolutive UMR 5558, Villeurbanne; Service de Biostatistique-Bioinformatique (A.G., M.R., F.S.), Hospices Civils de Lyon; Université de Lyon (F.R., R.C., S.V.), Université Claude Bernard Lyon 1; Observatoire Français de La Sclérose en Plaques (F.R., R.C., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., R.C., S.V.), State-approved Foundation, Bron; Nancy University Hospital (M.D.), Department of Neurology, Université de Lorraine, APEMAC; CHU Pontchaillou (E.L.P.), CIC1414 INSERM, Rennes; CHU de Toulouse (J.C.), Hôpital Pierre-Paul Riquet, Department of Neurology, CRC-SEP, Toulouse; Infinity (J.C.), INSERM UMR1291-CNRS UMR5051, Université Toulouse III; CHU de Strasbourg (J.D.S.), Department of Neurology and Clinical Investigation Center, CIC 1434, INSERM 1434; Univ. Bordeaux (A.R.), F-33000 Bordeaux INSERM U1215, Neurocentre Magendie, F-33000 Bordeaux CHU de Bordeaux, Department of Neurology, CIC Bordeaux CIC1401; Département de Neurologie (E.M.), Hôpital Pitié-Salpêtrière, APHP, Paris; Centre de Ressources et de Compétences SEP Paris (E.M.); CHU de Montpellier (P.L.), MS Unit; University of Montpellier (MUSE) (P.L.); CHU Lille (H.Z.), CRCSEP Lille, Univ Lille, U1172; Fondation Rotschild (C. Papeix), Department of Neurology, Paris; CHU de Caen (G.D.), MS Expert Centre, Department of Neurology, Avenue de La Côte-de-Nacre, Normandy University, Caen; Neurology (C.L.-F.), UR2CA, Centre Hospitalier Universitaire Pasteur2, Université Nice Côte d'Azur, Nice; CHU de Dijon (T.M.), Department of Neurology, EA4184; CHU de Nantes (D.A.L.), Service de Neurologie & CIC015 INSERM; CRTI-Inserm U1064 (D.A.L.), Nantes; CHU de Besançon (E.B.), Service de Neurologie; Sorbonne Universités (B.S.), UPMC Paris 06, Brain and Spine Institute, ICM, Hôpital de La Pitié Salpêtrière, Inserm UMR S 1127, CNRS UMR 7225, and Department of Neurology, AP-HP, Saint-Antoine Hospital; CHU Clermont-Ferrand (Pierre Clavelou), Department of Neurology, F-63000 Clermont-Ferrand Université Clermont Auvergne, Inserm, Neuro-Dol, F-63000 Clermont-Ferrand; Department of Neurology (E.T.), Nimes University Hospital; Institut de Génomique Fonctionnelle (E.T.), UMR5203, INSERM 1191, Univ. Montpellier; Hôpital de Poissy (O.H.), Department of Neurology; Aix Marseille Univ (J.P.), APHM, Hôpital de La Timone, Pôle de Neurosciences Cliniques, Service de Neurologie; CHU d'Amiens (A.A.K.), Department of Neurology; CHU Grenoble Alpes (O.C.), Department of Neurology, La Tronche/Grenoble; CHU de Rouen (B.B.), Department of Neurology; CHU de La Martinique (Philippe Cabre), Department of Neurology, Fort-de-France; APHP (A.W.), Hôpital Henri Mondor, Department of Neurology, Créteil; CHU de Limoges (L.M.), Hôpital Dupuytren, Department of Neurology; CHU de Saint-Étienne (J.-P.C.), Hôpital Nord, Department of Neurology; CHU de Tours (A.M.), Hôpital Bretonneau, CRC SEP and Department of Neurology; CHU de Reims (S.M.), CRC-SEP, Department of Neurology; Hôpital Sud Francilien (N.H.B.), Department of Neurology, Corbeil Essonnes; CHU Bicêtre (D.D.B.), Department of Neurology, Le Kremlin Bicêtre; Department of Neurology (K.H.), Hôpital Pierre Delafontaine, Centre Hospitalier de Saint-Denis; CHU La Milétrie (J.-P.N.), Hôpital Jean Bernard, Department of Neurology, Poitiers; CH de Pontoise (C. Pottier), Hôpital René Dubos, Department of Neurology; and Centre Hospitalier de Versailles (C.N.), Department of Neurology, F-78150 Le Chesnay, France
| | - Olivier Casez
- From the Service de Neurologie (A.G., F.R., R.C., S.V.), Sclérose en Plaques, Pathologies de La Myéline et Neuro-inflammation, Hôpital Neurologique Pierre-Wertheimer, Hospices Civils de Lyon, Bron; Université de Lyon (A.G., M.R., F.S.), Université Claude Bernard Lyon 1, CNRS, Laboratoire de Biométrie et Biologie Évolutive UMR 5558, Villeurbanne; Service de Biostatistique-Bioinformatique (A.G., M.R., F.S.), Hospices Civils de Lyon; Université de Lyon (F.R., R.C., S.V.), Université Claude Bernard Lyon 1; Observatoire Français de La Sclérose en Plaques (F.R., R.C., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., R.C., S.V.), State-approved Foundation, Bron; Nancy University Hospital (M.D.), Department of Neurology, Université de Lorraine, APEMAC; CHU Pontchaillou (E.L.P.), CIC1414 INSERM, Rennes; CHU de Toulouse (J.C.), Hôpital Pierre-Paul Riquet, Department of Neurology, CRC-SEP, Toulouse; Infinity (J.C.), INSERM UMR1291-CNRS UMR5051, Université Toulouse III; CHU de Strasbourg (J.D.S.), Department of Neurology and Clinical Investigation Center, CIC 1434, INSERM 1434; Univ. Bordeaux (A.R.), F-33000 Bordeaux INSERM U1215, Neurocentre Magendie, F-33000 Bordeaux CHU de Bordeaux, Department of Neurology, CIC Bordeaux CIC1401; Département de Neurologie (E.M.), Hôpital Pitié-Salpêtrière, APHP, Paris; Centre de Ressources et de Compétences SEP Paris (E.M.); CHU de Montpellier (P.L.), MS Unit; University of Montpellier (MUSE) (P.L.); CHU Lille (H.Z.), CRCSEP Lille, Univ Lille, U1172; Fondation Rotschild (C. Papeix), Department of Neurology, Paris; CHU de Caen (G.D.), MS Expert Centre, Department of Neurology, Avenue de La Côte-de-Nacre, Normandy University, Caen; Neurology (C.L.-F.), UR2CA, Centre Hospitalier Universitaire Pasteur2, Université Nice Côte d'Azur, Nice; CHU de Dijon (T.M.), Department of Neurology, EA4184; CHU de Nantes (D.A.L.), Service de Neurologie & CIC015 INSERM; CRTI-Inserm U1064 (D.A.L.), Nantes; CHU de Besançon (E.B.), Service de Neurologie; Sorbonne Universités (B.S.), UPMC Paris 06, Brain and Spine Institute, ICM, Hôpital de La Pitié Salpêtrière, Inserm UMR S 1127, CNRS UMR 7225, and Department of Neurology, AP-HP, Saint-Antoine Hospital; CHU Clermont-Ferrand (Pierre Clavelou), Department of Neurology, F-63000 Clermont-Ferrand Université Clermont Auvergne, Inserm, Neuro-Dol, F-63000 Clermont-Ferrand; Department of Neurology (E.T.), Nimes University Hospital; Institut de Génomique Fonctionnelle (E.T.), UMR5203, INSERM 1191, Univ. Montpellier; Hôpital de Poissy (O.H.), Department of Neurology; Aix Marseille Univ (J.P.), APHM, Hôpital de La Timone, Pôle de Neurosciences Cliniques, Service de Neurologie; CHU d'Amiens (A.A.K.), Department of Neurology; CHU Grenoble Alpes (O.C.), Department of Neurology, La Tronche/Grenoble; CHU de Rouen (B.B.), Department of Neurology; CHU de La Martinique (Philippe Cabre), Department of Neurology, Fort-de-France; APHP (A.W.), Hôpital Henri Mondor, Department of Neurology, Créteil; CHU de Limoges (L.M.), Hôpital Dupuytren, Department of Neurology; CHU de Saint-Étienne (J.-P.C.), Hôpital Nord, Department of Neurology; CHU de Tours (A.M.), Hôpital Bretonneau, CRC SEP and Department of Neurology; CHU de Reims (S.M.), CRC-SEP, Department of Neurology; Hôpital Sud Francilien (N.H.B.), Department of Neurology, Corbeil Essonnes; CHU Bicêtre (D.D.B.), Department of Neurology, Le Kremlin Bicêtre; Department of Neurology (K.H.), Hôpital Pierre Delafontaine, Centre Hospitalier de Saint-Denis; CHU La Milétrie (J.-P.N.), Hôpital Jean Bernard, Department of Neurology, Poitiers; CH de Pontoise (C. Pottier), Hôpital René Dubos, Department of Neurology; and Centre Hospitalier de Versailles (C.N.), Department of Neurology, F-78150 Le Chesnay, France
| | - Bertrand Bourre
- From the Service de Neurologie (A.G., F.R., R.C., S.V.), Sclérose en Plaques, Pathologies de La Myéline et Neuro-inflammation, Hôpital Neurologique Pierre-Wertheimer, Hospices Civils de Lyon, Bron; Université de Lyon (A.G., M.R., F.S.), Université Claude Bernard Lyon 1, CNRS, Laboratoire de Biométrie et Biologie Évolutive UMR 5558, Villeurbanne; Service de Biostatistique-Bioinformatique (A.G., M.R., F.S.), Hospices Civils de Lyon; Université de Lyon (F.R., R.C., S.V.), Université Claude Bernard Lyon 1; Observatoire Français de La Sclérose en Plaques (F.R., R.C., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., R.C., S.V.), State-approved Foundation, Bron; Nancy University Hospital (M.D.), Department of Neurology, Université de Lorraine, APEMAC; CHU Pontchaillou (E.L.P.), CIC1414 INSERM, Rennes; CHU de Toulouse (J.C.), Hôpital Pierre-Paul Riquet, Department of Neurology, CRC-SEP, Toulouse; Infinity (J.C.), INSERM UMR1291-CNRS UMR5051, Université Toulouse III; CHU de Strasbourg (J.D.S.), Department of Neurology and Clinical Investigation Center, CIC 1434, INSERM 1434; Univ. Bordeaux (A.R.), F-33000 Bordeaux INSERM U1215, Neurocentre Magendie, F-33000 Bordeaux CHU de Bordeaux, Department of Neurology, CIC Bordeaux CIC1401; Département de Neurologie (E.M.), Hôpital Pitié-Salpêtrière, APHP, Paris; Centre de Ressources et de Compétences SEP Paris (E.M.); CHU de Montpellier (P.L.), MS Unit; University of Montpellier (MUSE) (P.L.); CHU Lille (H.Z.), CRCSEP Lille, Univ Lille, U1172; Fondation Rotschild (C. Papeix), Department of Neurology, Paris; CHU de Caen (G.D.), MS Expert Centre, Department of Neurology, Avenue de La Côte-de-Nacre, Normandy University, Caen; Neurology (C.L.-F.), UR2CA, Centre Hospitalier Universitaire Pasteur2, Université Nice Côte d'Azur, Nice; CHU de Dijon (T.M.), Department of Neurology, EA4184; CHU de Nantes (D.A.L.), Service de Neurologie & CIC015 INSERM; CRTI-Inserm U1064 (D.A.L.), Nantes; CHU de Besançon (E.B.), Service de Neurologie; Sorbonne Universités (B.S.), UPMC Paris 06, Brain and Spine Institute, ICM, Hôpital de La Pitié Salpêtrière, Inserm UMR S 1127, CNRS UMR 7225, and Department of Neurology, AP-HP, Saint-Antoine Hospital; CHU Clermont-Ferrand (Pierre Clavelou), Department of Neurology, F-63000 Clermont-Ferrand Université Clermont Auvergne, Inserm, Neuro-Dol, F-63000 Clermont-Ferrand; Department of Neurology (E.T.), Nimes University Hospital; Institut de Génomique Fonctionnelle (E.T.), UMR5203, INSERM 1191, Univ. Montpellier; Hôpital de Poissy (O.H.), Department of Neurology; Aix Marseille Univ (J.P.), APHM, Hôpital de La Timone, Pôle de Neurosciences Cliniques, Service de Neurologie; CHU d'Amiens (A.A.K.), Department of Neurology; CHU Grenoble Alpes (O.C.), Department of Neurology, La Tronche/Grenoble; CHU de Rouen (B.B.), Department of Neurology; CHU de La Martinique (Philippe Cabre), Department of Neurology, Fort-de-France; APHP (A.W.), Hôpital Henri Mondor, Department of Neurology, Créteil; CHU de Limoges (L.M.), Hôpital Dupuytren, Department of Neurology; CHU de Saint-Étienne (J.-P.C.), Hôpital Nord, Department of Neurology; CHU de Tours (A.M.), Hôpital Bretonneau, CRC SEP and Department of Neurology; CHU de Reims (S.M.), CRC-SEP, Department of Neurology; Hôpital Sud Francilien (N.H.B.), Department of Neurology, Corbeil Essonnes; CHU Bicêtre (D.D.B.), Department of Neurology, Le Kremlin Bicêtre; Department of Neurology (K.H.), Hôpital Pierre Delafontaine, Centre Hospitalier de Saint-Denis; CHU La Milétrie (J.-P.N.), Hôpital Jean Bernard, Department of Neurology, Poitiers; CH de Pontoise (C. Pottier), Hôpital René Dubos, Department of Neurology; and Centre Hospitalier de Versailles (C.N.), Department of Neurology, F-78150 Le Chesnay, France
| | - Philippe Cabre
- From the Service de Neurologie (A.G., F.R., R.C., S.V.), Sclérose en Plaques, Pathologies de La Myéline et Neuro-inflammation, Hôpital Neurologique Pierre-Wertheimer, Hospices Civils de Lyon, Bron; Université de Lyon (A.G., M.R., F.S.), Université Claude Bernard Lyon 1, CNRS, Laboratoire de Biométrie et Biologie Évolutive UMR 5558, Villeurbanne; Service de Biostatistique-Bioinformatique (A.G., M.R., F.S.), Hospices Civils de Lyon; Université de Lyon (F.R., R.C., S.V.), Université Claude Bernard Lyon 1; Observatoire Français de La Sclérose en Plaques (F.R., R.C., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., R.C., S.V.), State-approved Foundation, Bron; Nancy University Hospital (M.D.), Department of Neurology, Université de Lorraine, APEMAC; CHU Pontchaillou (E.L.P.), CIC1414 INSERM, Rennes; CHU de Toulouse (J.C.), Hôpital Pierre-Paul Riquet, Department of Neurology, CRC-SEP, Toulouse; Infinity (J.C.), INSERM UMR1291-CNRS UMR5051, Université Toulouse III; CHU de Strasbourg (J.D.S.), Department of Neurology and Clinical Investigation Center, CIC 1434, INSERM 1434; Univ. Bordeaux (A.R.), F-33000 Bordeaux INSERM U1215, Neurocentre Magendie, F-33000 Bordeaux CHU de Bordeaux, Department of Neurology, CIC Bordeaux CIC1401; Département de Neurologie (E.M.), Hôpital Pitié-Salpêtrière, APHP, Paris; Centre de Ressources et de Compétences SEP Paris (E.M.); CHU de Montpellier (P.L.), MS Unit; University of Montpellier (MUSE) (P.L.); CHU Lille (H.Z.), CRCSEP Lille, Univ Lille, U1172; Fondation Rotschild (C. Papeix), Department of Neurology, Paris; CHU de Caen (G.D.), MS Expert Centre, Department of Neurology, Avenue de La Côte-de-Nacre, Normandy University, Caen; Neurology (C.L.-F.), UR2CA, Centre Hospitalier Universitaire Pasteur2, Université Nice Côte d'Azur, Nice; CHU de Dijon (T.M.), Department of Neurology, EA4184; CHU de Nantes (D.A.L.), Service de Neurologie & CIC015 INSERM; CRTI-Inserm U1064 (D.A.L.), Nantes; CHU de Besançon (E.B.), Service de Neurologie; Sorbonne Universités (B.S.), UPMC Paris 06, Brain and Spine Institute, ICM, Hôpital de La Pitié Salpêtrière, Inserm UMR S 1127, CNRS UMR 7225, and Department of Neurology, AP-HP, Saint-Antoine Hospital; CHU Clermont-Ferrand (Pierre Clavelou), Department of Neurology, F-63000 Clermont-Ferrand Université Clermont Auvergne, Inserm, Neuro-Dol, F-63000 Clermont-Ferrand; Department of Neurology (E.T.), Nimes University Hospital; Institut de Génomique Fonctionnelle (E.T.), UMR5203, INSERM 1191, Univ. Montpellier; Hôpital de Poissy (O.H.), Department of Neurology; Aix Marseille Univ (J.P.), APHM, Hôpital de La Timone, Pôle de Neurosciences Cliniques, Service de Neurologie; CHU d'Amiens (A.A.K.), Department of Neurology; CHU Grenoble Alpes (O.C.), Department of Neurology, La Tronche/Grenoble; CHU de Rouen (B.B.), Department of Neurology; CHU de La Martinique (Philippe Cabre), Department of Neurology, Fort-de-France; APHP (A.W.), Hôpital Henri Mondor, Department of Neurology, Créteil; CHU de Limoges (L.M.), Hôpital Dupuytren, Department of Neurology; CHU de Saint-Étienne (J.-P.C.), Hôpital Nord, Department of Neurology; CHU de Tours (A.M.), Hôpital Bretonneau, CRC SEP and Department of Neurology; CHU de Reims (S.M.), CRC-SEP, Department of Neurology; Hôpital Sud Francilien (N.H.B.), Department of Neurology, Corbeil Essonnes; CHU Bicêtre (D.D.B.), Department of Neurology, Le Kremlin Bicêtre; Department of Neurology (K.H.), Hôpital Pierre Delafontaine, Centre Hospitalier de Saint-Denis; CHU La Milétrie (J.-P.N.), Hôpital Jean Bernard, Department of Neurology, Poitiers; CH de Pontoise (C. Pottier), Hôpital René Dubos, Department of Neurology; and Centre Hospitalier de Versailles (C.N.), Department of Neurology, F-78150 Le Chesnay, France
| | - Abir Wahab
- From the Service de Neurologie (A.G., F.R., R.C., S.V.), Sclérose en Plaques, Pathologies de La Myéline et Neuro-inflammation, Hôpital Neurologique Pierre-Wertheimer, Hospices Civils de Lyon, Bron; Université de Lyon (A.G., M.R., F.S.), Université Claude Bernard Lyon 1, CNRS, Laboratoire de Biométrie et Biologie Évolutive UMR 5558, Villeurbanne; Service de Biostatistique-Bioinformatique (A.G., M.R., F.S.), Hospices Civils de Lyon; Université de Lyon (F.R., R.C., S.V.), Université Claude Bernard Lyon 1; Observatoire Français de La Sclérose en Plaques (F.R., R.C., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., R.C., S.V.), State-approved Foundation, Bron; Nancy University Hospital (M.D.), Department of Neurology, Université de Lorraine, APEMAC; CHU Pontchaillou (E.L.P.), CIC1414 INSERM, Rennes; CHU de Toulouse (J.C.), Hôpital Pierre-Paul Riquet, Department of Neurology, CRC-SEP, Toulouse; Infinity (J.C.), INSERM UMR1291-CNRS UMR5051, Université Toulouse III; CHU de Strasbourg (J.D.S.), Department of Neurology and Clinical Investigation Center, CIC 1434, INSERM 1434; Univ. Bordeaux (A.R.), F-33000 Bordeaux INSERM U1215, Neurocentre Magendie, F-33000 Bordeaux CHU de Bordeaux, Department of Neurology, CIC Bordeaux CIC1401; Département de Neurologie (E.M.), Hôpital Pitié-Salpêtrière, APHP, Paris; Centre de Ressources et de Compétences SEP Paris (E.M.); CHU de Montpellier (P.L.), MS Unit; University of Montpellier (MUSE) (P.L.); CHU Lille (H.Z.), CRCSEP Lille, Univ Lille, U1172; Fondation Rotschild (C. Papeix), Department of Neurology, Paris; CHU de Caen (G.D.), MS Expert Centre, Department of Neurology, Avenue de La Côte-de-Nacre, Normandy University, Caen; Neurology (C.L.-F.), UR2CA, Centre Hospitalier Universitaire Pasteur2, Université Nice Côte d'Azur, Nice; CHU de Dijon (T.M.), Department of Neurology, EA4184; CHU de Nantes (D.A.L.), Service de Neurologie & CIC015 INSERM; CRTI-Inserm U1064 (D.A.L.), Nantes; CHU de Besançon (E.B.), Service de Neurologie; Sorbonne Universités (B.S.), UPMC Paris 06, Brain and Spine Institute, ICM, Hôpital de La Pitié Salpêtrière, Inserm UMR S 1127, CNRS UMR 7225, and Department of Neurology, AP-HP, Saint-Antoine Hospital; CHU Clermont-Ferrand (Pierre Clavelou), Department of Neurology, F-63000 Clermont-Ferrand Université Clermont Auvergne, Inserm, Neuro-Dol, F-63000 Clermont-Ferrand; Department of Neurology (E.T.), Nimes University Hospital; Institut de Génomique Fonctionnelle (E.T.), UMR5203, INSERM 1191, Univ. Montpellier; Hôpital de Poissy (O.H.), Department of Neurology; Aix Marseille Univ (J.P.), APHM, Hôpital de La Timone, Pôle de Neurosciences Cliniques, Service de Neurologie; CHU d'Amiens (A.A.K.), Department of Neurology; CHU Grenoble Alpes (O.C.), Department of Neurology, La Tronche/Grenoble; CHU de Rouen (B.B.), Department of Neurology; CHU de La Martinique (Philippe Cabre), Department of Neurology, Fort-de-France; APHP (A.W.), Hôpital Henri Mondor, Department of Neurology, Créteil; CHU de Limoges (L.M.), Hôpital Dupuytren, Department of Neurology; CHU de Saint-Étienne (J.-P.C.), Hôpital Nord, Department of Neurology; CHU de Tours (A.M.), Hôpital Bretonneau, CRC SEP and Department of Neurology; CHU de Reims (S.M.), CRC-SEP, Department of Neurology; Hôpital Sud Francilien (N.H.B.), Department of Neurology, Corbeil Essonnes; CHU Bicêtre (D.D.B.), Department of Neurology, Le Kremlin Bicêtre; Department of Neurology (K.H.), Hôpital Pierre Delafontaine, Centre Hospitalier de Saint-Denis; CHU La Milétrie (J.-P.N.), Hôpital Jean Bernard, Department of Neurology, Poitiers; CH de Pontoise (C. Pottier), Hôpital René Dubos, Department of Neurology; and Centre Hospitalier de Versailles (C.N.), Department of Neurology, F-78150 Le Chesnay, France
| | - Laurent Magy
- From the Service de Neurologie (A.G., F.R., R.C., S.V.), Sclérose en Plaques, Pathologies de La Myéline et Neuro-inflammation, Hôpital Neurologique Pierre-Wertheimer, Hospices Civils de Lyon, Bron; Université de Lyon (A.G., M.R., F.S.), Université Claude Bernard Lyon 1, CNRS, Laboratoire de Biométrie et Biologie Évolutive UMR 5558, Villeurbanne; Service de Biostatistique-Bioinformatique (A.G., M.R., F.S.), Hospices Civils de Lyon; Université de Lyon (F.R., R.C., S.V.), Université Claude Bernard Lyon 1; Observatoire Français de La Sclérose en Plaques (F.R., R.C., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., R.C., S.V.), State-approved Foundation, Bron; Nancy University Hospital (M.D.), Department of Neurology, Université de Lorraine, APEMAC; CHU Pontchaillou (E.L.P.), CIC1414 INSERM, Rennes; CHU de Toulouse (J.C.), Hôpital Pierre-Paul Riquet, Department of Neurology, CRC-SEP, Toulouse; Infinity (J.C.), INSERM UMR1291-CNRS UMR5051, Université Toulouse III; CHU de Strasbourg (J.D.S.), Department of Neurology and Clinical Investigation Center, CIC 1434, INSERM 1434; Univ. Bordeaux (A.R.), F-33000 Bordeaux INSERM U1215, Neurocentre Magendie, F-33000 Bordeaux CHU de Bordeaux, Department of Neurology, CIC Bordeaux CIC1401; Département de Neurologie (E.M.), Hôpital Pitié-Salpêtrière, APHP, Paris; Centre de Ressources et de Compétences SEP Paris (E.M.); CHU de Montpellier (P.L.), MS Unit; University of Montpellier (MUSE) (P.L.); CHU Lille (H.Z.), CRCSEP Lille, Univ Lille, U1172; Fondation Rotschild (C. Papeix), Department of Neurology, Paris; CHU de Caen (G.D.), MS Expert Centre, Department of Neurology, Avenue de La Côte-de-Nacre, Normandy University, Caen; Neurology (C.L.-F.), UR2CA, Centre Hospitalier Universitaire Pasteur2, Université Nice Côte d'Azur, Nice; CHU de Dijon (T.M.), Department of Neurology, EA4184; CHU de Nantes (D.A.L.), Service de Neurologie & CIC015 INSERM; CRTI-Inserm U1064 (D.A.L.), Nantes; CHU de Besançon (E.B.), Service de Neurologie; Sorbonne Universités (B.S.), UPMC Paris 06, Brain and Spine Institute, ICM, Hôpital de La Pitié Salpêtrière, Inserm UMR S 1127, CNRS UMR 7225, and Department of Neurology, AP-HP, Saint-Antoine Hospital; CHU Clermont-Ferrand (Pierre Clavelou), Department of Neurology, F-63000 Clermont-Ferrand Université Clermont Auvergne, Inserm, Neuro-Dol, F-63000 Clermont-Ferrand; Department of Neurology (E.T.), Nimes University Hospital; Institut de Génomique Fonctionnelle (E.T.), UMR5203, INSERM 1191, Univ. Montpellier; Hôpital de Poissy (O.H.), Department of Neurology; Aix Marseille Univ (J.P.), APHM, Hôpital de La Timone, Pôle de Neurosciences Cliniques, Service de Neurologie; CHU d'Amiens (A.A.K.), Department of Neurology; CHU Grenoble Alpes (O.C.), Department of Neurology, La Tronche/Grenoble; CHU de Rouen (B.B.), Department of Neurology; CHU de La Martinique (Philippe Cabre), Department of Neurology, Fort-de-France; APHP (A.W.), Hôpital Henri Mondor, Department of Neurology, Créteil; CHU de Limoges (L.M.), Hôpital Dupuytren, Department of Neurology; CHU de Saint-Étienne (J.-P.C.), Hôpital Nord, Department of Neurology; CHU de Tours (A.M.), Hôpital Bretonneau, CRC SEP and Department of Neurology; CHU de Reims (S.M.), CRC-SEP, Department of Neurology; Hôpital Sud Francilien (N.H.B.), Department of Neurology, Corbeil Essonnes; CHU Bicêtre (D.D.B.), Department of Neurology, Le Kremlin Bicêtre; Department of Neurology (K.H.), Hôpital Pierre Delafontaine, Centre Hospitalier de Saint-Denis; CHU La Milétrie (J.-P.N.), Hôpital Jean Bernard, Department of Neurology, Poitiers; CH de Pontoise (C. Pottier), Hôpital René Dubos, Department of Neurology; and Centre Hospitalier de Versailles (C.N.), Department of Neurology, F-78150 Le Chesnay, France
| | - Jean-Philippe Camdessanche
- From the Service de Neurologie (A.G., F.R., R.C., S.V.), Sclérose en Plaques, Pathologies de La Myéline et Neuro-inflammation, Hôpital Neurologique Pierre-Wertheimer, Hospices Civils de Lyon, Bron; Université de Lyon (A.G., M.R., F.S.), Université Claude Bernard Lyon 1, CNRS, Laboratoire de Biométrie et Biologie Évolutive UMR 5558, Villeurbanne; Service de Biostatistique-Bioinformatique (A.G., M.R., F.S.), Hospices Civils de Lyon; Université de Lyon (F.R., R.C., S.V.), Université Claude Bernard Lyon 1; Observatoire Français de La Sclérose en Plaques (F.R., R.C., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., R.C., S.V.), State-approved Foundation, Bron; Nancy University Hospital (M.D.), Department of Neurology, Université de Lorraine, APEMAC; CHU Pontchaillou (E.L.P.), CIC1414 INSERM, Rennes; CHU de Toulouse (J.C.), Hôpital Pierre-Paul Riquet, Department of Neurology, CRC-SEP, Toulouse; Infinity (J.C.), INSERM UMR1291-CNRS UMR5051, Université Toulouse III; CHU de Strasbourg (J.D.S.), Department of Neurology and Clinical Investigation Center, CIC 1434, INSERM 1434; Univ. Bordeaux (A.R.), F-33000 Bordeaux INSERM U1215, Neurocentre Magendie, F-33000 Bordeaux CHU de Bordeaux, Department of Neurology, CIC Bordeaux CIC1401; Département de Neurologie (E.M.), Hôpital Pitié-Salpêtrière, APHP, Paris; Centre de Ressources et de Compétences SEP Paris (E.M.); CHU de Montpellier (P.L.), MS Unit; University of Montpellier (MUSE) (P.L.); CHU Lille (H.Z.), CRCSEP Lille, Univ Lille, U1172; Fondation Rotschild (C. Papeix), Department of Neurology, Paris; CHU de Caen (G.D.), MS Expert Centre, Department of Neurology, Avenue de La Côte-de-Nacre, Normandy University, Caen; Neurology (C.L.-F.), UR2CA, Centre Hospitalier Universitaire Pasteur2, Université Nice Côte d'Azur, Nice; CHU de Dijon (T.M.), Department of Neurology, EA4184; CHU de Nantes (D.A.L.), Service de Neurologie & CIC015 INSERM; CRTI-Inserm U1064 (D.A.L.), Nantes; CHU de Besançon (E.B.), Service de Neurologie; Sorbonne Universités (B.S.), UPMC Paris 06, Brain and Spine Institute, ICM, Hôpital de La Pitié Salpêtrière, Inserm UMR S 1127, CNRS UMR 7225, and Department of Neurology, AP-HP, Saint-Antoine Hospital; CHU Clermont-Ferrand (Pierre Clavelou), Department of Neurology, F-63000 Clermont-Ferrand Université Clermont Auvergne, Inserm, Neuro-Dol, F-63000 Clermont-Ferrand; Department of Neurology (E.T.), Nimes University Hospital; Institut de Génomique Fonctionnelle (E.T.), UMR5203, INSERM 1191, Univ. Montpellier; Hôpital de Poissy (O.H.), Department of Neurology; Aix Marseille Univ (J.P.), APHM, Hôpital de La Timone, Pôle de Neurosciences Cliniques, Service de Neurologie; CHU d'Amiens (A.A.K.), Department of Neurology; CHU Grenoble Alpes (O.C.), Department of Neurology, La Tronche/Grenoble; CHU de Rouen (B.B.), Department of Neurology; CHU de La Martinique (Philippe Cabre), Department of Neurology, Fort-de-France; APHP (A.W.), Hôpital Henri Mondor, Department of Neurology, Créteil; CHU de Limoges (L.M.), Hôpital Dupuytren, Department of Neurology; CHU de Saint-Étienne (J.-P.C.), Hôpital Nord, Department of Neurology; CHU de Tours (A.M.), Hôpital Bretonneau, CRC SEP and Department of Neurology; CHU de Reims (S.M.), CRC-SEP, Department of Neurology; Hôpital Sud Francilien (N.H.B.), Department of Neurology, Corbeil Essonnes; CHU Bicêtre (D.D.B.), Department of Neurology, Le Kremlin Bicêtre; Department of Neurology (K.H.), Hôpital Pierre Delafontaine, Centre Hospitalier de Saint-Denis; CHU La Milétrie (J.-P.N.), Hôpital Jean Bernard, Department of Neurology, Poitiers; CH de Pontoise (C. Pottier), Hôpital René Dubos, Department of Neurology; and Centre Hospitalier de Versailles (C.N.), Department of Neurology, F-78150 Le Chesnay, France
| | - Aude Maurousset
- From the Service de Neurologie (A.G., F.R., R.C., S.V.), Sclérose en Plaques, Pathologies de La Myéline et Neuro-inflammation, Hôpital Neurologique Pierre-Wertheimer, Hospices Civils de Lyon, Bron; Université de Lyon (A.G., M.R., F.S.), Université Claude Bernard Lyon 1, CNRS, Laboratoire de Biométrie et Biologie Évolutive UMR 5558, Villeurbanne; Service de Biostatistique-Bioinformatique (A.G., M.R., F.S.), Hospices Civils de Lyon; Université de Lyon (F.R., R.C., S.V.), Université Claude Bernard Lyon 1; Observatoire Français de La Sclérose en Plaques (F.R., R.C., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., R.C., S.V.), State-approved Foundation, Bron; Nancy University Hospital (M.D.), Department of Neurology, Université de Lorraine, APEMAC; CHU Pontchaillou (E.L.P.), CIC1414 INSERM, Rennes; CHU de Toulouse (J.C.), Hôpital Pierre-Paul Riquet, Department of Neurology, CRC-SEP, Toulouse; Infinity (J.C.), INSERM UMR1291-CNRS UMR5051, Université Toulouse III; CHU de Strasbourg (J.D.S.), Department of Neurology and Clinical Investigation Center, CIC 1434, INSERM 1434; Univ. Bordeaux (A.R.), F-33000 Bordeaux INSERM U1215, Neurocentre Magendie, F-33000 Bordeaux CHU de Bordeaux, Department of Neurology, CIC Bordeaux CIC1401; Département de Neurologie (E.M.), Hôpital Pitié-Salpêtrière, APHP, Paris; Centre de Ressources et de Compétences SEP Paris (E.M.); CHU de Montpellier (P.L.), MS Unit; University of Montpellier (MUSE) (P.L.); CHU Lille (H.Z.), CRCSEP Lille, Univ Lille, U1172; Fondation Rotschild (C. Papeix), Department of Neurology, Paris; CHU de Caen (G.D.), MS Expert Centre, Department of Neurology, Avenue de La Côte-de-Nacre, Normandy University, Caen; Neurology (C.L.-F.), UR2CA, Centre Hospitalier Universitaire Pasteur2, Université Nice Côte d'Azur, Nice; CHU de Dijon (T.M.), Department of Neurology, EA4184; CHU de Nantes (D.A.L.), Service de Neurologie & CIC015 INSERM; CRTI-Inserm U1064 (D.A.L.), Nantes; CHU de Besançon (E.B.), Service de Neurologie; Sorbonne Universités (B.S.), UPMC Paris 06, Brain and Spine Institute, ICM, Hôpital de La Pitié Salpêtrière, Inserm UMR S 1127, CNRS UMR 7225, and Department of Neurology, AP-HP, Saint-Antoine Hospital; CHU Clermont-Ferrand (Pierre Clavelou), Department of Neurology, F-63000 Clermont-Ferrand Université Clermont Auvergne, Inserm, Neuro-Dol, F-63000 Clermont-Ferrand; Department of Neurology (E.T.), Nimes University Hospital; Institut de Génomique Fonctionnelle (E.T.), UMR5203, INSERM 1191, Univ. Montpellier; Hôpital de Poissy (O.H.), Department of Neurology; Aix Marseille Univ (J.P.), APHM, Hôpital de La Timone, Pôle de Neurosciences Cliniques, Service de Neurologie; CHU d'Amiens (A.A.K.), Department of Neurology; CHU Grenoble Alpes (O.C.), Department of Neurology, La Tronche/Grenoble; CHU de Rouen (B.B.), Department of Neurology; CHU de La Martinique (Philippe Cabre), Department of Neurology, Fort-de-France; APHP (A.W.), Hôpital Henri Mondor, Department of Neurology, Créteil; CHU de Limoges (L.M.), Hôpital Dupuytren, Department of Neurology; CHU de Saint-Étienne (J.-P.C.), Hôpital Nord, Department of Neurology; CHU de Tours (A.M.), Hôpital Bretonneau, CRC SEP and Department of Neurology; CHU de Reims (S.M.), CRC-SEP, Department of Neurology; Hôpital Sud Francilien (N.H.B.), Department of Neurology, Corbeil Essonnes; CHU Bicêtre (D.D.B.), Department of Neurology, Le Kremlin Bicêtre; Department of Neurology (K.H.), Hôpital Pierre Delafontaine, Centre Hospitalier de Saint-Denis; CHU La Milétrie (J.-P.N.), Hôpital Jean Bernard, Department of Neurology, Poitiers; CH de Pontoise (C. Pottier), Hôpital René Dubos, Department of Neurology; and Centre Hospitalier de Versailles (C.N.), Department of Neurology, F-78150 Le Chesnay, France
| | - Solène Moulin
- From the Service de Neurologie (A.G., F.R., R.C., S.V.), Sclérose en Plaques, Pathologies de La Myéline et Neuro-inflammation, Hôpital Neurologique Pierre-Wertheimer, Hospices Civils de Lyon, Bron; Université de Lyon (A.G., M.R., F.S.), Université Claude Bernard Lyon 1, CNRS, Laboratoire de Biométrie et Biologie Évolutive UMR 5558, Villeurbanne; Service de Biostatistique-Bioinformatique (A.G., M.R., F.S.), Hospices Civils de Lyon; Université de Lyon (F.R., R.C., S.V.), Université Claude Bernard Lyon 1; Observatoire Français de La Sclérose en Plaques (F.R., R.C., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., R.C., S.V.), State-approved Foundation, Bron; Nancy University Hospital (M.D.), Department of Neurology, Université de Lorraine, APEMAC; CHU Pontchaillou (E.L.P.), CIC1414 INSERM, Rennes; CHU de Toulouse (J.C.), Hôpital Pierre-Paul Riquet, Department of Neurology, CRC-SEP, Toulouse; Infinity (J.C.), INSERM UMR1291-CNRS UMR5051, Université Toulouse III; CHU de Strasbourg (J.D.S.), Department of Neurology and Clinical Investigation Center, CIC 1434, INSERM 1434; Univ. Bordeaux (A.R.), F-33000 Bordeaux INSERM U1215, Neurocentre Magendie, F-33000 Bordeaux CHU de Bordeaux, Department of Neurology, CIC Bordeaux CIC1401; Département de Neurologie (E.M.), Hôpital Pitié-Salpêtrière, APHP, Paris; Centre de Ressources et de Compétences SEP Paris (E.M.); CHU de Montpellier (P.L.), MS Unit; University of Montpellier (MUSE) (P.L.); CHU Lille (H.Z.), CRCSEP Lille, Univ Lille, U1172; Fondation Rotschild (C. Papeix), Department of Neurology, Paris; CHU de Caen (G.D.), MS Expert Centre, Department of Neurology, Avenue de La Côte-de-Nacre, Normandy University, Caen; Neurology (C.L.-F.), UR2CA, Centre Hospitalier Universitaire Pasteur2, Université Nice Côte d'Azur, Nice; CHU de Dijon (T.M.), Department of Neurology, EA4184; CHU de Nantes (D.A.L.), Service de Neurologie & CIC015 INSERM; CRTI-Inserm U1064 (D.A.L.), Nantes; CHU de Besançon (E.B.), Service de Neurologie; Sorbonne Universités (B.S.), UPMC Paris 06, Brain and Spine Institute, ICM, Hôpital de La Pitié Salpêtrière, Inserm UMR S 1127, CNRS UMR 7225, and Department of Neurology, AP-HP, Saint-Antoine Hospital; CHU Clermont-Ferrand (Pierre Clavelou), Department of Neurology, F-63000 Clermont-Ferrand Université Clermont Auvergne, Inserm, Neuro-Dol, F-63000 Clermont-Ferrand; Department of Neurology (E.T.), Nimes University Hospital; Institut de Génomique Fonctionnelle (E.T.), UMR5203, INSERM 1191, Univ. Montpellier; Hôpital de Poissy (O.H.), Department of Neurology; Aix Marseille Univ (J.P.), APHM, Hôpital de La Timone, Pôle de Neurosciences Cliniques, Service de Neurologie; CHU d'Amiens (A.A.K.), Department of Neurology; CHU Grenoble Alpes (O.C.), Department of Neurology, La Tronche/Grenoble; CHU de Rouen (B.B.), Department of Neurology; CHU de La Martinique (Philippe Cabre), Department of Neurology, Fort-de-France; APHP (A.W.), Hôpital Henri Mondor, Department of Neurology, Créteil; CHU de Limoges (L.M.), Hôpital Dupuytren, Department of Neurology; CHU de Saint-Étienne (J.-P.C.), Hôpital Nord, Department of Neurology; CHU de Tours (A.M.), Hôpital Bretonneau, CRC SEP and Department of Neurology; CHU de Reims (S.M.), CRC-SEP, Department of Neurology; Hôpital Sud Francilien (N.H.B.), Department of Neurology, Corbeil Essonnes; CHU Bicêtre (D.D.B.), Department of Neurology, Le Kremlin Bicêtre; Department of Neurology (K.H.), Hôpital Pierre Delafontaine, Centre Hospitalier de Saint-Denis; CHU La Milétrie (J.-P.N.), Hôpital Jean Bernard, Department of Neurology, Poitiers; CH de Pontoise (C. Pottier), Hôpital René Dubos, Department of Neurology; and Centre Hospitalier de Versailles (C.N.), Department of Neurology, F-78150 Le Chesnay, France
| | - Nasr Haifa Ben
- From the Service de Neurologie (A.G., F.R., R.C., S.V.), Sclérose en Plaques, Pathologies de La Myéline et Neuro-inflammation, Hôpital Neurologique Pierre-Wertheimer, Hospices Civils de Lyon, Bron; Université de Lyon (A.G., M.R., F.S.), Université Claude Bernard Lyon 1, CNRS, Laboratoire de Biométrie et Biologie Évolutive UMR 5558, Villeurbanne; Service de Biostatistique-Bioinformatique (A.G., M.R., F.S.), Hospices Civils de Lyon; Université de Lyon (F.R., R.C., S.V.), Université Claude Bernard Lyon 1; Observatoire Français de La Sclérose en Plaques (F.R., R.C., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., R.C., S.V.), State-approved Foundation, Bron; Nancy University Hospital (M.D.), Department of Neurology, Université de Lorraine, APEMAC; CHU Pontchaillou (E.L.P.), CIC1414 INSERM, Rennes; CHU de Toulouse (J.C.), Hôpital Pierre-Paul Riquet, Department of Neurology, CRC-SEP, Toulouse; Infinity (J.C.), INSERM UMR1291-CNRS UMR5051, Université Toulouse III; CHU de Strasbourg (J.D.S.), Department of Neurology and Clinical Investigation Center, CIC 1434, INSERM 1434; Univ. Bordeaux (A.R.), F-33000 Bordeaux INSERM U1215, Neurocentre Magendie, F-33000 Bordeaux CHU de Bordeaux, Department of Neurology, CIC Bordeaux CIC1401; Département de Neurologie (E.M.), Hôpital Pitié-Salpêtrière, APHP, Paris; Centre de Ressources et de Compétences SEP Paris (E.M.); CHU de Montpellier (P.L.), MS Unit; University of Montpellier (MUSE) (P.L.); CHU Lille (H.Z.), CRCSEP Lille, Univ Lille, U1172; Fondation Rotschild (C. Papeix), Department of Neurology, Paris; CHU de Caen (G.D.), MS Expert Centre, Department of Neurology, Avenue de La Côte-de-Nacre, Normandy University, Caen; Neurology (C.L.-F.), UR2CA, Centre Hospitalier Universitaire Pasteur2, Université Nice Côte d'Azur, Nice; CHU de Dijon (T.M.), Department of Neurology, EA4184; CHU de Nantes (D.A.L.), Service de Neurologie & CIC015 INSERM; CRTI-Inserm U1064 (D.A.L.), Nantes; CHU de Besançon (E.B.), Service de Neurologie; Sorbonne Universités (B.S.), UPMC Paris 06, Brain and Spine Institute, ICM, Hôpital de La Pitié Salpêtrière, Inserm UMR S 1127, CNRS UMR 7225, and Department of Neurology, AP-HP, Saint-Antoine Hospital; CHU Clermont-Ferrand (Pierre Clavelou), Department of Neurology, F-63000 Clermont-Ferrand Université Clermont Auvergne, Inserm, Neuro-Dol, F-63000 Clermont-Ferrand; Department of Neurology (E.T.), Nimes University Hospital; Institut de Génomique Fonctionnelle (E.T.), UMR5203, INSERM 1191, Univ. Montpellier; Hôpital de Poissy (O.H.), Department of Neurology; Aix Marseille Univ (J.P.), APHM, Hôpital de La Timone, Pôle de Neurosciences Cliniques, Service de Neurologie; CHU d'Amiens (A.A.K.), Department of Neurology; CHU Grenoble Alpes (O.C.), Department of Neurology, La Tronche/Grenoble; CHU de Rouen (B.B.), Department of Neurology; CHU de La Martinique (Philippe Cabre), Department of Neurology, Fort-de-France; APHP (A.W.), Hôpital Henri Mondor, Department of Neurology, Créteil; CHU de Limoges (L.M.), Hôpital Dupuytren, Department of Neurology; CHU de Saint-Étienne (J.-P.C.), Hôpital Nord, Department of Neurology; CHU de Tours (A.M.), Hôpital Bretonneau, CRC SEP and Department of Neurology; CHU de Reims (S.M.), CRC-SEP, Department of Neurology; Hôpital Sud Francilien (N.H.B.), Department of Neurology, Corbeil Essonnes; CHU Bicêtre (D.D.B.), Department of Neurology, Le Kremlin Bicêtre; Department of Neurology (K.H.), Hôpital Pierre Delafontaine, Centre Hospitalier de Saint-Denis; CHU La Milétrie (J.-P.N.), Hôpital Jean Bernard, Department of Neurology, Poitiers; CH de Pontoise (C. Pottier), Hôpital René Dubos, Department of Neurology; and Centre Hospitalier de Versailles (C.N.), Department of Neurology, F-78150 Le Chesnay, France
| | - Dalia Dimitri Boulos
- From the Service de Neurologie (A.G., F.R., R.C., S.V.), Sclérose en Plaques, Pathologies de La Myéline et Neuro-inflammation, Hôpital Neurologique Pierre-Wertheimer, Hospices Civils de Lyon, Bron; Université de Lyon (A.G., M.R., F.S.), Université Claude Bernard Lyon 1, CNRS, Laboratoire de Biométrie et Biologie Évolutive UMR 5558, Villeurbanne; Service de Biostatistique-Bioinformatique (A.G., M.R., F.S.), Hospices Civils de Lyon; Université de Lyon (F.R., R.C., S.V.), Université Claude Bernard Lyon 1; Observatoire Français de La Sclérose en Plaques (F.R., R.C., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., R.C., S.V.), State-approved Foundation, Bron; Nancy University Hospital (M.D.), Department of Neurology, Université de Lorraine, APEMAC; CHU Pontchaillou (E.L.P.), CIC1414 INSERM, Rennes; CHU de Toulouse (J.C.), Hôpital Pierre-Paul Riquet, Department of Neurology, CRC-SEP, Toulouse; Infinity (J.C.), INSERM UMR1291-CNRS UMR5051, Université Toulouse III; CHU de Strasbourg (J.D.S.), Department of Neurology and Clinical Investigation Center, CIC 1434, INSERM 1434; Univ. Bordeaux (A.R.), F-33000 Bordeaux INSERM U1215, Neurocentre Magendie, F-33000 Bordeaux CHU de Bordeaux, Department of Neurology, CIC Bordeaux CIC1401; Département de Neurologie (E.M.), Hôpital Pitié-Salpêtrière, APHP, Paris; Centre de Ressources et de Compétences SEP Paris (E.M.); CHU de Montpellier (P.L.), MS Unit; University of Montpellier (MUSE) (P.L.); CHU Lille (H.Z.), CRCSEP Lille, Univ Lille, U1172; Fondation Rotschild (C. Papeix), Department of Neurology, Paris; CHU de Caen (G.D.), MS Expert Centre, Department of Neurology, Avenue de La Côte-de-Nacre, Normandy University, Caen; Neurology (C.L.-F.), UR2CA, Centre Hospitalier Universitaire Pasteur2, Université Nice Côte d'Azur, Nice; CHU de Dijon (T.M.), Department of Neurology, EA4184; CHU de Nantes (D.A.L.), Service de Neurologie & CIC015 INSERM; CRTI-Inserm U1064 (D.A.L.), Nantes; CHU de Besançon (E.B.), Service de Neurologie; Sorbonne Universités (B.S.), UPMC Paris 06, Brain and Spine Institute, ICM, Hôpital de La Pitié Salpêtrière, Inserm UMR S 1127, CNRS UMR 7225, and Department of Neurology, AP-HP, Saint-Antoine Hospital; CHU Clermont-Ferrand (Pierre Clavelou), Department of Neurology, F-63000 Clermont-Ferrand Université Clermont Auvergne, Inserm, Neuro-Dol, F-63000 Clermont-Ferrand; Department of Neurology (E.T.), Nimes University Hospital; Institut de Génomique Fonctionnelle (E.T.), UMR5203, INSERM 1191, Univ. Montpellier; Hôpital de Poissy (O.H.), Department of Neurology; Aix Marseille Univ (J.P.), APHM, Hôpital de La Timone, Pôle de Neurosciences Cliniques, Service de Neurologie; CHU d'Amiens (A.A.K.), Department of Neurology; CHU Grenoble Alpes (O.C.), Department of Neurology, La Tronche/Grenoble; CHU de Rouen (B.B.), Department of Neurology; CHU de La Martinique (Philippe Cabre), Department of Neurology, Fort-de-France; APHP (A.W.), Hôpital Henri Mondor, Department of Neurology, Créteil; CHU de Limoges (L.M.), Hôpital Dupuytren, Department of Neurology; CHU de Saint-Étienne (J.-P.C.), Hôpital Nord, Department of Neurology; CHU de Tours (A.M.), Hôpital Bretonneau, CRC SEP and Department of Neurology; CHU de Reims (S.M.), CRC-SEP, Department of Neurology; Hôpital Sud Francilien (N.H.B.), Department of Neurology, Corbeil Essonnes; CHU Bicêtre (D.D.B.), Department of Neurology, Le Kremlin Bicêtre; Department of Neurology (K.H.), Hôpital Pierre Delafontaine, Centre Hospitalier de Saint-Denis; CHU La Milétrie (J.-P.N.), Hôpital Jean Bernard, Department of Neurology, Poitiers; CH de Pontoise (C. Pottier), Hôpital René Dubos, Department of Neurology; and Centre Hospitalier de Versailles (C.N.), Department of Neurology, F-78150 Le Chesnay, France
| | - Karolina Hankiewicz
- From the Service de Neurologie (A.G., F.R., R.C., S.V.), Sclérose en Plaques, Pathologies de La Myéline et Neuro-inflammation, Hôpital Neurologique Pierre-Wertheimer, Hospices Civils de Lyon, Bron; Université de Lyon (A.G., M.R., F.S.), Université Claude Bernard Lyon 1, CNRS, Laboratoire de Biométrie et Biologie Évolutive UMR 5558, Villeurbanne; Service de Biostatistique-Bioinformatique (A.G., M.R., F.S.), Hospices Civils de Lyon; Université de Lyon (F.R., R.C., S.V.), Université Claude Bernard Lyon 1; Observatoire Français de La Sclérose en Plaques (F.R., R.C., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., R.C., S.V.), State-approved Foundation, Bron; Nancy University Hospital (M.D.), Department of Neurology, Université de Lorraine, APEMAC; CHU Pontchaillou (E.L.P.), CIC1414 INSERM, Rennes; CHU de Toulouse (J.C.), Hôpital Pierre-Paul Riquet, Department of Neurology, CRC-SEP, Toulouse; Infinity (J.C.), INSERM UMR1291-CNRS UMR5051, Université Toulouse III; CHU de Strasbourg (J.D.S.), Department of Neurology and Clinical Investigation Center, CIC 1434, INSERM 1434; Univ. Bordeaux (A.R.), F-33000 Bordeaux INSERM U1215, Neurocentre Magendie, F-33000 Bordeaux CHU de Bordeaux, Department of Neurology, CIC Bordeaux CIC1401; Département de Neurologie (E.M.), Hôpital Pitié-Salpêtrière, APHP, Paris; Centre de Ressources et de Compétences SEP Paris (E.M.); CHU de Montpellier (P.L.), MS Unit; University of Montpellier (MUSE) (P.L.); CHU Lille (H.Z.), CRCSEP Lille, Univ Lille, U1172; Fondation Rotschild (C. Papeix), Department of Neurology, Paris; CHU de Caen (G.D.), MS Expert Centre, Department of Neurology, Avenue de La Côte-de-Nacre, Normandy University, Caen; Neurology (C.L.-F.), UR2CA, Centre Hospitalier Universitaire Pasteur2, Université Nice Côte d'Azur, Nice; CHU de Dijon (T.M.), Department of Neurology, EA4184; CHU de Nantes (D.A.L.), Service de Neurologie & CIC015 INSERM; CRTI-Inserm U1064 (D.A.L.), Nantes; CHU de Besançon (E.B.), Service de Neurologie; Sorbonne Universités (B.S.), UPMC Paris 06, Brain and Spine Institute, ICM, Hôpital de La Pitié Salpêtrière, Inserm UMR S 1127, CNRS UMR 7225, and Department of Neurology, AP-HP, Saint-Antoine Hospital; CHU Clermont-Ferrand (Pierre Clavelou), Department of Neurology, F-63000 Clermont-Ferrand Université Clermont Auvergne, Inserm, Neuro-Dol, F-63000 Clermont-Ferrand; Department of Neurology (E.T.), Nimes University Hospital; Institut de Génomique Fonctionnelle (E.T.), UMR5203, INSERM 1191, Univ. Montpellier; Hôpital de Poissy (O.H.), Department of Neurology; Aix Marseille Univ (J.P.), APHM, Hôpital de La Timone, Pôle de Neurosciences Cliniques, Service de Neurologie; CHU d'Amiens (A.A.K.), Department of Neurology; CHU Grenoble Alpes (O.C.), Department of Neurology, La Tronche/Grenoble; CHU de Rouen (B.B.), Department of Neurology; CHU de La Martinique (Philippe Cabre), Department of Neurology, Fort-de-France; APHP (A.W.), Hôpital Henri Mondor, Department of Neurology, Créteil; CHU de Limoges (L.M.), Hôpital Dupuytren, Department of Neurology; CHU de Saint-Étienne (J.-P.C.), Hôpital Nord, Department of Neurology; CHU de Tours (A.M.), Hôpital Bretonneau, CRC SEP and Department of Neurology; CHU de Reims (S.M.), CRC-SEP, Department of Neurology; Hôpital Sud Francilien (N.H.B.), Department of Neurology, Corbeil Essonnes; CHU Bicêtre (D.D.B.), Department of Neurology, Le Kremlin Bicêtre; Department of Neurology (K.H.), Hôpital Pierre Delafontaine, Centre Hospitalier de Saint-Denis; CHU La Milétrie (J.-P.N.), Hôpital Jean Bernard, Department of Neurology, Poitiers; CH de Pontoise (C. Pottier), Hôpital René Dubos, Department of Neurology; and Centre Hospitalier de Versailles (C.N.), Department of Neurology, F-78150 Le Chesnay, France
| | - Jean-Philippe Neau
- From the Service de Neurologie (A.G., F.R., R.C., S.V.), Sclérose en Plaques, Pathologies de La Myéline et Neuro-inflammation, Hôpital Neurologique Pierre-Wertheimer, Hospices Civils de Lyon, Bron; Université de Lyon (A.G., M.R., F.S.), Université Claude Bernard Lyon 1, CNRS, Laboratoire de Biométrie et Biologie Évolutive UMR 5558, Villeurbanne; Service de Biostatistique-Bioinformatique (A.G., M.R., F.S.), Hospices Civils de Lyon; Université de Lyon (F.R., R.C., S.V.), Université Claude Bernard Lyon 1; Observatoire Français de La Sclérose en Plaques (F.R., R.C., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., R.C., S.V.), State-approved Foundation, Bron; Nancy University Hospital (M.D.), Department of Neurology, Université de Lorraine, APEMAC; CHU Pontchaillou (E.L.P.), CIC1414 INSERM, Rennes; CHU de Toulouse (J.C.), Hôpital Pierre-Paul Riquet, Department of Neurology, CRC-SEP, Toulouse; Infinity (J.C.), INSERM UMR1291-CNRS UMR5051, Université Toulouse III; CHU de Strasbourg (J.D.S.), Department of Neurology and Clinical Investigation Center, CIC 1434, INSERM 1434; Univ. Bordeaux (A.R.), F-33000 Bordeaux INSERM U1215, Neurocentre Magendie, F-33000 Bordeaux CHU de Bordeaux, Department of Neurology, CIC Bordeaux CIC1401; Département de Neurologie (E.M.), Hôpital Pitié-Salpêtrière, APHP, Paris; Centre de Ressources et de Compétences SEP Paris (E.M.); CHU de Montpellier (P.L.), MS Unit; University of Montpellier (MUSE) (P.L.); CHU Lille (H.Z.), CRCSEP Lille, Univ Lille, U1172; Fondation Rotschild (C. Papeix), Department of Neurology, Paris; CHU de Caen (G.D.), MS Expert Centre, Department of Neurology, Avenue de La Côte-de-Nacre, Normandy University, Caen; Neurology (C.L.-F.), UR2CA, Centre Hospitalier Universitaire Pasteur2, Université Nice Côte d'Azur, Nice; CHU de Dijon (T.M.), Department of Neurology, EA4184; CHU de Nantes (D.A.L.), Service de Neurologie & CIC015 INSERM; CRTI-Inserm U1064 (D.A.L.), Nantes; CHU de Besançon (E.B.), Service de Neurologie; Sorbonne Universités (B.S.), UPMC Paris 06, Brain and Spine Institute, ICM, Hôpital de La Pitié Salpêtrière, Inserm UMR S 1127, CNRS UMR 7225, and Department of Neurology, AP-HP, Saint-Antoine Hospital; CHU Clermont-Ferrand (Pierre Clavelou), Department of Neurology, F-63000 Clermont-Ferrand Université Clermont Auvergne, Inserm, Neuro-Dol, F-63000 Clermont-Ferrand; Department of Neurology (E.T.), Nimes University Hospital; Institut de Génomique Fonctionnelle (E.T.), UMR5203, INSERM 1191, Univ. Montpellier; Hôpital de Poissy (O.H.), Department of Neurology; Aix Marseille Univ (J.P.), APHM, Hôpital de La Timone, Pôle de Neurosciences Cliniques, Service de Neurologie; CHU d'Amiens (A.A.K.), Department of Neurology; CHU Grenoble Alpes (O.C.), Department of Neurology, La Tronche/Grenoble; CHU de Rouen (B.B.), Department of Neurology; CHU de La Martinique (Philippe Cabre), Department of Neurology, Fort-de-France; APHP (A.W.), Hôpital Henri Mondor, Department of Neurology, Créteil; CHU de Limoges (L.M.), Hôpital Dupuytren, Department of Neurology; CHU de Saint-Étienne (J.-P.C.), Hôpital Nord, Department of Neurology; CHU de Tours (A.M.), Hôpital Bretonneau, CRC SEP and Department of Neurology; CHU de Reims (S.M.), CRC-SEP, Department of Neurology; Hôpital Sud Francilien (N.H.B.), Department of Neurology, Corbeil Essonnes; CHU Bicêtre (D.D.B.), Department of Neurology, Le Kremlin Bicêtre; Department of Neurology (K.H.), Hôpital Pierre Delafontaine, Centre Hospitalier de Saint-Denis; CHU La Milétrie (J.-P.N.), Hôpital Jean Bernard, Department of Neurology, Poitiers; CH de Pontoise (C. Pottier), Hôpital René Dubos, Department of Neurology; and Centre Hospitalier de Versailles (C.N.), Department of Neurology, F-78150 Le Chesnay, France
| | - Corinne Pottier
- From the Service de Neurologie (A.G., F.R., R.C., S.V.), Sclérose en Plaques, Pathologies de La Myéline et Neuro-inflammation, Hôpital Neurologique Pierre-Wertheimer, Hospices Civils de Lyon, Bron; Université de Lyon (A.G., M.R., F.S.), Université Claude Bernard Lyon 1, CNRS, Laboratoire de Biométrie et Biologie Évolutive UMR 5558, Villeurbanne; Service de Biostatistique-Bioinformatique (A.G., M.R., F.S.), Hospices Civils de Lyon; Université de Lyon (F.R., R.C., S.V.), Université Claude Bernard Lyon 1; Observatoire Français de La Sclérose en Plaques (F.R., R.C., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., R.C., S.V.), State-approved Foundation, Bron; Nancy University Hospital (M.D.), Department of Neurology, Université de Lorraine, APEMAC; CHU Pontchaillou (E.L.P.), CIC1414 INSERM, Rennes; CHU de Toulouse (J.C.), Hôpital Pierre-Paul Riquet, Department of Neurology, CRC-SEP, Toulouse; Infinity (J.C.), INSERM UMR1291-CNRS UMR5051, Université Toulouse III; CHU de Strasbourg (J.D.S.), Department of Neurology and Clinical Investigation Center, CIC 1434, INSERM 1434; Univ. Bordeaux (A.R.), F-33000 Bordeaux INSERM U1215, Neurocentre Magendie, F-33000 Bordeaux CHU de Bordeaux, Department of Neurology, CIC Bordeaux CIC1401; Département de Neurologie (E.M.), Hôpital Pitié-Salpêtrière, APHP, Paris; Centre de Ressources et de Compétences SEP Paris (E.M.); CHU de Montpellier (P.L.), MS Unit; University of Montpellier (MUSE) (P.L.); CHU Lille (H.Z.), CRCSEP Lille, Univ Lille, U1172; Fondation Rotschild (C. Papeix), Department of Neurology, Paris; CHU de Caen (G.D.), MS Expert Centre, Department of Neurology, Avenue de La Côte-de-Nacre, Normandy University, Caen; Neurology (C.L.-F.), UR2CA, Centre Hospitalier Universitaire Pasteur2, Université Nice Côte d'Azur, Nice; CHU de Dijon (T.M.), Department of Neurology, EA4184; CHU de Nantes (D.A.L.), Service de Neurologie & CIC015 INSERM; CRTI-Inserm U1064 (D.A.L.), Nantes; CHU de Besançon (E.B.), Service de Neurologie; Sorbonne Universités (B.S.), UPMC Paris 06, Brain and Spine Institute, ICM, Hôpital de La Pitié Salpêtrière, Inserm UMR S 1127, CNRS UMR 7225, and Department of Neurology, AP-HP, Saint-Antoine Hospital; CHU Clermont-Ferrand (Pierre Clavelou), Department of Neurology, F-63000 Clermont-Ferrand Université Clermont Auvergne, Inserm, Neuro-Dol, F-63000 Clermont-Ferrand; Department of Neurology (E.T.), Nimes University Hospital; Institut de Génomique Fonctionnelle (E.T.), UMR5203, INSERM 1191, Univ. Montpellier; Hôpital de Poissy (O.H.), Department of Neurology; Aix Marseille Univ (J.P.), APHM, Hôpital de La Timone, Pôle de Neurosciences Cliniques, Service de Neurologie; CHU d'Amiens (A.A.K.), Department of Neurology; CHU Grenoble Alpes (O.C.), Department of Neurology, La Tronche/Grenoble; CHU de Rouen (B.B.), Department of Neurology; CHU de La Martinique (Philippe Cabre), Department of Neurology, Fort-de-France; APHP (A.W.), Hôpital Henri Mondor, Department of Neurology, Créteil; CHU de Limoges (L.M.), Hôpital Dupuytren, Department of Neurology; CHU de Saint-Étienne (J.-P.C.), Hôpital Nord, Department of Neurology; CHU de Tours (A.M.), Hôpital Bretonneau, CRC SEP and Department of Neurology; CHU de Reims (S.M.), CRC-SEP, Department of Neurology; Hôpital Sud Francilien (N.H.B.), Department of Neurology, Corbeil Essonnes; CHU Bicêtre (D.D.B.), Department of Neurology, Le Kremlin Bicêtre; Department of Neurology (K.H.), Hôpital Pierre Delafontaine, Centre Hospitalier de Saint-Denis; CHU La Milétrie (J.-P.N.), Hôpital Jean Bernard, Department of Neurology, Poitiers; CH de Pontoise (C. Pottier), Hôpital René Dubos, Department of Neurology; and Centre Hospitalier de Versailles (C.N.), Department of Neurology, F-78150 Le Chesnay, France
| | - Chantal Nifle
- From the Service de Neurologie (A.G., F.R., R.C., S.V.), Sclérose en Plaques, Pathologies de La Myéline et Neuro-inflammation, Hôpital Neurologique Pierre-Wertheimer, Hospices Civils de Lyon, Bron; Université de Lyon (A.G., M.R., F.S.), Université Claude Bernard Lyon 1, CNRS, Laboratoire de Biométrie et Biologie Évolutive UMR 5558, Villeurbanne; Service de Biostatistique-Bioinformatique (A.G., M.R., F.S.), Hospices Civils de Lyon; Université de Lyon (F.R., R.C., S.V.), Université Claude Bernard Lyon 1; Observatoire Français de La Sclérose en Plaques (F.R., R.C., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., R.C., S.V.), State-approved Foundation, Bron; Nancy University Hospital (M.D.), Department of Neurology, Université de Lorraine, APEMAC; CHU Pontchaillou (E.L.P.), CIC1414 INSERM, Rennes; CHU de Toulouse (J.C.), Hôpital Pierre-Paul Riquet, Department of Neurology, CRC-SEP, Toulouse; Infinity (J.C.), INSERM UMR1291-CNRS UMR5051, Université Toulouse III; CHU de Strasbourg (J.D.S.), Department of Neurology and Clinical Investigation Center, CIC 1434, INSERM 1434; Univ. Bordeaux (A.R.), F-33000 Bordeaux INSERM U1215, Neurocentre Magendie, F-33000 Bordeaux CHU de Bordeaux, Department of Neurology, CIC Bordeaux CIC1401; Département de Neurologie (E.M.), Hôpital Pitié-Salpêtrière, APHP, Paris; Centre de Ressources et de Compétences SEP Paris (E.M.); CHU de Montpellier (P.L.), MS Unit; University of Montpellier (MUSE) (P.L.); CHU Lille (H.Z.), CRCSEP Lille, Univ Lille, U1172; Fondation Rotschild (C. Papeix), Department of Neurology, Paris; CHU de Caen (G.D.), MS Expert Centre, Department of Neurology, Avenue de La Côte-de-Nacre, Normandy University, Caen; Neurology (C.L.-F.), UR2CA, Centre Hospitalier Universitaire Pasteur2, Université Nice Côte d'Azur, Nice; CHU de Dijon (T.M.), Department of Neurology, EA4184; CHU de Nantes (D.A.L.), Service de Neurologie & CIC015 INSERM; CRTI-Inserm U1064 (D.A.L.), Nantes; CHU de Besançon (E.B.), Service de Neurologie; Sorbonne Universités (B.S.), UPMC Paris 06, Brain and Spine Institute, ICM, Hôpital de La Pitié Salpêtrière, Inserm UMR S 1127, CNRS UMR 7225, and Department of Neurology, AP-HP, Saint-Antoine Hospital; CHU Clermont-Ferrand (Pierre Clavelou), Department of Neurology, F-63000 Clermont-Ferrand Université Clermont Auvergne, Inserm, Neuro-Dol, F-63000 Clermont-Ferrand; Department of Neurology (E.T.), Nimes University Hospital; Institut de Génomique Fonctionnelle (E.T.), UMR5203, INSERM 1191, Univ. Montpellier; Hôpital de Poissy (O.H.), Department of Neurology; Aix Marseille Univ (J.P.), APHM, Hôpital de La Timone, Pôle de Neurosciences Cliniques, Service de Neurologie; CHU d'Amiens (A.A.K.), Department of Neurology; CHU Grenoble Alpes (O.C.), Department of Neurology, La Tronche/Grenoble; CHU de Rouen (B.B.), Department of Neurology; CHU de La Martinique (Philippe Cabre), Department of Neurology, Fort-de-France; APHP (A.W.), Hôpital Henri Mondor, Department of Neurology, Créteil; CHU de Limoges (L.M.), Hôpital Dupuytren, Department of Neurology; CHU de Saint-Étienne (J.-P.C.), Hôpital Nord, Department of Neurology; CHU de Tours (A.M.), Hôpital Bretonneau, CRC SEP and Department of Neurology; CHU de Reims (S.M.), CRC-SEP, Department of Neurology; Hôpital Sud Francilien (N.H.B.), Department of Neurology, Corbeil Essonnes; CHU Bicêtre (D.D.B.), Department of Neurology, Le Kremlin Bicêtre; Department of Neurology (K.H.), Hôpital Pierre Delafontaine, Centre Hospitalier de Saint-Denis; CHU La Milétrie (J.-P.N.), Hôpital Jean Bernard, Department of Neurology, Poitiers; CH de Pontoise (C. Pottier), Hôpital René Dubos, Department of Neurology; and Centre Hospitalier de Versailles (C.N.), Department of Neurology, F-78150 Le Chesnay, France
| | - Muriel Rabilloud
- From the Service de Neurologie (A.G., F.R., R.C., S.V.), Sclérose en Plaques, Pathologies de La Myéline et Neuro-inflammation, Hôpital Neurologique Pierre-Wertheimer, Hospices Civils de Lyon, Bron; Université de Lyon (A.G., M.R., F.S.), Université Claude Bernard Lyon 1, CNRS, Laboratoire de Biométrie et Biologie Évolutive UMR 5558, Villeurbanne; Service de Biostatistique-Bioinformatique (A.G., M.R., F.S.), Hospices Civils de Lyon; Université de Lyon (F.R., R.C., S.V.), Université Claude Bernard Lyon 1; Observatoire Français de La Sclérose en Plaques (F.R., R.C., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., R.C., S.V.), State-approved Foundation, Bron; Nancy University Hospital (M.D.), Department of Neurology, Université de Lorraine, APEMAC; CHU Pontchaillou (E.L.P.), CIC1414 INSERM, Rennes; CHU de Toulouse (J.C.), Hôpital Pierre-Paul Riquet, Department of Neurology, CRC-SEP, Toulouse; Infinity (J.C.), INSERM UMR1291-CNRS UMR5051, Université Toulouse III; CHU de Strasbourg (J.D.S.), Department of Neurology and Clinical Investigation Center, CIC 1434, INSERM 1434; Univ. Bordeaux (A.R.), F-33000 Bordeaux INSERM U1215, Neurocentre Magendie, F-33000 Bordeaux CHU de Bordeaux, Department of Neurology, CIC Bordeaux CIC1401; Département de Neurologie (E.M.), Hôpital Pitié-Salpêtrière, APHP, Paris; Centre de Ressources et de Compétences SEP Paris (E.M.); CHU de Montpellier (P.L.), MS Unit; University of Montpellier (MUSE) (P.L.); CHU Lille (H.Z.), CRCSEP Lille, Univ Lille, U1172; Fondation Rotschild (C. Papeix), Department of Neurology, Paris; CHU de Caen (G.D.), MS Expert Centre, Department of Neurology, Avenue de La Côte-de-Nacre, Normandy University, Caen; Neurology (C.L.-F.), UR2CA, Centre Hospitalier Universitaire Pasteur2, Université Nice Côte d'Azur, Nice; CHU de Dijon (T.M.), Department of Neurology, EA4184; CHU de Nantes (D.A.L.), Service de Neurologie & CIC015 INSERM; CRTI-Inserm U1064 (D.A.L.), Nantes; CHU de Besançon (E.B.), Service de Neurologie; Sorbonne Universités (B.S.), UPMC Paris 06, Brain and Spine Institute, ICM, Hôpital de La Pitié Salpêtrière, Inserm UMR S 1127, CNRS UMR 7225, and Department of Neurology, AP-HP, Saint-Antoine Hospital; CHU Clermont-Ferrand (Pierre Clavelou), Department of Neurology, F-63000 Clermont-Ferrand Université Clermont Auvergne, Inserm, Neuro-Dol, F-63000 Clermont-Ferrand; Department of Neurology (E.T.), Nimes University Hospital; Institut de Génomique Fonctionnelle (E.T.), UMR5203, INSERM 1191, Univ. Montpellier; Hôpital de Poissy (O.H.), Department of Neurology; Aix Marseille Univ (J.P.), APHM, Hôpital de La Timone, Pôle de Neurosciences Cliniques, Service de Neurologie; CHU d'Amiens (A.A.K.), Department of Neurology; CHU Grenoble Alpes (O.C.), Department of Neurology, La Tronche/Grenoble; CHU de Rouen (B.B.), Department of Neurology; CHU de La Martinique (Philippe Cabre), Department of Neurology, Fort-de-France; APHP (A.W.), Hôpital Henri Mondor, Department of Neurology, Créteil; CHU de Limoges (L.M.), Hôpital Dupuytren, Department of Neurology; CHU de Saint-Étienne (J.-P.C.), Hôpital Nord, Department of Neurology; CHU de Tours (A.M.), Hôpital Bretonneau, CRC SEP and Department of Neurology; CHU de Reims (S.M.), CRC-SEP, Department of Neurology; Hôpital Sud Francilien (N.H.B.), Department of Neurology, Corbeil Essonnes; CHU Bicêtre (D.D.B.), Department of Neurology, Le Kremlin Bicêtre; Department of Neurology (K.H.), Hôpital Pierre Delafontaine, Centre Hospitalier de Saint-Denis; CHU La Milétrie (J.-P.N.), Hôpital Jean Bernard, Department of Neurology, Poitiers; CH de Pontoise (C. Pottier), Hôpital René Dubos, Department of Neurology; and Centre Hospitalier de Versailles (C.N.), Department of Neurology, F-78150 Le Chesnay, France
| | - Fabien Subtil
- From the Service de Neurologie (A.G., F.R., R.C., S.V.), Sclérose en Plaques, Pathologies de La Myéline et Neuro-inflammation, Hôpital Neurologique Pierre-Wertheimer, Hospices Civils de Lyon, Bron; Université de Lyon (A.G., M.R., F.S.), Université Claude Bernard Lyon 1, CNRS, Laboratoire de Biométrie et Biologie Évolutive UMR 5558, Villeurbanne; Service de Biostatistique-Bioinformatique (A.G., M.R., F.S.), Hospices Civils de Lyon; Université de Lyon (F.R., R.C., S.V.), Université Claude Bernard Lyon 1; Observatoire Français de La Sclérose en Plaques (F.R., R.C., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., R.C., S.V.), State-approved Foundation, Bron; Nancy University Hospital (M.D.), Department of Neurology, Université de Lorraine, APEMAC; CHU Pontchaillou (E.L.P.), CIC1414 INSERM, Rennes; CHU de Toulouse (J.C.), Hôpital Pierre-Paul Riquet, Department of Neurology, CRC-SEP, Toulouse; Infinity (J.C.), INSERM UMR1291-CNRS UMR5051, Université Toulouse III; CHU de Strasbourg (J.D.S.), Department of Neurology and Clinical Investigation Center, CIC 1434, INSERM 1434; Univ. Bordeaux (A.R.), F-33000 Bordeaux INSERM U1215, Neurocentre Magendie, F-33000 Bordeaux CHU de Bordeaux, Department of Neurology, CIC Bordeaux CIC1401; Département de Neurologie (E.M.), Hôpital Pitié-Salpêtrière, APHP, Paris; Centre de Ressources et de Compétences SEP Paris (E.M.); CHU de Montpellier (P.L.), MS Unit; University of Montpellier (MUSE) (P.L.); CHU Lille (H.Z.), CRCSEP Lille, Univ Lille, U1172; Fondation Rotschild (C. Papeix), Department of Neurology, Paris; CHU de Caen (G.D.), MS Expert Centre, Department of Neurology, Avenue de La Côte-de-Nacre, Normandy University, Caen; Neurology (C.L.-F.), UR2CA, Centre Hospitalier Universitaire Pasteur2, Université Nice Côte d'Azur, Nice; CHU de Dijon (T.M.), Department of Neurology, EA4184; CHU de Nantes (D.A.L.), Service de Neurologie & CIC015 INSERM; CRTI-Inserm U1064 (D.A.L.), Nantes; CHU de Besançon (E.B.), Service de Neurologie; Sorbonne Universités (B.S.), UPMC Paris 06, Brain and Spine Institute, ICM, Hôpital de La Pitié Salpêtrière, Inserm UMR S 1127, CNRS UMR 7225, and Department of Neurology, AP-HP, Saint-Antoine Hospital; CHU Clermont-Ferrand (Pierre Clavelou), Department of Neurology, F-63000 Clermont-Ferrand Université Clermont Auvergne, Inserm, Neuro-Dol, F-63000 Clermont-Ferrand; Department of Neurology (E.T.), Nimes University Hospital; Institut de Génomique Fonctionnelle (E.T.), UMR5203, INSERM 1191, Univ. Montpellier; Hôpital de Poissy (O.H.), Department of Neurology; Aix Marseille Univ (J.P.), APHM, Hôpital de La Timone, Pôle de Neurosciences Cliniques, Service de Neurologie; CHU d'Amiens (A.A.K.), Department of Neurology; CHU Grenoble Alpes (O.C.), Department of Neurology, La Tronche/Grenoble; CHU de Rouen (B.B.), Department of Neurology; CHU de La Martinique (Philippe Cabre), Department of Neurology, Fort-de-France; APHP (A.W.), Hôpital Henri Mondor, Department of Neurology, Créteil; CHU de Limoges (L.M.), Hôpital Dupuytren, Department of Neurology; CHU de Saint-Étienne (J.-P.C.), Hôpital Nord, Department of Neurology; CHU de Tours (A.M.), Hôpital Bretonneau, CRC SEP and Department of Neurology; CHU de Reims (S.M.), CRC-SEP, Department of Neurology; Hôpital Sud Francilien (N.H.B.), Department of Neurology, Corbeil Essonnes; CHU Bicêtre (D.D.B.), Department of Neurology, Le Kremlin Bicêtre; Department of Neurology (K.H.), Hôpital Pierre Delafontaine, Centre Hospitalier de Saint-Denis; CHU La Milétrie (J.-P.N.), Hôpital Jean Bernard, Department of Neurology, Poitiers; CH de Pontoise (C. Pottier), Hôpital René Dubos, Department of Neurology; and Centre Hospitalier de Versailles (C.N.), Department of Neurology, F-78150 Le Chesnay, France
| | - Sandra Vukusic
- From the Service de Neurologie (A.G., F.R., R.C., S.V.), Sclérose en Plaques, Pathologies de La Myéline et Neuro-inflammation, Hôpital Neurologique Pierre-Wertheimer, Hospices Civils de Lyon, Bron; Université de Lyon (A.G., M.R., F.S.), Université Claude Bernard Lyon 1, CNRS, Laboratoire de Biométrie et Biologie Évolutive UMR 5558, Villeurbanne; Service de Biostatistique-Bioinformatique (A.G., M.R., F.S.), Hospices Civils de Lyon; Université de Lyon (F.R., R.C., S.V.), Université Claude Bernard Lyon 1; Observatoire Français de La Sclérose en Plaques (F.R., R.C., S.V.), Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR; EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis (F.R., R.C., S.V.), State-approved Foundation, Bron; Nancy University Hospital (M.D.), Department of Neurology, Université de Lorraine, APEMAC; CHU Pontchaillou (E.L.P.), CIC1414 INSERM, Rennes; CHU de Toulouse (J.C.), Hôpital Pierre-Paul Riquet, Department of Neurology, CRC-SEP, Toulouse; Infinity (J.C.), INSERM UMR1291-CNRS UMR5051, Université Toulouse III; CHU de Strasbourg (J.D.S.), Department of Neurology and Clinical Investigation Center, CIC 1434, INSERM 1434; Univ. Bordeaux (A.R.), F-33000 Bordeaux INSERM U1215, Neurocentre Magendie, F-33000 Bordeaux CHU de Bordeaux, Department of Neurology, CIC Bordeaux CIC1401; Département de Neurologie (E.M.), Hôpital Pitié-Salpêtrière, APHP, Paris; Centre de Ressources et de Compétences SEP Paris (E.M.); CHU de Montpellier (P.L.), MS Unit; University of Montpellier (MUSE) (P.L.); CHU Lille (H.Z.), CRCSEP Lille, Univ Lille, U1172; Fondation Rotschild (C. Papeix), Department of Neurology, Paris; CHU de Caen (G.D.), MS Expert Centre, Department of Neurology, Avenue de La Côte-de-Nacre, Normandy University, Caen; Neurology (C.L.-F.), UR2CA, Centre Hospitalier Universitaire Pasteur2, Université Nice Côte d'Azur, Nice; CHU de Dijon (T.M.), Department of Neurology, EA4184; CHU de Nantes (D.A.L.), Service de Neurologie & CIC015 INSERM; CRTI-Inserm U1064 (D.A.L.), Nantes; CHU de Besançon (E.B.), Service de Neurologie; Sorbonne Universités (B.S.), UPMC Paris 06, Brain and Spine Institute, ICM, Hôpital de La Pitié Salpêtrière, Inserm UMR S 1127, CNRS UMR 7225, and Department of Neurology, AP-HP, Saint-Antoine Hospital; CHU Clermont-Ferrand (Pierre Clavelou), Department of Neurology, F-63000 Clermont-Ferrand Université Clermont Auvergne, Inserm, Neuro-Dol, F-63000 Clermont-Ferrand; Department of Neurology (E.T.), Nimes University Hospital; Institut de Génomique Fonctionnelle (E.T.), UMR5203, INSERM 1191, Univ. Montpellier; Hôpital de Poissy (O.H.), Department of Neurology; Aix Marseille Univ (J.P.), APHM, Hôpital de La Timone, Pôle de Neurosciences Cliniques, Service de Neurologie; CHU d'Amiens (A.A.K.), Department of Neurology; CHU Grenoble Alpes (O.C.), Department of Neurology, La Tronche/Grenoble; CHU de Rouen (B.B.), Department of Neurology; CHU de La Martinique (Philippe Cabre), Department of Neurology, Fort-de-France; APHP (A.W.), Hôpital Henri Mondor, Department of Neurology, Créteil; CHU de Limoges (L.M.), Hôpital Dupuytren, Department of Neurology; CHU de Saint-Étienne (J.-P.C.), Hôpital Nord, Department of Neurology; CHU de Tours (A.M.), Hôpital Bretonneau, CRC SEP and Department of Neurology; CHU de Reims (S.M.), CRC-SEP, Department of Neurology; Hôpital Sud Francilien (N.H.B.), Department of Neurology, Corbeil Essonnes; CHU Bicêtre (D.D.B.), Department of Neurology, Le Kremlin Bicêtre; Department of Neurology (K.H.), Hôpital Pierre Delafontaine, Centre Hospitalier de Saint-Denis; CHU La Milétrie (J.-P.N.), Hôpital Jean Bernard, Department of Neurology, Poitiers; CH de Pontoise (C. Pottier), Hôpital René Dubos, Department of Neurology; and Centre Hospitalier de Versailles (C.N.), Department of Neurology, F-78150 Le Chesnay, France
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Sabathé C, Casey R, Vukusic S, Leray E, Mathey G, De Sèze J, Ciron J, Wiertlewski S, Ruet A, Pelletier J, Zéphir H, Michel L, Lebrun-Frenay C, Moisset X, Thouvenot E, Camdessanché JP, Bakchine S, Stankoff B, Al Khedr A, Cabre P, Maillart E, Berger E, Heinzlef O, Hankiewicz K, Moreau T, Gout O, Bourre B, Wahab A, Labauge P, Montcuquet A, Defer G, Maurousset A, Maubeuge N, Dimitri Boulos D, Ben Nasr H, Nifle C, Casez O, Laplaud DA, Foucher Y. Improving the decision to switch from first- to second-line therapy in multiple sclerosis: A dynamic scoring system. Mult Scler 2023; 29:236-247. [PMID: 36515394 DOI: 10.1177/13524585221139156] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND In relapsing-remitting multiple sclerosis (RRMS), early identification of suboptimal responders can prevent disability progression. OBJECTIVE We aimed to develop and validate a dynamic score to guide the early decision to switch from first- to second-line therapy. METHODS Using time-dependent propensity scores (PS) from a French cohort of 12,823 patients with RRMS, we constructed one training and two validation PS-matched cohorts to compare the switched patients to second-line treatment and the maintained patients. We used a frailty Cox model for predicting individual hazard ratios (iHRs). RESULTS From the validation PS-matched cohort of 348 independent patients with iHR ⩽ 0.69, we reported the 5-year relapse-free survival at 0.14 (95% confidence interval (CI) 0.09-0.22) for the waiting group and 0.40 (95% CI 0.32-0.51) for the switched group. From the validation PS-matched cohort of 518 independent patients with iHR > 0.69, these values were 0.37 (95% CI 0.30-0.46) and 0.44 (95% CI 0.37-0.52), respectively. CONCLUSIONS By using the proposed dynamic score, we estimated that at least one-third of patients could benefit from an earlier switch to prevent relapse.
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Affiliation(s)
- Camille Sabathé
- Université de Nantes, Université de Tours, Inserm, UMR1246 Sphere, Nantes, France
| | - Romain Casey
- Université de Lyon, Université Claude Bernard Lyon 1, Lyon, France/Hospices Civils de Lyon, Service de Neurologie, sclérose en plaques, pathologies de la myéline et neuro-inflammation, Lyon, France/Observatoire Français de la Sclérose en Plaques, Centre de Recherche en Neurosciences de Lyon, Lyon, France/EUGENE DEVIC EDMUS Foundation against Multiple Sclerosis, State-Approved Foundation, Lyon, France
| | - Sandra Vukusic
- Hospices Civils de Lyon, Service de Neurologie, sclérose en plaques, pathologies de la myéline et neuro-inflammation, Lyon, France/Observatoire Français de la Sclérose en Plaques, Centre de Recherche en Neurosciences de Lyon, Lyon, France/Faculté de médecine Lyon Est, Université Claude Bernard Lyon 1, Lyon, France
| | | | - Guillaume Mathey
- Department of Neurology, Nancy University Hospital, Hôpital Central, Service de Neurologie, Nancy, France/Université de Lorraine, Nancy, France
| | - Jérôme De Sèze
- Department of Neurology and Clinical Investigation Center, CHU de Strasbourg, Strasbourg, France
| | - Jonathan Ciron
- Department of Neurology, Hôpital Pierre-Paul Riquet, CHU de Toulouse, Toulouse, France
| | - Sandrine Wiertlewski
- Université de Nantes, Nantes, France/Service de Neurologie, Centre de Ressources et de Compétences Sclérose en Plaques, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - Aurélie Ruet
- University of Bordeaux, Bordeaux, France/Department of Neurology, CHU de Bordeaux, Bordeaux, France
| | - Jean Pelletier
- Aix Marseille University, APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, Marseille, France
| | | | - Laure Michel
- Clinical Neuroscience Centre, Rennes University Hospital, Rennes, France/Microenvironment, Cell Differentiation, Immunology and Cancer Unit, Rennes, France/Neurology Department, Rennes University Hospital, Rennes, France
| | | | - Xavier Moisset
- Université Clermont Auvergne, CHU de Clermont-Ferrand, Inserm, Neuro-Dol, Clermont-Ferrand, France
| | - Eric Thouvenot
- Department of Neurology, Nimes University Hospital, Nimes, France/Institut de Génomique Fonctionnelle, Université de Montpellier, Montpellier, France
| | | | | | - Bruno Stankoff
- Sorbonne Universités, Brain and Spine Institute, ICM, Hôpital de la Pitié Salpêtrière, Paris, France/Department of Neurology, AP-HP, Saint-Antoine Hospital, Paris, France
| | | | - Philippe Cabre
- Department of Neurology, CHU de la Martinique, Fort-de-France, France
| | - Elisabeth Maillart
- Département de Neurologie, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France/Centre de Ressources et de Compétences SEP, Paris, France
| | - Eric Berger
- Service de Neurologie Besançon, CHU de Besançon, Besançon, France
| | | | - Karolina Hankiewicz
- Department of Neurology, Centre Hospitalier de Saint-Denis, Hôpital Pierre Delafontaine, Saint-Denis, France
| | | | - Olivier Gout
- Department of Neurology, Fondation Rothschild, Paris, France
| | | | - Abir Wahab
- Department of Neurology, AP-HP, Hôpital Henri Mondor, Créteil, France
| | - Pierre Labauge
- CRC SEP, Montpellier University Hospital, INSERM, Université de Montpellier, Montpellier, France
| | - Alexis Montcuquet
- Department of Neurology, Hôpital Dupuytren, CHU de Limoges, Limoges, France
| | - Gilles Defer
- CHU de Caen, MS Expert Centre, Department of Neurology, Normandy University, Caen, France
| | - Aude Maurousset
- CRC SEP and Department of Neurology, Hôpital Bretonneau, CHU de Tours, Tours, France
| | - Nicolas Maubeuge
- Department of Neurology, Hôpital Jean Bernard, CHU La Milétrie, Poitiers, France
| | | | - Haïfa Ben Nasr
- Department of Neurology, Hôpital Sud Francilien, Corbeil-Essonnes, France
| | - Chantal Nifle
- Department of Neurology, Hopital Andre Mignot, Le Chesnay, France
| | - Olivier Casez
- Department of Neurology, CHU Grenoble Alpes, Grenoble, France
| | - David-Axel Laplaud
- Université de Nantes, Nantes, France/Service de Neurologie, Centre de Ressources et de Compétences Sclérose en Plaques, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - Yohann Foucher
- Yohann Foucher CIC 1402, CHU de Poitiers, Université de Poitiers, Poitiers, France
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11
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Wilson S, Calocer F, Rollot F, Fauvernier M, Remontet L, Tron L, Vukusic S, Le Page E, Debouverie M, Ciron J, Ruet A, De Sèze J, Zephir H, Moreau T, Lebrun-Frénay C, Laplaud DA, Clavelou P, Labauge P, Berger E, Pelletier J, Heinzlef O, Thouvenot E, Camdessanché JP, Leray E, Dejardin O, Defer G. Effects of socioeconomic status on excess mortality in patients with multiple sclerosis in France: A retrospective observational cohort study. Lancet Reg Health Eur 2023; 24:100542. [PMID: 36426377 PMCID: PMC9678948 DOI: 10.1016/j.lanepe.2022.100542] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 10/21/2022] [Accepted: 10/25/2022] [Indexed: 11/19/2022] Open
Abstract
Background The effects of socio-economic status on mortality in patients with multiple sclerosis is not well known. The objective was to examine mortality due to multiple sclerosis according to socio-economic status. Methods A retrospective observational cohort design was used with recruitment from 18 French multiple sclerosis expert centers participating in the Observatoire Français de la Sclérose en Plaques. All patients lived in metropolitan France and had a definite or probable diagnosis of multiple sclerosis according to either Poser or McDonald criteria with an onset of disease between 1960 and 2015. Initial phenotype was either relapsing-onset or primary progressive onset. Vital status was updated on January 1st 2016. Socio-economic status was measured by an ecological index, the European Deprivation Index and was attributed to each patient according to their home address. Excess death rates were studied according to socio-economic status using additive excess hazard models with multidimensional penalised splines. The initial hypothesis was a potential socio-economic gradient in excess mortality. Findings A total of 34,169 multiple sclerosis patients were included (88% relapsing onset (n = 30,083), 12% progressive onset (n = 4086)), female/male sex ratio 2.7 for relapsing-onset and 1.3 for progressive-onset). Mean age at disease onset was 31.6 (SD = 9.8) for relapsing-onset and 42.7 (SD = 10.8) for progressive-onset. At the end of follow-up, 1849 patients had died (4.4% for relapsing-onset (n = 1311) and 13.2% for progressive-onset (n = 538)). A socio-economic gradient was found for relapsing-onset patients; more deprived patients had a greater excess death rate. At thirty years of disease duration and a year of onset of symptoms of 1980, survival probability difference (or deprivation gap) between less deprived relapsing-onset patients (EDI = −6) and more deprived relapsing-onset patients (EDI = 12) was 16.6% (95% confidence interval (CI) [10.3%–22.9%]) for men and 12.3% (95%CI [7.6%–17.0%]) for women. No clear socio-economic mortality gradient was found in progressive-onset patients. Interpretation Socio-economic status was associated with mortality due to multiple sclerosis in relapsing-onset patients. Improvements in overall care of more socio-economically deprived patients with multiple sclerosis could help reduce these socio-economic inequalities in multiple sclerosis-related mortality. Funding This study was funded by the ARSEP foundation “Fondation pour l'aide à la recherche sur la Sclérose en Plaques” (Grant Reference Number 1122). Data collection has been supported by a grant provided by the French State and handled by the “Agence Nationale de la Recherche,” within the framework of the “Investments for the Future” programme, under the reference ANR-10-COHO-002, Observatoire Français de la Sclérose en Plaques (OFSEP).
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Affiliation(s)
- Sarah Wilson
- UNICAEN, CHU de Caen, INSERM U1086 ANTICIPE, Pôle de Recherche, Normandy University, Caen 14000, France
- Corresponding author. INSERM UMR 1086 “ANTICIPE”, University of Caen Normandy, Comprehensive Cancer Center Francois Baclesse, Avenue du General Harris, 14076 Caen Cedex 5, France.
| | - Floriane Calocer
- Department of Neurology, UNICAEN, Normandy University, MS Expert Center, CHU de Caen Normandy, Caen 14000, France
| | - Fabien Rollot
- Université de Lyon, Université Claude Bernard Lyon 1, Lyon 69000, France
- Hospices Civils de Lyon, Hôpital Neurologique, Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-Inflammation, Bron 69500, France
- Observatoire Français de la Sclérose en Plaques, Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR 5292, Lyon 69000, France
- EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis, State-Approved Foundation, Bron, France
| | - Mathieu Fauvernier
- Service de Biostatistique–Bioinformatique, Pôle Santé Publique, Hospices Civils de Lyon, Lyon 69000, France
- Université Lyon 1, CNRS, UMR 5558, Laboratoire de Biométrie et Biologie Evolutive, Lyon 69000, France
| | - Laurent Remontet
- Service de Biostatistique–Bioinformatique, Pôle Santé Publique, Hospices Civils de Lyon, Lyon 69000, France
- Université Lyon 1, CNRS, UMR 5558, Laboratoire de Biométrie et Biologie Evolutive, Lyon 69000, France
| | - Laure Tron
- UNICAEN, CHU de Caen, INSERM U1086 ANTICIPE, Pôle de Recherche, Normandy University, Caen 14000, France
| | - Sandra Vukusic
- Université de Lyon, Université Claude Bernard Lyon 1, Lyon 69000, France
- Hospices Civils de Lyon, Hôpital Neurologique, Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-Inflammation, Bron 69500, France
- Observatoire Français de la Sclérose en Plaques, Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR 5292, Lyon 69000, France
- EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis, State-Approved Foundation, Bron, France
| | | | - Marc Debouverie
- Department of Neurology, Nancy University Hospital, Nancy, France
- Université de Lorraine, APEMAC, Nancy F-54000, France
| | - Jonathan Ciron
- Department of Neurology, CHU de Toulouse, CRC-SEP, Toulouse Cedex 9 F-31059, France
- Université Toulouse III, Infinity, INSERM UMR1291 - CNRS UMR5051, Toulouse Cedex 3 F-31024, France
| | - Aurélie Ruet
- Univ. Bordeaux, Bordeaux F-33000, France
- INSERM U1215, Neurocentre Magendie, Bordeaux F-33000, France
- Department of Neurology, CHU de Bordeaux, CIC Bordeaux CIC1401, Bordeaux F-33000, France
| | - Jérôme De Sèze
- Department of Neurology and Clinical Investigation Center, CHU de Strasbourg, CIC 1434, INSERM 1434, Strasbourg F-67000, France
| | - Hélène Zephir
- CHU Lille, CRCSEP Lille, Univ Lille, U1172, Lille F-59000, France
| | - Thibault Moreau
- Department of Neurology, CHU de Dijon, EA4184, Dijon F-21000, France
| | - Christine Lebrun-Frénay
- Neurology, UR2CA, Centre Hospitalier Universitaire Pasteur2, Université Nice Côte d’Azur, Nice, France
| | - David-Axel Laplaud
- Nantes Université, CHU Nantes, INSERM, Center for Research in Transplantation and Translational Immunology, UMR 1064, CIC INSERM 1413, Service de Neurologie, Nantes F-44000, France
| | - Pierre Clavelou
- Department of Neurology, CHU Clermont-Ferrand, Clermont-Ferrand F-63000, France
- Université Clermont Auvergne, Inserm, Neuro-Dol, Clermont-Ferrand F-63000, France
| | - Pierre Labauge
- MS Unit, CHU de Montpellier, Montpellier Cedex 5 F-34295, France
- University of Montpellier (MUSE), Montpellier F-34000, France
| | - Eric Berger
- CHU de Besançon, Service de Neurologie 25 030, Besançon, France
| | - Jean Pelletier
- Aix Marseille Univ, APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, Marseille 13005, France
| | - Olivier Heinzlef
- Departement of Neurology, Hôpital de Poissy, Poissy F-78300, France
| | - Eric Thouvenot
- Department of Neurology, Nimes University Hospital, Nimes Cedex 9 F-30029, France
- Institut de Génomique Fonctionnelle, UMR5203, INSERM 1191, Univ. Montpellier, Montpellier Cedex 5 F-34094, France
| | | | - Emmanuelle Leray
- Univ Rennes, EHESP, CNRS, Inserm, Arènes - UMR 6051, RSMS (Recherche sur les Services et Management en Santé) - U 1309, Rennes F-35000, France
| | - Olivier Dejardin
- UNICAEN, CHU de Caen, INSERM U1086 ANTICIPE, Pôle de Recherche, Normandy University, Caen 14000, France
| | - Gilles Defer
- Department of Neurology, UNICAEN, Normandy University, MS Expert Center, CHU de Caen Normandy, Caen 14000, France
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12
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Roos I, Malpas C, Leray E, Casey R, Horakova D, Havrdova EK, Debouverie M, Patti F, De Seze J, Izquierdo G, Eichau S, Edan G, Prat A, Girard M, Ozakbas S, Grammond P, Zephir H, Ciron J, Maillart E, Moreau T, Amato MP, Labauge P, Alroughani R, Buzzard K, Skibina O, Terzi M, Laplaud DA, Berger E, Grand'Maison F, Lebrun-Frenay C, Cartechini E, Boz C, Lechner-Scott J, Clavelou P, Stankoff B, Prevost J, Kappos L, Pelletier J, Shaygannejad V, Yamout BI, Khoury SJ, Gerlach O, Spitaleri DLA, Van Pesch V, Gout O, Turkoglu R, Heinzlef O, Thouvenot E, McCombe PA, Soysal A, Bourre B, Slee M, Castillo-Trivino T, Bakchine S, Ampapa R, Butler EG, Wahab A, Macdonell RA, Aguera-Morales E, Cabre P, Ben NH, Van der Walt A, Laureys G, Van Hijfte L, Ramo-Tello CM, Maubeuge N, Hodgkinson S, Sánchez-Menoyo JL, Barnett MH, Labeyrie C, Vucic S, Sidhom Y, Gouider R, Csepany T, Sotoca J, de Gans K, Al-Asmi A, Fragoso YD, Vukusic S, Butzkueven H, Kalincik T. Disease Reactivation After Cessation of Disease-Modifying Therapy in Patients With Relapsing-Remitting Multiple Sclerosis. Neurology 2022; 99:e1926-e1944. [PMID: 35977837 DOI: 10.1212/wnl.0000000000201029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 06/13/2022] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES To evaluate the rate of return of disease activity after cessation of multiple sclerosis (MS) disease-modifying therapy. METHODS This was a retrospective cohort study from two large observational MS registries: MSBase and OFSEP. Patients with relapsing-remitting MS who had ceased a disease-modifying therapy and were followed up for the subsequent 12-months were included in the analysis. The primary study outcome was annualised relapse rate in the 12 months after disease-modifying therapy discontinuation stratified by patients who did, and did not, commence a subsequent therapy. The secondary endpoint was the predictors of first relapse and disability accumulation after treatment discontinuation. RESULTS 14,213 patients, with 18,029 eligible treatment discontinuation epochs, were identified for seven therapies. Annualised rates of relapse (ARR) started to increase 2-months after natalizumab cessation (month 2-4 ARR, 95% confidence interval): 0.47, 0.43-0.51). Commencement of a subsequent therapy within 2-4 months reduced the magnitude of disease reactivation (mean ARR difference: 0.15, 0.08-0.22). After discontinuation of fingolimod, rates of relapse increased overall (month 1-2 ARR: 0.80, 0.70-0.89), and stabilised faster in patients who started a new therapy within 1-2 months (mean ARR difference: 0.14, -0.01-0.29). Magnitude of disease reactivation for other therapies was low, but reduced further by commencement of another treatment 1-10 months after treatment discontinuation. Predictors of relapse were higher relapse rate in the year before cessation, female sex, younger age and higher EDSS. Commencement of a subsequent therapy reduced both the risk of relapse (HR 0.76, 95%CI 0.72-0.81) and disability accumulation (0.73, 0.65-0.80). CONCLUSION The rate of disease reactivation after treatment cessation differs among MS treatments, with the peaks of relapse activity ranging from 1 to 10 months in untreated cohorts that discontinued different therapies. These results suggest that untreated intervals should be minimised after stopping anti-trafficking therapies (natalizumab and fingolimod). CLASSIFICATION OF EVIDENCE This study provides class III that disease reactivation occurs within months of discontinuation of multiple sclerosis disease-modifying therapies. Risk of disease activity is reduced by commencement of a subsequent therapy.
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Affiliation(s)
- Izanne Roos
- CORe, Department of Medicine, University of Melbourne, Melbourne, Australia.,Melbourne MS Centre, Department of Neurology, Royal Melbourne Hospital, Melbourne, Australia
| | - Charles Malpas
- CORe, Department of Medicine, University of Melbourne, Melbourne, Australia.,Melbourne MS Centre, Department of Neurology, Royal Melbourne Hospital, Melbourne, Australia
| | - Emmanuelle Leray
- Rennes University, EHESP, REPERES EA 7449, F-35000 Rennes, France.,Univ Rennes, CHU Rennes, Inserm, CIC 1414 [(Centre dInvestigation Clinique de Rennes)], F-35000 Rennes, France
| | - Romain Casey
- Université de Lyon, Université Claude Bernard Lyon 1, F-69000 Lyon, France.,Hospices Civils de Lyon, Service de Neurologie, sclérose en plaques, pathologies de la myéline et neuro-inflammation, F-69677 Bron, France.,Observatoire Français de la Sclérose en Plaques, Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR 5292, F-69003 Lyon, France.,EUGENE DEVIC EDMUS Foundation against multiple sclerosis, state-approved foundation, F-69677 Bron, France
| | - Dana Horakova
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University in Prague and General University Hospital, Prague, Czech Republic
| | - Eva Kubala Havrdova
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University in Prague and General University Hospital, Prague, Czech Republic
| | - Marc Debouverie
- Nancy University Hospital, Department of Neurology, Nancy, France.,Université de Lorraine, APEMAC, F-54000 Nancy, France
| | - Francesco Patti
- Department of Medical and Surgical Sciences and Advanced Technologies, GF Ingrassia, Catania, Italy.,Multiple Sclerosis Center, University of Catania, Catania, Italy
| | - Jerome De Seze
- CHU de Strasbourg, Department of Neurology and Clinical Investigation Center, CIC 1434, INSERM 1434, F-67000 Strasbourg, France
| | | | - Sara Eichau
- Hospital Universitario Virgen Macarena, Sevilla, Spain
| | - Gilles Edan
- CHU Pontchaillou, CIC1414 INSERM, F-35000 Rennes France
| | - Alexandre Prat
- CHUM MS Center and Universite de Montreal, Montreal, Canada
| | - Marc Girard
- CHUM MS Center and Universite de Montreal, Montreal, Canada
| | | | | | - Helene Zephir
- CHU Lille, CRCSEP Lille, Univ Lille, U1172, F-59000 Lille, France
| | - Jonathan Ciron
- CHU de Toulouse, Hôpital Pierre-Paul Riquet, Department of Neurology, CRC-SEP, F-31059 Toulouse Cedex 9, France
| | | | - Thibault Moreau
- CHU de Dijon, Department of Neurology, EA4184, F-21000 Dijon, France
| | - Maria Pia Amato
- Department NEUROFARBA, University of Florence, Florence, Italy
| | - Pierre Labauge
- CHU de Montpellier, MS Unit, F-34295 Montpellier Cedex 5, France.,University of Montpellier (MUSE), F-34000 Montpellier, France
| | - Raed Alroughani
- Division of Neurology, Department of Medicine, Amiri Hospital, Sharq, Kuwait
| | - Katherine Buzzard
- Department of Neurology, Box Hill Hospital, Melbourne, Australia.,Monash University, Melbourne, Australia.,Melbourne MS Centre, Royal Melbourne Hospital, Melbourne, Australia
| | - Olga Skibina
- Department of Neurology, Box Hill Hospital, Melbourne, Australia.,Monash University, Melbourne, Australia.,The Alfred Hospital, Melbourne, Australia
| | - Murat Terzi
- Medical Faculty, 19 Mayis University, Samsun, Turkey
| | - David Axel Laplaud
- CHU de Nantes, Service de Neurologie & CIC015 INSERM, F-44093 Nantes, France.,CRTI-Inserm U1064, F-44000 Nantes, France
| | - Eric Berger
- CHU de Besançon, Service de Neurologie 25 030 Besançon, France
| | | | - Christine Lebrun-Frenay
- Neurology, UR2CA, Centre Hospitalier Universitaire Pasteur2, Université Nice Côte d'Azur, Nice, France
| | | | - Cavit Boz
- KTU Medical Faculty Farabi Hospital, Trabzon, Turkey
| | - Jeannette Lechner-Scott
- School of Medicine and Public Health, University Newcastle, Newcastle, Australia.,Department of Neurology, John Hunter Hospital, Hunter New England Health, Newcastle, Australia
| | - Pierre Clavelou
- CHU Clermont-Ferrand, Department of Neurology, F-63000 Clermont-Ferrand ; Université Clermont Auvergne, Inserm, Neuro-Dol, F-63000 Clermont-Ferrand, France
| | - Bruno Stankoff
- Sorbonne Universités, UPMC Paris 06, Brain and Spine Institute, ICM, Hôpital de la Pitié Salpêtrière, Inserm UMR S 1127, CNRS UMR 7225, and Department of Neurology, AP-HP, Saint-Antoine hospital, F-75000 Paris, France
| | | | - Ludwig Kappos
- Neurologic Clinic and Policlinic, Departments of Medicine and Clinical Research, University Hospital and University of Basel, Basel, Switzerland
| | - Jean Pelletier
- Aix Marseille Univ, APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, 13005 Marseille, France
| | | | - Bassem I Yamout
- Nehme and Therese Tohme Multiple Sclerosis Center, American University of Beirut Medical Center, Beirut, Lebanon
| | - Samia J Khoury
- Nehme and Therese Tohme Multiple Sclerosis Center, American University of Beirut Medical Center, Beirut, Lebanon
| | - Oliver Gerlach
- Department of Neurology, Zuyderland Medical Center, Sittard-Geleen, Netherlands
| | - Daniele L A Spitaleri
- Azienda Ospedaliera di Rilievo Nazionale San Giuseppe Moscati Avellino, Avellino, Italy
| | - Vincent Van Pesch
- Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Olivier Gout
- Fondation Rotschild, Department of Neurology, F-75000 Paris, France
| | - Recai Turkoglu
- Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
| | - Olivier Heinzlef
- Hôpital de Poissy, Departement of Neurology, F-78300 Poissy, France
| | - Eric Thouvenot
- Department of Neurology, Nimes University Hospital, F-30029 Nimes Cedex 9, France.,Institut de Génomique Fonctionnelle, UMR5203, INSERM 1191, Univ. Montpellier, F-34094 Montpellier Cedex 5, France
| | - Pamela Ann McCombe
- University of Queensland, Brisbane, Australia.,Royal Brisbane and Women's Hospital, Brisbane, Australia
| | - Aysun Soysal
- Bakirkoy Education and Research Hospital for Psychiatric and Neurological Diseases, Istanbul, Turkey
| | - Bertrand Bourre
- CHU de Rouen, Departement of Neurology, F-76000 Rouen, France
| | - Mark Slee
- Flinders University, Adelaide, Australia
| | - Tamara Castillo-Trivino
- Instituto de Investigación Sanitaria Biodonostia, Hospital Universitario Donostia, San Sebastián, Spain
| | - Serge Bakchine
- CHU de Reims, Department of neurology, F-51092 Reims cedex, France
| | | | | | - Abir Wahab
- APHP, Hôpital Henri Mondor, Department of neurology, F-94000 Créteil, France
| | | | | | - Philippe Cabre
- CHU de la Martinique, Department of Neurology, F-97200 Fort-de-France, France
| | - Nasr Haifa Ben
- Hôpital Sud Francilien, Department of neurology, F-91160 Corbeil Essonnes, France
| | - Anneke Van der Walt
- Department of Neurology, The Alfred Hospital, Melbourne, Australia.,Central Clinical School, Monash University, Melbourne, Australia
| | - Guy Laureys
- Department of Neurology, Universitary Hospital Ghent, Ghent, Belgium
| | | | | | - Nicolas Maubeuge
- CHU La Milétrie, Hôpital Jean Bernard, Department of neurology, F-86000 Poitiers, France
| | | | | | | | - Celine Labeyrie
- . CHU Bicêtre, Department of neurology, F-94275 Le Kremlin Bicêtre, France
| | | | - Youssef Sidhom
- Department of Neurology, Razi Hospital, Manouba, Tunisia
| | - Riadh Gouider
- Department of Neurology, Razi Hospital, Manouba, Tunisia
| | - Tunde Csepany
- Department of Neurology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Javier Sotoca
- Hospital Universitari MútuaTerrassa, Barcelona, Spain
| | | | | | | | - Sandra Vukusic
- Service de neurologie, sclérose en plaques, pathologies de la myéline et neuro-inflammation, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, 69677 Lyon/Bron, France.,Centre des Neurosciences de Lyon, Observatoire Français de la Sclérose en Plaques, INSERM 1028 et CNRS UMR5292, 69003 Lyon, France.,Université Claude Bernard Lyon 1, Faculté de médecine Lyon Est, F-69000 Lyon, France
| | - Helmut Butzkueven
- Department of Neurology, The Alfred Hospital, Melbourne, Australia.,Central Clinical School, Monash University, Melbourne, Australia
| | - Tomas Kalincik
- CORe, Department of Medicine, University of Melbourne, Melbourne, Australia .,Melbourne MS Centre, Department of Neurology, Royal Melbourne Hospital, Melbourne, Australia
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13
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Lefort M, Sharmin S, Andersen JB, Vukusic S, Casey R, Debouverie M, Edan G, Ciron J, Ruet A, De Sèze J, Maillart E, Zephir H, Labauge P, Defer G, Lebrun-Frenay C, Moreau T, Berger E, Clavelou P, Pelletier J, Stankoff B, Gout O, Thouvenot E, Heinzlef O, Al-Khedr A, Bourre B, Casez O, Cabre P, Montcuquet A, Wahab A, Camdessanché JP, Maurousset A, Ben Nasr H, Hankiewicz K, Pottier C, Maubeuge N, Dimitri-Boulos D, Nifle C, Laplaud DA, Horakova D, Havrdova EK, Alroughani R, Izquierdo G, Eichau S, Ozakbas S, Patti F, Onofrj M, Lugaresi A, Terzi M, Grammond P, Grand'Maison F, Yamout B, Prat A, Girard M, Duquette P, Boz C, Trojano M, McCombe P, Slee M, Lechner-Scott J, Turkoglu R, Sola P, Ferraro D, Granella F, Shaygannejad V, Prevost J, Maimone D, Skibina O, Buzzard K, Van der Walt A, Karabudak R, Van Wijmeersch B, Csepany T, Spitaleri D, Vucic S, Koch-Henriksen N, Sellebjerg F, Soerensen PS, Hilt Christensen CC, Rasmussen PV, Jensen MB, Frederiksen JL, Bramow S, Mathiesen HK, Schreiber KI, Butzkueven H, Magyari M, Kalincik T, Leray E. Impact of methodological choices in comparative effectiveness studies: application in natalizumab versus fingolimod comparison among patients with multiple sclerosis. BMC Med Res Methodol 2022; 22:155. [PMID: 35637426 PMCID: PMC9150358 DOI: 10.1186/s12874-022-01623-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 04/25/2022] [Indexed: 11/18/2022] Open
Abstract
Background Natalizumab and fingolimod are used as high-efficacy treatments in relapsing–remitting multiple sclerosis. Several observational studies comparing these two drugs have shown variable results, using different methods to control treatment indication bias and manage censoring. The objective of this empirical study was to elucidate the impact of methods of causal inference on the results of comparative effectiveness studies. Methods Data from three observational multiple sclerosis registries (MSBase, the Danish MS Registry and French OFSEP registry) were combined. Four clinical outcomes were studied. Propensity scores were used to match or weigh the compared groups, allowing for estimating average treatment effect for treated or average treatment effect for the entire population. Analyses were conducted both in intention-to-treat and per-protocol frameworks. The impact of the positivity assumption was also assessed. Results Overall, 5,148 relapsing–remitting multiple sclerosis patients were included. In this well-powered sample, the 95% confidence intervals of the estimates overlapped widely. Propensity scores weighting and propensity scores matching procedures led to consistent results. Some differences were observed between average treatment effect for the entire population and average treatment effect for treated estimates. Intention-to-treat analyses were more conservative than per-protocol analyses. The most pronounced irregularities in outcomes and propensity scores were introduced by violation of the positivity assumption. Conclusions This applied study elucidates the influence of methodological decisions on the results of comparative effectiveness studies of treatments for multiple sclerosis. According to our results, there are no material differences between conclusions obtained with propensity scores matching or propensity scores weighting given that a study is sufficiently powered, models are correctly specified and positivity assumption is fulfilled. Supplementary Information The online version contains supplementary material available at 10.1186/s12874-022-01623-8.
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Affiliation(s)
- M Lefort
- Arènes - UMR 6051, RSMS (Recherche sur les Services et Management en Santé) - U 1309, Univ Rennes, EHESP, CNRS, Inserm, Rennes, France.,Univ Rennes, CHU Rennes, Investigation Clinique de Rennes)], CIC 1414 [(Centre d, 35000, InsermRennes, France
| | - S Sharmin
- Department of Medicine, University of Melbourne, Melbourne, Australia.,Melbourne MS Centre, Department of Neurology, Royal Melbourne Hospital, Melbourne, Australia
| | - J B Andersen
- Department of Neurology, The Danish Multiple Sclerosis Registry, Copenhagen University Hospital, Rigshospitalet Glostrup, Denmark
| | - S Vukusic
- Service de Neurologie, Sclérose en Plaques, Pathologies de La Myéline Et Neuro-Inflammation, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, 69677, Lyon/Bron, France.,Centre Des Neurosciences de Lyon, UMR5292, Observatoire Français de La Sclérose en Plaques, INSERM, 1028 et CNRS, 69003, Lyon, France.,Université, Claude Bernard Lyon 1, Faculté de médecine Lyon Est, 69000, Lyon, France
| | - R Casey
- Service de Neurologie, Sclérose en Plaques, Pathologies de La Myéline Et Neuro-Inflammation, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, 69677, Lyon/Bron, France.,Centre Des Neurosciences de Lyon, UMR5292, Observatoire Français de La Sclérose en Plaques, INSERM, 1028 et CNRS, 69003, Lyon, France.,Université, Claude Bernard Lyon 1, Faculté de médecine Lyon Est, 69000, Lyon, France.,Eugene Devic EDMUS Foundation, 69677, Lyon/Bron, France
| | - M Debouverie
- Centre Hospitalier Régional Universitaire de Nancy, Hôpital Central, Service de neurologie, Nancy, France
| | - G Edan
- Centre Hospitalier Universitaire de Rennes, Hôpital Pontchaillou, Service de neurologie, Rennes, France
| | - J Ciron
- Centre Hospitalier Universitaire de Toulouse, Hôpital Purpan, CRC-SEP, Département de neurologie, Toulouse, France
| | - A Ruet
- Centre Hospitalier Universitaire de Bordeaux, Hôpital Pellegrin, Service de neurologie, Bordeaux, France
| | - J De Sèze
- Service des maladies inflammatoires du système nerveux - neurologie, centre d'investigation clinique de Strasbourg, Hôpitaux Universitaire de Strasbourg, Hôpital de Hautepierre, INSERM 1434, Strasbourg, France
| | - E Maillart
- Assistance Publique Des Hôpitaux de Paris, Hôpital de La Pitié-Salpêtrière, Service de neurologie, Paris, France
| | - H Zephir
- Centre Hospitalier Universitaire de Lille, Hôpital Salengro, Service de neurologie D, Lille, France
| | - P Labauge
- Centre Hospitalier Universitaire de Montpellier, Hôpital Gui de Chauliac, Service de neurologie, Montpellier, France
| | - G Defer
- Centre Hospitalier Universitaire de Caen Normandie, Hôpital Côte de Nacre, Service de neurologie, Caen, France
| | - C Lebrun-Frenay
- Centre Hospitalier Universitaire de Nice, UR2CA-URRIS,, Université Nice Côte d'Azur, Hôpital, Pasteur 2, Service de neurologie, Nice, France
| | - T Moreau
- Centre Hospitalier Universitaire Dijon Bourgogne, Hôpital François Mitterrand, Maladies Inflammatoires du Système Nerveux Et Neurologie Générale, Service de neurologie, Dijon, France
| | - E Berger
- Centre Hospitalier Régional Universitaire de Besançon, Hôpital Jean Minjoz, Service de neurologie, Besançon, France
| | - P Clavelou
- Centre Hospitalier Universitaire de Clermont-Ferrand, Hôpital Gabriel-Montpied, Service de neurologie, Clermont-Ferrand, France
| | - J Pelletier
- Service de Neurologie, Aix Marseille Univ, APHM, Hôpital de La Timone, Pôle de Neurosciences Cliniques, 13005, Marseille, France
| | - B Stankoff
- Assistance Publique Des Hôpitaux de Paris, Hôpital Saint-Antoine, Service de neurologie, Paris, France
| | - O Gout
- Fondation Adolphe de Rothschild de L'œil Et du Cerveau, Service de neurologie, Paris, France
| | - E Thouvenot
- Centre Hospitalier Universitaire de Nîmes, Hôpital Carémeau, Service de neurologie, Nîmes, France
| | - O Heinzlef
- Centre Hospitalier Intercommunal de Poissy Saint-Germain-en-Laye, Service de neurologie, Poissy, France
| | - A Al-Khedr
- Centre Hospitalier Universitaire d'Amiens Picardie, Site sud, Service de neurologie, Amiens, France
| | - B Bourre
- Rouen University Hospital, 76000, Rouen, France
| | - O Casez
- Centre Hospitalier Universitaire Grenoble-Alpes, Site nord, Service de neurologie, Grenoble/La Tronche, France
| | - P Cabre
- Centre Hospitalier Universitaire de Martinique, Hôpital Pierre Zobda-Quitman, Service de neurologie, Fort-de-France, France
| | - A Montcuquet
- Centre Hospitalier Universitaire Limoges, Hôpital Dupuytren, Service de neurologie, Limoges, France
| | - A Wahab
- Assistance Publique Des Hôpitaux de Paris, Hôpital Henri Mondor, Service de neurologie, Créteil, France
| | - J P Camdessanché
- Centre Hospitalier Universitaire de Saint-Étienne, Hôpital Nord, Service de neurologie, Saint-Étienne, France
| | - A Maurousset
- Centre Hospitalier Régional Universitaire de Tours, Hôpital Bretonneau, Service de neurologie, Tours, France
| | - H Ben Nasr
- Centre Hospitalier Sud Francilien, Service de neurologie, Corbeil-Essonnes, France
| | - K Hankiewicz
- Centre Hospitalier de Saint-Denis, Hôpital Casanova, Service de neurologie, Saint-Denis, France
| | - C Pottier
- Centre Hospitalier de Pontoise, Service de neurologie, Pontoise, France
| | - N Maubeuge
- Centre Hospitalier Universitaire de Poitiers, Site de La Milétrie, Service de neurologie, Poitiers, France
| | - D Dimitri-Boulos
- Assistance Publique Des Hôpitaux de Paris, Hôpital Bicêtre, Service de neurologie, Le Kremlin-Bicêtre, France
| | - C Nifle
- Centre Hospitalier de Versailles, Hôpital André-Mignot, Service de neurologie, Le Chesnay, France
| | - D A Laplaud
- CHU de Nantes, Service de Neurologie & CIC015 INSERM, 44093, Nantes, France.,INSERM CR1064, 44000, Nantes, France
| | - D Horakova
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University in Prague and General University Hospital, Prague, Czech Republic
| | - E K Havrdova
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University in Prague and General University Hospital, Prague, Czech Republic
| | - R Alroughani
- Division of Neurology, Department of Medicine, Amiri Hospital, Sharq, Kuwait
| | - G Izquierdo
- Hospital Universitario Virgen Macarena, Seville, Spain
| | - S Eichau
- Hospital Universitario Virgen Macarena, Seville, Spain
| | - S Ozakbas
- Dokuz Eylul University, Konak/Izmir, Turkey
| | - F Patti
- GF Ingrassia Department, University of Catania, Catania, Italy.,Policlinico G Rodolico, Catania, Italy
| | - M Onofrj
- Department of Neuroscience, Imaging, and Clinical Sciences, University G. d'Annunzio, Chieti, Italy
| | - A Lugaresi
- Dipartimento Di Scienze Biomediche E Neuromotorie, Università Di Bologna, Bologna, Italy.,IRCCS Istituto Delle Scienze Neurologiche Di Bologna, Bologna, Italy
| | - M Terzi
- Medical Faculty, 19 Mayis University, Samsun, Turkey
| | - P Grammond
- CISSS Chaudiere-Appalache, Levis, Canada
| | | | - B Yamout
- Nehme and Therese Tohme Multiple Sclerosis Center, American University of Beirut Medical Center, Beirut, Lebanon
| | - A Prat
- Hopital Notre Dame, Montreal, Canada.,CHUM and Universite de Montreal, Montreal, Canada
| | - M Girard
- Hopital Notre Dame, Montreal, Canada.,CHUM and Universite de Montreal, Montreal, Canada
| | - P Duquette
- Hopital Notre Dame, Montreal, Canada.,CHUM and Universite de Montreal, Montreal, Canada
| | - C Boz
- KTU Medical Faculty Farabi Hospital, Trabzon, Turkey
| | - M Trojano
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari, Bari, Italy
| | - P McCombe
- University of Queensland, Brisbane, Australia.,Royal Brisbane and Women's Hospital, Herston, Australia
| | - M Slee
- Flinders University, Adelaide, Australia
| | - J Lechner-Scott
- School of Medicine and Public Health, University Newcastle, Newcastle, Australia.,Department of Neurology, John Hunter Hospital, Hunter New England Health, Newcastle, Australia
| | - R Turkoglu
- Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
| | - P Sola
- Department of Neuroscience, Azienda Ospedaliera Universitaria, Modena, Italy
| | - D Ferraro
- Department of Neuroscience, Azienda Ospedaliera Universitaria, Modena, Italy
| | - F Granella
- Department of Medicine and Surgery, University of Parma, Parma, Italy.,Department of Emergency and General Medicine, Parma University Hospital, Parma, Italy
| | | | - J Prevost
- CSSS Saint-Jérôme, Saint-Jerome, Canada
| | | | - O Skibina
- Monash University, Melbourne, Australia
| | - K Buzzard
- Monash University, Melbourne, Australia
| | | | | | - B Van Wijmeersch
- Rehabilitation and MS-Centre Overpelt and Hasselt University, Hasselt, Belgium
| | - T Csepany
- Department of Neurology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - D Spitaleri
- Azienda Ospedaliera Di Rilievo Nazionale San Giuseppe Moscati Avellino, Avellino, Italy
| | - S Vucic
- Westmead Hospital, Sydney, Australia
| | - N Koch-Henriksen
- Department of Clinical Epidemiology, Aarhus University Hospital Aarhus, Aarhus, Denmark
| | - F Sellebjerg
- Danish Multiple Sclerosis Centre, Department of Neurology, Copenhagen University Hospital, Rigshospitalet Glostrup, 2600, Glostrup, Denmark
| | - P S Soerensen
- Danish Multiple Sclerosis Centre, Department of Neurology, Copenhagen University Hospital, Rigshospitalet Glostrup, 2600, Glostrup, Denmark
| | - C C Hilt Christensen
- Department of Neurology, Aalborg University Hospital, Multiple Sclerosis Unit, Aalborg, Denmark
| | - P V Rasmussen
- Aarhus University Hospital, Neurology, PJJ Boulevard, DK-8200, Aarhus N, Denmark
| | - M B Jensen
- Department of Neurology, University Hospital of Northern Sealand, Copenhagen, Denmark
| | - J L Frederiksen
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - S Bramow
- Danish Multiple Sclerosis Centre, Department of Neurology, Copenhagen University Hospital, Rigshospitalet Glostrup, 2600, Glostrup, Denmark
| | - H K Mathiesen
- Department of Neurology, Copenhagen University Hospital Herlev, Copenhagen, Denmark
| | - K I Schreiber
- Danish Multiple Sclerosis Centre, Department of Neurology, Copenhagen University Hospital, Rigshospitalet Glostrup, 2600, Glostrup, Denmark
| | - H Butzkueven
- Central Clinical School, Monash University, Melbourne, Australia.,Department of Neurology, The Alfred Hospital, Melbourne, Australia.,Department of Neurology, Box Hill Hospital, Monash University, Melbourne, Australia
| | - M Magyari
- Melbourne MS Centre, Department of Neurology, Royal Melbourne Hospital, Melbourne, Australia.,Danish Multiple Sclerosis Centre, Department of Neurology, Copenhagen University Hospital, Rigshospitalet Glostrup, 2600, Glostrup, Denmark
| | - T Kalincik
- Department of Medicine, University of Melbourne, Melbourne, Australia.
| | - E Leray
- Arènes - UMR 6051, RSMS (Recherche sur les Services et Management en Santé) - U 1309, Univ Rennes, EHESP, CNRS, Inserm, Rennes, France. .,Univ Rennes, CHU Rennes, Investigation Clinique de Rennes)], CIC 1414 [(Centre d, 35000, InsermRennes, France.
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Bikouta R, Heinzlef O. Myélopathie révélatrice d’une carence en B12 chez un sujet végétalien. Rev Neurol (Paris) 2022. [DOI: 10.1016/j.neurol.2022.02.169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Hamelin F, Blanchere M, Barbot F, Vaugier I, Thomas S, Manchon E, Bensmail D, Heinzlef O, Gay MC. Efficacité à long terme des approches cognitives et comportementales (TCC) dans la gestion de la fatigue chez les patients atteints de sclérose en plaques récurrente-rémittente (SEP-RR) : un essai clinique randomisé (ECR), en groupes parallèles, multicentrique, ouvert et contrôlé par rapport aux soins standards. Rev Neurol (Paris) 2022. [DOI: 10.1016/j.neurol.2022.02.384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Torkhani E, Dematte E, Slawinski J, Csillik A, Gay MC, Bensmaïl D, Heinzlef O, de Marco G. Improving Health of People With Multiple Sclerosis From a Multicenter Randomized Controlled Study in Parallel Groups: Preliminary Results on the Efficacy of a Mindfulness Intervention and Intention Implementation Associated With a Physical Activity Program. Front Psychol 2022; 12:767784. [PMID: 35002857 PMCID: PMC8740326 DOI: 10.3389/fpsyg.2021.767784] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 12/03/2021] [Indexed: 11/30/2022] Open
Abstract
Objectives: The objective of this study is to investigate the efficacy of psychological Interventions – Mindfulness or Implementation Intention – associated with a Physical Activity program, delivered via internet, in reducing Multiple Sclerosis symptoms. Method: Thirty-five adults were randomly assigned to one of the three groups: a Mindfulness-Based Intervention group (N = 12), Implementation Intention group (N = 11), and a Control Group (N = 12). All the groups received the same Physical Activity program. The Mindfulness condition group received daily training in the form of pre-recorded sessions while the Implementation group elaborated their specific plans once a week. Mobility, fatigue, and the impact of the disease on the patient’s life were measured. Two measurement times are carried out in pre-post intervention, at baseline and after eight weeks. Results: Overall, after 8 weeks intervention, results show that there was a significant increase in Walking distance in the three groups. In addition, the within-group analysis showed a statistically significant improvement between pre and post intervention on the physical component of the Disease Impact scale in the Implementation Intention group (p = 0.023) with large effect size, in the Mindfulness-Based Intervention group (p = 0.008) with a medium effect size and in the control group (p = 0.028) with small effect size. In the Implementation Intention group, all physical, psychosocial and cognitive Fatigue Impact subscales scores decreased significantly (p = 0.022, p = 0.023, and p = 0.012, respectively) and the physical component was statistically and negatively correlated (r = −0.745; p = 0.008) when Implementation Intention group practice a mild to moderate physical activity. In the Mindfulness-Based Intervention group, the physical component (MFIS) showed a statistically significant improvement (p = 0.028) but no correlation with moderate-to-vigorous physical activity (MVPA); the control group outcomes did not reveal any significant change. Conclusion: The results of this study are very encouraging and show the feasibility of Mindfulness interventions associated with physical activity to improve the health of people with MS. Further study should assess Mindfulness interventions tailored to MS condition and using both hedonic and eudemonic measures of happiness.
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Affiliation(s)
- Eya Torkhani
- Laboratoire LINP2, Université Paris Nanterre, UPL, Nanterre, France
| | - Emilie Dematte
- Laboratoire LINP2, Université Paris Nanterre, UPL, Nanterre, France
| | - Jean Slawinski
- Laboratoire LINP2, Université Paris Nanterre, UPL, Nanterre, France.,French National Institute of Sport, Expertise and Performance, Sport, Expertise and Performance Laboratory, Paris, France
| | - Antonia Csillik
- iMSpire (International Multiple Sclerosis Partnership in Research) Special Interest Group, Paris Nanterre University, Nanterre, France.,Department of Psychology, Université Paris Nanterre, Nanterre, France
| | - Marie-Claire Gay
- iMSpire (International Multiple Sclerosis Partnership in Research) Special Interest Group, Paris Nanterre University, Nanterre, France.,Department of Psychology, Université Paris Nanterre, Nanterre, France
| | - Djamel Bensmaïl
- Department of Physical and Rehabilitation Medicine, Raymond Poincaré Hospital - APHP Paris Saclay, Garches, France.,UMR 1179 INSERM-UVSQ, Neuromuscular Handicap - University of Versailles, Montigny-le-Bretonneux, France
| | - Olivier Heinzlef
- Laboratoire LINP2, Université Paris Nanterre, UPL, Nanterre, France.,iMSpire (International Multiple Sclerosis Partnership in Research) Special Interest Group, Paris Nanterre University, Nanterre, France.,CHI de Poissy-St Germain, Conflans-Sainte-Honorine, France
| | - Giovanni de Marco
- Laboratoire LINP2, Université Paris Nanterre, UPL, Nanterre, France.,iMSpire (International Multiple Sclerosis Partnership in Research) Special Interest Group, Paris Nanterre University, Nanterre, France
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17
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Sharmin S, Lefort M, Andersen JB, Leray E, Horakova D, Havrdova EK, Alroughani R, Izquierdo G, Ozakbas S, Patti F, Onofrj M, Lugaresi A, Terzi M, Grammond P, Grand'Maison F, Yamout B, Prat A, Girard M, Duquette P, Boz C, Trojano M, McCombe P, Slee M, Lechner-Scott J, Turkoglu R, Sola P, Ferraro D, Granella F, Prevost J, Maimone D, Skibina O, Buzzard K, Van der Walt A, Van Wijmeersch B, Csepany T, Spitaleri D, Vucic S, Casey R, Debouverie M, Edan G, Ciron J, Ruet A, De Sèze J, Maillart E, Zephir H, Labauge P, Defer G, Lebrun-Frénay C, Moreau T, Berger E, Clavelou P, Pelletier J, Stankoff B, Gout O, Thouvenot E, Heinzlef O, Al-Khedr A, Bourre B, Casez O, Cabre P, Montcuquet A, Wahab A, Camdessanché JP, Maurousset A, Patry I, Hankiewicz K, Pottier C, Maubeuge N, Labeyrie C, Nifle C, Laplaud D, Koch-Henriksen N, Sellebjerg FT, Soerensen PS, Pfleger CC, Rasmussen PV, Jensen MB, Frederiksen JL, Bramow S, Mathiesen HK, Schreiber KI, Magyari M, Vukusic S, Butzkueven H, Kalincik T. Natalizumab Versus Fingolimod in Patients with Relapsing-Remitting Multiple Sclerosis: A Subgroup Analysis From Three International Cohorts. CNS Drugs 2021; 35:1217-1232. [PMID: 34536228 DOI: 10.1007/s40263-021-00860-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/16/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Natalizumab has proved to be more effective than fingolimod in reducing disease activity in relapsing-remitting multiple sclerosis (RRMS). Whether this association is universal for all patient groups remains to be determined. OBJECTIVE The aim of this study was to compare the relative effectiveness of natalizumab and fingolimod in RRMS subgroups defined by the baseline demographic and clinical characteristics of interest. METHODS Patients with RRMS who were given natalizumab or fingolimod were identified in a merged cohort from three international registries. Efficacy outcomes were compared across subgroups based on patients' sex, age, disease duration, Expanded Disability Status Scale (EDSS) score, and disease and magnetic resonance imaging (MRI) activity 12 months prior to treatment initiation. Study endpoints were number of relapses (analyzed with weighted negative binomial generalized linear model) and 6-month confirmed disability worsening and improvement events (weighted Cox proportional hazards model), recorded during study therapy. Each patient was weighted using inverse probability of treatment weighting based on propensity score. RESULTS A total of 5148 patients (natalizumab 1989; fingolimod 3159) were included, with a mean ± standard deviation age at baseline of 38 ± 10 years, and the majority (72%) were women. The median on-treatment follow-up was 25 (quartiles 15-41) months. Natalizumab was associated with fewer relapses than fingolimod (incidence rate ratio [IRR]; 95% confidence interval [CI]) in women (0.76; 0.65-0.88); in those aged ≤ 38 years (0.64; 0.54-0.76); in those with disease duration ≤ 7 years (0.63; 0.53-0.76); in those with EDSS score < 4 (0.75; 0.64-0.88), < 6 (0.80; 0.70-0.91), and ≥ 6 (0.52; 0.31-0.86); and in patients with pre-baseline relapses (0.74; 0.64-0.86). A higher probability of confirmed disability improvement on natalizumab versus fingolimod (hazard ratio [HR]; 95% CI) was observed among women (1.36; 1.10-1.66); those aged > 38 years (1.34; 1.04-1.73); those with disease duration > 7 years (1.33; 1.01-1.74); those with EDSS score < 6 (1.21; 1.01-1.46) and ≥ 6 (1.93; 1.11-3.34); and patients with no new MRI lesion (1.73; 1.19-2.51). CONCLUSIONS Overall, in women, younger patients, those with shorter disease durations, and patients with pre-treatment relapses, natalizumab was associated with a lower frequency of multiple sclerosis relapses than fingolimod. It was also associated with an increased chance of recovery from disability among most patients, particularly women and those with no recent MRI activity.
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Affiliation(s)
- Sifat Sharmin
- CORe, Department of Medicine, University of Melbourne, L4 East, Grattan St, Melbourne, VIC, 3050, Australia
| | - Mathilde Lefort
- Rennes University, EHESP, REPERES, EA, 7449, Rennes, France.,Univ Rennes, CHU Rennes, Inserm, CIC 1414 (Centre d'Investigation Clinique de Rennes), Rennes, France
| | - Johanna Balslev Andersen
- The Danish Multiple Sclerosis Registry, Department of Neurology, University of Copenhagen, Rigshospitalet, Copenhagen, Denmark
| | - Emmanuelle Leray
- Rennes University, EHESP, REPERES, EA, 7449, Rennes, France.,Univ Rennes, CHU Rennes, Inserm, CIC 1414 (Centre d'Investigation Clinique de Rennes), Rennes, France
| | - Dana Horakova
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University in Prague and General University Hospital, Prague, Czech Republic
| | - Eva Kubala Havrdova
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University in Prague and General University Hospital, Prague, Czech Republic
| | - Raed Alroughani
- Division of Neurology, Department of Medicine, Amiri Hospital, Sharq, Kuwait
| | | | | | - Francesco Patti
- Department of Medical and Surgical Sciences and Advanced Technologies, GF Ingrassia, Catania, Italy.,Multiple Sclerosis Center, University of Catania, Catania, Italy
| | - Marco Onofrj
- Department of Neuroscience, Imaging, and Clinical Sciences, University G. d'Annunzio, Chieti, Italy
| | - Alessandra Lugaresi
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy.,Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna, Bologna, Italia
| | - Murat Terzi
- Medical Faculty, 19 Mayis University, Samsun, Turkey
| | | | | | - Bassem Yamout
- Nehme and Therese Tohme Multiple Sclerosis Center, American University of Beirut Medical Center, Beirut, Lebanon
| | - Alexandre Prat
- CHUM MS Center and Universite de Montreal, Montreal, Canada
| | - Marc Girard
- CHUM MS Center and Universite de Montreal, Montreal, Canada
| | | | - Cavit Boz
- KTU Medical Faculty Farabi Hospital, Trabzon, Turkey
| | - Maria Trojano
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari, Bari, Italy
| | - Pamela McCombe
- University of Queensland, Brisbane, Australia.,Royal Brisbane and Women's Hospital, Brisbane, Australia
| | - Mark Slee
- College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Jeannette Lechner-Scott
- School of Medicine and Public Health, University Newcastle, Newcastle, Australia.,Department of Neurology, John Hunter Hospital, Hunter New England Health, Newcastle, Australia
| | - Recai Turkoglu
- Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
| | - Patrizia Sola
- Department of Neuroscience, Azienda Ospedaliera Universitaria, Modena, Italy
| | - Diana Ferraro
- Department of Neuroscience, Azienda Ospedaliera Universitaria, Modena, Italy
| | - Franco Granella
- Department of Medicine and Surgery, University of Parma, Parma, Italy.,Department of Emergency and General Medicine, Parma University Hospital, Parma, Italy
| | | | | | - Olga Skibina
- Department of Neuroscience, Monash University, Melbourne, Australia.,Department of Neurology, The Alfred Hospital, Melbourne, Australia
| | - Katherine Buzzard
- Department of Neurology, The Alfred Hospital, Melbourne, Australia.,Central Clinical School, Monash University, Melbourne, Australia
| | - Anneke Van der Walt
- Department of Neurology, The Alfred Hospital, Melbourne, Australia.,Central Clinical School, Monash University, Melbourne, Australia
| | - Bart Van Wijmeersch
- Rehabilitation and MS-Centre Overpelt and Hasselt University, Hasselt, Belgium
| | - Tunde Csepany
- Department of Neurology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Daniele Spitaleri
- Azienda Ospedaliera di Rilievo Nazionale San Giuseppe Moscati Avellino, Avellino, Italy
| | - Steve Vucic
- Neurophysiology Department, Westmead Hospital, Sydney, Australia
| | - Romain Casey
- Université de Lyon, Université, Claude Bernard Lyon 1, F-69000, Lyon, France.,Service de neurologie, sclérose en plaques, pathologies de la myéline et neuro-inflammation, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron, Lyon, France.,Observatoire Français de la Sclérose en Plaques, Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR 5292, 69003, Lyon, France.,EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis, State-Approved Foundation, 69677, Bron, France
| | - Marc Debouverie
- Department of Neurology, Nancy University Hospital, Nancy, France.,Université de Lorraine, APEMAC, 54000, Nancy, France
| | - Gilles Edan
- CHU Pontchaillou, CIC1414 INSERM, 35000, Rennes, France
| | - Jonathan Ciron
- Department of Neurology, CHU de Toulouse, Hôpital Pierre-Paul Riquet, CRC-SEP, 31059, Toulouse Cedex 9, France
| | - Aurélie Ruet
- Neurocentre Magendie, Université de Bordeaux, 33000, Bordeaux, France.,INSERM U1215, Neurocentre Magendie, 33000, Bordeaux, France.,Department of Neurology, CHU de Bordeaux, CIC Bordeaux CIC1401, 33000, Bordeaux, France
| | - Jérôme De Sèze
- Department of Neurology and Clinical Investigation Center, CHU de Strasbourg, CIC 1434, INSERM 1434, 67000, Strasbourg, France
| | - Elisabeth Maillart
- Département de neurologie, Hôpital Pitié-Salpêtrière, APHP, Paris, France.,Centre de Ressources et de Compétences SEP, Paris, France
| | - Hélène Zephir
- CHU Lille, CRCSEP Lille, Univ Lille, U1172, 59000, Lille, France
| | - Pierre Labauge
- MS Unit, CHU de Montpellier, 34295, Montpellier Cedex 5, France.,University of Montpellier (MUSE), 34000, Montpellier, France
| | - Gilles Defer
- Department of Neurology, CHU de Caen, MS Expert Centre, Normandy University, avenue de la Côte-de-Nacre, 14033, Caen, France
| | | | - Thibault Moreau
- Department of Neurology, CHU de Dijon, EA4184, 21000, Dijon, France
| | - Eric Berger
- CHU de Besançon, Service de Neurologie 25 030, Besançon, France
| | - Pierre Clavelou
- Department of Neurology, CHU Clermont-Ferrand, 63000, Clermont-Ferrand, France.,Université Clermont Auvergne, Inserm, Neuro-Dol, 63000, Clermont-Ferrand, France
| | - Jean Pelletier
- Aix Marseille Univ, APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, 13005, Marseille, France
| | - Bruno Stankoff
- Sorbonne Universités, UPMC Paris 06, Brain and Spine Institute, ICM, Hôpital de la Pitié Salpêtrière, Inserm UMR S 1127, CNRS UMR 7225, Paris, France.,Department of Neurology, AP-HP, Saint-Antoine Hospital, 75000, Paris, France
| | - Olivier Gout
- Department of Neurology, Fondation Rotschild, 75000, Paris, France
| | - Eric Thouvenot
- Department of Neurology, Nimes University Hospital, 30029, Nimes Cedex 9, France.,Institut de Génomique Fonctionnelle, UMR5203, INSERM 1191, Univ. Montpellier, 34094, Montpellier Cedex 5, France
| | - Olivier Heinzlef
- Department of Neurology, Hôpital de Poissy, 78300, Poissy, France
| | | | | | - Olivier Casez
- Department of Neurology, CHU Grenoble Alpes, La Tronche, 38700, Grenoble, France
| | - Philippe Cabre
- Department of Neurology, CHU de la Martinique, 97200, Fort-de-France, France
| | - Alexis Montcuquet
- Department of Neurology, CHU de Limoges, Hôpital Dupuytren, 87000, Limoges, France
| | - Abir Wahab
- Department of Neurology, APHP, Hôpital Henri Mondor, 94000, Créteil, France
| | | | - Aude Maurousset
- CRC SEP and Department of Neurology, CHU de Tours, Hôpital Bretonneau, 37000, Tours, France
| | - Ivania Patry
- Department of Neurology, Hôpital Sud Francilien, 91160, Corbeil Essonnes, France
| | - Karolina Hankiewicz
- Department of Neurology, Hôpital Pierre Delafontaine, Centre Hospitalier de Saint-Denis, 93200, Saint-Denis, France
| | - Corinne Pottier
- Department of Neurology, CH de Pontoise, Hôpital René Dubos, 95300, Pontoise, France
| | - Nicolas Maubeuge
- Department of Neurology, CHU La Milétrie, Hôpital Jean Bernard, 86000, Poitiers, France
| | - Céline Labeyrie
- Department of Neurology, CHU Bicêtre, 94275, Le Kremlin Bicêtre, France
| | - Chantal Nifle
- Department of Neurology, Centre Hospitalier de Versailles, 78150, Le Chesnay, France
| | - David Laplaud
- CHU de Nantes, Service de Neurologie & CIC015 INSERM, 44093, Nantes, France.,CRTI-Inserm U1064, 44000, Nantes, France
| | - Niels Koch-Henriksen
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
| | - Finn Thorup Sellebjerg
- Department of Neurology, The Danish Multiple Sclerosis Center, University of Copenhagen, Rigshospitalet, Copenhagen, Denmark
| | - Per Soelberg Soerensen
- Department of Neurology, The Danish Multiple Sclerosis Center, University of Copenhagen, Rigshospitalet, Copenhagen, Denmark
| | | | | | | | - Jette Lautrup Frederiksen
- Department of Neurology, Rigshospitalet Glostrup, Copenhagen, Denmark.,Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Stephan Bramow
- Department of Neurology, Danish Multiple Sclerosis Centre, Copenhagen University Hospital, Rigshospitalet in Glostrup, 2600, Glostrup, Denmark
| | | | - Karen Ingrid Schreiber
- Department of Neurology, The Danish Multiple Sclerosis Center, University of Copenhagen, Rigshospitalet, Copenhagen, Denmark
| | - Melinda Magyari
- The Danish Multiple Sclerosis Registry, Department of Neurology, University of Copenhagen, Rigshospitalet, Copenhagen, Denmark.,Department of Neurology, The Danish Multiple Sclerosis Center, University of Copenhagen, Rigshospitalet, Copenhagen, Denmark
| | - Sandra Vukusic
- Service de neurologie, sclérose en plaques, pathologies de la myéline et neuro-inflammation, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron, Lyon, France.,Centre des Neurosciences de Lyon, Observatoire Français de la Sclérose en Plaques, INSERM 1028 et CNRS UMR5292, 69003, Lyon, France.,Université Claude Bernard Lyon 1, Faculté de médecine Lyon Est, F-69000, Lyon, France
| | - Helmut Butzkueven
- Department of Neurology, The Alfred Hospital, Melbourne, Australia.,Central Clinical School, Monash University, Melbourne, Australia.,Department of Neurology, Box Hill Hospital, Monash University, Melbourne, Australia
| | - Tomas Kalincik
- CORe, Department of Medicine, University of Melbourne, L4 East, Grattan St, Melbourne, VIC, 3050, Australia. .,MS Centre, Department of Neurology, Royal Melbourne Hospital, Melbourne, Australia.
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Bosco-Lévy P, Debouverie M, Brochet B, Guillemin F, Louapre C, Maillart E, Heinzlef O, Lignot S, Diez P, Abouelfath A, Lassalle R, Blin P, Droz-Perroteau C. Comparative effectiveness of dimethyl fumarate in multiple sclerosis. Br J Clin Pharmacol 2021; 88:1268-1278. [PMID: 34505304 DOI: 10.1111/bcp.15071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 08/26/2021] [Accepted: 08/29/2021] [Indexed: 12/21/2022] Open
Abstract
AIMS To assess the effectiveness of dimethyl fumarate (DMF) on annual rate of relapse subject to treatment (ARRt) and disability progression in multiple sclerosis (MS) compared to injectable immunomodulators (IMM), teriflunomide (TERI) and fingolimob (FTY), in real-life setting. METHODS A population-based cohort study was conducted using data of the French nationwide claims database, SNDS. All patients initiating IMM, TERI, FTY or DMF between 1 July 2015 and 12 December 2017, with 4.5 years of database history and 1-3.5 years of follow-up were included in this study. DMF patients were 1:1 matched to IMM, TERI or FTY using a high dimensional propensity score. Negative binomial regression and a logistic regression model were used to estimate the relative risk (RR ± [95% CI]) of ARRt and the odds ratio (OR ± [95% CI]) of disability progression, respectively. RESULTS Overall, 9304 subjects were identified: 29.0% initiated DMF, 33.2% TERI, 5.6% FTY and 32.2% an IMM. The matched cohorts consisted of 1779 DMF-IMM patients, 1679 DMF-TERI patients, and 376 DMF-FTY patients. DMF significantly reduced ARRt compared to IMM (RR 0.72 [0.61-0.86]) and TERI (0.81 [0.68-0.96]) and did not show any significant difference when compared with FTY. The risk of the progression of MS-specific disability was not significantly different for any matched cohorts. CONCLUSION DMF is associated with lower risk of treated relapse for patients with RRMS than other first-line RRMS agents (TERI and IIM).
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Affiliation(s)
- Pauline Bosco-Lévy
- Univ. Bordeaux, INSERM CIC-P1401, Bordeaux PharmacoEpi, Bordeaux, France
| | - Marc Debouverie
- Département de neurologie, CHU Nancy, Nancy, France.,Univ. Lorraine, EA 4360 APEMACVandoeuvre-Lès Nancy, France
| | - Bruno Brochet
- CRC SEP, Neurology Department, CHU de Bordeaux, Bordeaux, France.,Univ. Bordeaux, INSERM, Neurocentre Magendie, U1215, Bordeaux, France
| | - Francis Guillemin
- Univ. Lorraine, EA 4360 APEMACVandoeuvre-Lès Nancy, France.,CHRU de Nancy, INSERM CIC 1433 Epidémiologie clinique, Nancy, France
| | - Céline Louapre
- Sorbonne Université, Institut du Cerveau et de la Moelle épinière, ICM, Hôpital de la Pitié Salpêtrière, Inserm UMR S 1127, CNRS UMR, Paris, France.,Neurology Department, Pitie Salpetriere Hospital, APHP, Paris, France
| | | | - Olivier Heinzlef
- Neurology Department, Hôpital CHI de Poissy/Saint-Germain-en-Laye, Paris, France
| | - Séverine Lignot
- Univ. Bordeaux, INSERM CIC-P1401, Bordeaux PharmacoEpi, Bordeaux, France
| | - Pauline Diez
- Univ. Bordeaux, INSERM CIC-P1401, Bordeaux PharmacoEpi, Bordeaux, France
| | | | - Régis Lassalle
- Univ. Bordeaux, INSERM CIC-P1401, Bordeaux PharmacoEpi, Bordeaux, France
| | - Patrick Blin
- Univ. Bordeaux, INSERM CIC-P1401, Bordeaux PharmacoEpi, Bordeaux, France
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19
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Andersen JB, Sharmin S, Lefort M, Koch-Henriksen N, Sellebjerg F, Sørensen PS, Hilt Christensen CC, Rasmussen PV, Jensen MB, Frederiksen JL, Bramow S, Mathiesen HK, Schreiber KI, Horakova D, Havrdova EK, Alroughani R, Izquierdo G, Eichau S, Ozakbas S, Patti F, Onofrj M, Lugaresi A, Terzi M, Grammond P, Grand Maison F, Yamout B, Prat A, Girard M, Duquette P, Boz C, Trojano M, McCombe P, Slee M, Lechner-Scott J, Turkoglu R, Sola P, Ferraro D, Granella F, Shaygannejad V, Prevost J, Skibina O, Solaro C, Karabudak R, Wijmeersch BV, Csepany T, Spitaleri D, Vucic S, Casey R, Debouverie M, Edan G, Ciron J, Ruet A, Sèze JD, Maillart E, Zephir H, Labauge P, Defer G, Lebrun C, Moreau T, Berger E, Clavelou P, Pelletier J, Stankoff B, Gout O, Thouvenot E, Heinzlef O, Al-Khedr A, Bourre B, Casez O, Cabre P, Montcuquet A, Wahab A, Camdessanché JP, Marousset A, Patry I, Hankiewicz K, Pottier C, Maubeuge N, Labeyrie C, Nifle C, Leray E, Laplaud DA, Butzkueven H, Kalincik T, Vukusic S, Magyari M. The effectiveness of natalizumab vs fingolimod-A comparison of international registry studies. Mult Scler Relat Disord 2021; 53:103012. [PMID: 34116480 DOI: 10.1016/j.msard.2021.103012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 04/21/2021] [Accepted: 04/29/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Natalizumab and fingolimod were the first preparations recommended for disease breakthrough in priorly treated relapsing-remitting multiple sclerosis. Of three published head-to-head studies two showed that natalizumab is the more effective to prevent relapses and EDSS worsening. METHODS By re-analyzing original published results from MSBase, France, and Denmark using uniform methodologies, we aimed at identifying the effects of differences in methodology, in the MS-populations, and at re-evaluating the differences in effectiveness between the two drugs. We gained access to copies of the individual amended databases and pooled all data. We used uniform inclusion/exclusion criteria and statistical methods with Inverse Probability Treatment Weighting. RESULTS The pooled analyses comprised 968 natalizumab- and 1479 fingolimod treated patients. The on-treatment natalizumab/fingolimod relapse rate ratio was 0.77 (p=0.004). The hazard ratio (HR) for a first relapse was 0.82 (p=0.030), and the HR for sustained EDSS improvement was 1.4 (p=0.009). There were modest differences between each of the original published studies and the replication study, but the conclusions of the three original studies remained unchanged: in two of them natalizumab was more effective, but in the third there was no difference between natalizumab and fingolimod. CONCLUSION The results were largely invariant to the epidemiological and statistical methods but differed between the MS populations. Generally, the advantage of natalizumab was confirmed.
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Affiliation(s)
- Johanna B Andersen
- The Danish Multiple Sclerosis Registry, Department of Neurology, University of Copenhagen, Rigshospitalet, Copenhagen, Denmark.
| | - Sifat Sharmin
- CORe, Department of Medicine, University of Melbourne, Melbourne, Australia; Department of Neurology, Royal Melbourne Hospital, Melbourne, Australia
| | - Mathilde Lefort
- Rennes University, EHESP, REPERES - EA 7449, F-35000 Rennes, France; Univ Rennes, CHU Rennes, Inserm, CIC 1414 (Centre d'Investigation Clinique de Rennes), F-35000 Rennes, France
| | - Nils Koch-Henriksen
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
| | - Finn Sellebjerg
- The Danish Multiple Sclerosis Center, Department of Neurology, Copenhagen University Hospital, Rigshospitalet Glostrup, Denmark
| | - Per Soelberg Sørensen
- The Danish Multiple Sclerosis Center, Department of Neurology, University of Copenhagen, Rigshospitalet, Copenhagen, Denmark
| | | | - Peter V Rasmussen
- Aarhus University Hospital, Neurology, PPJ Boulevard, DK-8200 Aarhus N
| | - Michael B Jensen
- Department of Neurology, University Hospital of Northern Sealand
| | - Jette L Frederiksen
- Danish Multiple Sclerosis Centre, Dept. of Neurology, Copenhagen University Hospital, Rigshospitalet in Glostrup, 2600 Glostrup, Denmark
| | - Stephan Bramow
- The Danish Multiple Sclerosis Center, Department of Neurology, Copenhagen University Hospital, Rigshospitalet Glostrup, Denmark
| | - Henrik K Mathiesen
- The Danish Multiple Sclerosis Center, Department of Neurology, University of Copenhagen, Rigshospitalet, Copenhagen, Denmark
| | - Karen I Schreiber
- The Danish Multiple Sclerosis Center, Department of Neurology, Copenhagen University Hospital, Rigshospitalet Glostrup, Denmark
| | - Dana Horakova
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University in Prague and General University Hospital, Prague, Czech Republic
| | - Eva K Havrdova
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University in Prague and General University Hospital, Prague, Czech Republic
| | - Raed Alroughani
- Division of Neurology, Department of Medicine, Amiri Hospital, Sharq, Kuwait
| | | | - Sara Eichau
- Hospital Universitario Virgen Macarena, Sevilla, Spain
| | | | - Francesco Patti
- GF Ingrassia Department, University of Catania, Catania, Policlinico G Rodolico, Italy
| | - Marco Onofrj
- Department of Neuroscience, Imaging, and Clinical Sciences, University G. d'Annunzio, Chieti, Italy
| | - Alessandra Lugaresi
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy, IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Murat Terzi
- Medical Faculty, 19 Mayis University, Samsun, Turkey
| | | | | | - Bassem Yamout
- Nehme and Therese Tohme Multiple Sclerosis Center, American University of Beirut Medical Center, Beirut, Lebanon
| | - Alexandre Prat
- Hopital Notre Dame, Montreal, Canada, CHUM and Universite de Montreal, Montreal, Canada
| | - Marc Girard
- Hopital Notre Dame, Montreal, Canada, CHUM and Universite de Montreal, Montreal, Canada
| | - Pierre Duquette
- Hopital Notre Dame, Montreal, Canada, CHUM and Universite de Montreal, Montreal, Canada
| | - Cavit Boz
- KTU Medical Faculty Farabi Hospital, Trabzon, Turkey
| | - Maria Trojano
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari, Bari, Italy
| | - Pamela McCombe
- University of Queensland, Brisbane, Australia, Royal Brisbane and Women's Hospital
| | - Mark Slee
- Flinders University, Adelaide, Australia
| | - Jeannette Lechner-Scott
- School of Medicine and Public Health, University Newcastle, Newcastle, Australia; Department of Neurology, John Hunter Hospital, Hunter New England Health, Newcastle, Australia
| | - Recai Turkoglu
- Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
| | - Patrizia Sola
- Department of Neuroscience, Azienda Ospedaliera Universitaria, Modena, Italy
| | - Diana Ferraro
- Department of Neuroscience, Azienda Ospedaliera Universitaria, Modena, Italy
| | - Franco Granella
- Department of Medicine and Surgery, University of Parma, Parma, Italy; Department of Emergency and General Medicine, Parma University Hospital, Parma, Italy
| | | | | | | | - Claudio Solaro
- Department of Neurology, ASL3 Genovese, Genova, Italy; Department of Rehabilitaiton, ML Novarese Hospital Moncrivello
| | | | - Bart V Wijmeersch
- Rehabilitation and MS-Centre Overpelt and Hasselt University, Hasselt, Belgium
| | - Tunde Csepany
- Department of Neurology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Daniele Spitaleri
- Azienda Ospedaliera di Rilievo Nazionale San Giuseppe Moscati Avellino, Avellino, Italy
| | | | - Romain Casey
- Service de neurologie, sclérose en plaques, pathologies de la myéline et neuro-inflammation, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, 69677 Lyon/Bron, France; Centre des Neurosciences de Lyon, Observatoire Français de la Sclérose en Plaques, INSERM 1028 et CNRS UMR5292, 69003 Lyon, France ; Université Claude Bernard Lyon 1, Faculté de médecine Lyon Est, F-69000 Lyon, France, Eugene Devic EDMUS Foundation, 69677 Lyon/Bron, France
| | - Marc Debouverie
- Centre hospitalier régional universitaire de Nancy, Hôpital central, Service de neurologie, Nancy, France
| | - Gilles Edan
- Centre hospitalier universitaire de Rennes, Hôpital Pontchaillou, Service de neurologie, Rennes, France
| | - Jonathan Ciron
- Centre hospitalier universitaire de Toulouse, Hôpital Purpan, Service de neurologie inflammatoire et neuro-oncologie, Toulouse, France
| | - Aurélie Ruet
- Centre hospitalier universitaire de Bordeaux, Hôpital Pellegrin, Service de neurologie, Bordeaux, France
| | - Jérôme D Sèze
- Hôpitaux universitaire de Strasbourg, Hôpital de Hautepierre, Service des maladies inflammatoires du système nerveux - neurologie, Strasbourg, France
| | - Elisabeth Maillart
- Assistance publique des hôpitaux de Paris, Hôpital de la Pitié-Salpêtrière, Service de neurologie, Paris, France
| | - Hélène Zephir
- Centre hospitalier universitaire de Lille, Hôpital Salengro, Service de neurologie D, Lille, France
| | - Pierre Labauge
- Centre hospitalier universitaire de Montpellier, Hôpital Gui de Chauliac, Service de neurologie, Montpellier, France
| | - Gilles Defer
- Centre hospitalier universitaire de Caen Normandie, Service de neurologie, Hôpital Côte de Nacre, Caen, France
| | - Christine Lebrun
- Centre hospitalier universitaire de Nice, Université Nice Côte d'Azur, Hôpital Pasteur, Service de neurologie, Nice, France
| | - Thibault Moreau
- Centre hospitalier universitaire Dijon Bourgogne, Hôpital François Mitterrand, Service de neurologie, maladies inflammatoires du système nerveux et neurologie générale, Dijon, France
| | - Eric Berger
- Centre hospitalier régional universitaire de Besançon, Hôpital Jean Minjoz, Service de neurologie, Besançon, France
| | - Pierre Clavelou
- Centre hospitalier universitaire de Clermont-Ferrand, Hôpital Gabriel-Montpied, Service de neurologie, Clermont-Ferrand, France
| | - Jean Pelletier
- Assistance publique des hôpitaux de Marseille, Centre hospitalier de la Timone, Service de neurologie et unité neuro-vasculaire, Marseille, France
| | - Bruno Stankoff
- Assistance publique des hôpitaux de Paris, Hôpital Saint-Antoine, Service de neurologie, Paris, France
| | - Olivier Gout
- Fondation Adolphe de Rothschild de l'œil et du cerveau, Service de neurologie, Paris, France
| | - Eric Thouvenot
- Centre hospitalier universitaire de Nîmes, Hôpital Carémeau, Service de neurologie, Nîmes, France
| | - Olivier Heinzlef
- Centre hospitalier intercommunal de Poissy Saint-Germain-en-Laye, Service de neurologie, Poissy, France
| | - Abdullatif Al-Khedr
- Centre hospitalier universitaire d'Amiens Picardie, Site sud, Service de neurologie, Amiens, France
| | - Bertrand Bourre
- Centre hospitalier universitaire Rouen Normandie, Hôpital Charles-Nicolle, Service de neurologie, Rouen, France
| | - Olivier Casez
- Centre hospitalier universitaire Grenoble-Alpes, Site nord, Service de neurologie, Grenoble/La Tronche, France
| | - Philippe Cabre
- Centre hospitalier universitaire de Martinique, Hôpital Pierre Zobda-Quitman, Service de Neurologie, Fort-de-France, France
| | - Alexis Montcuquet
- Centre hospitalier universitaire Limoges, Hôpital Dupuytren, Service de neurologie, Limoges, France
| | - Abir Wahab
- Hôpital Henri Mondor, Department of Neurology, F-94000 Créteil, France
| | - Jean-Philippe Camdessanché
- Centre hospitalier universitaire de Saint-Étienne, Hôpital Nord, Service de neurologie, Saint-Étienne, France
| | - Aude Marousset
- Centre hospitalier régional universitaire de Tours, Hôpital Bretonneau, Service de neurologie, Tours, France
| | - Ivania Patry
- Centre hospitalier sud francilien, Service de neurologie, Corbeil-Essonnes, France
| | - Karolina Hankiewicz
- Centre hospitalier de Saint-Denis, Hôpital Casanova, Service de neurologie, Saint-Denis, France
| | - Corinne Pottier
- Centre hospitalier de Pontoise, Service de neurologie, Pontoise, France
| | - Nicolas Maubeuge
- Centre hospitalier universitaire de Poitiers, Site de la Milétrie, Service de neurologie, Poitiers, France
| | - Céline Labeyrie
- Assistance publique des hôpitaux de Paris, Hôpital Bicêtre, Service de neurologie, Le Kremlin-Bicêtre, France
| | - Chantal Nifle
- Centre hospitalier de Versailles, Hôpital André-Mignot, Service de neurologie, Le Chesnay, France
| | - Emmanuelle Leray
- Rennes University, EHESP, REPERES - EA 7449, F-35000 Rennes, France; Univ Rennes, CHU Rennes, Inserm, CIC 1414 (Centre d'Investigation Clinique de Rennes), F-35000 Rennes, France
| | - David A Laplaud
- CHU de Nantes, Service de Neurologie & CIC015 INSERM, F-44093 Nantes, France; INSERM CR1064, F-44000 Nantes, France
| | - Helmut Butzkueven
- Central Clinical School, Monash University, Melbourne, Australia; Department of Neurology, The Alfred Hospital, Melbourne, Australia; Department of Neurology, Box Hill Hospital, Monash University, Melbourne, Australia
| | - Tomas Kalincik
- CORe, Department of Medicine, University of Melbourne, Melbourne, Australia; Melbourne MS Centre, Department of Neurology, Royal Melbourne Hospital, Melbourne, Australia
| | - Sandra Vukusic
- The Danish Multiple Sclerosis Registry, Department of Neurology, University of Copenhagen, Rigshospitalet, Copenhagen, Denmark; The Danish Multiple Sclerosis Center, Department of Neurology, University of Copenhagen, Rigshospitalet, Copenhagen, Denmark
| | - Melinda Magyari
- The Danish Multiple Sclerosis Registry, Department of Neurology, University of Copenhagen, Rigshospitalet, Copenhagen, Denmark; The Danish Multiple Sclerosis Center, Department of Neurology, Copenhagen University Hospital, Rigshospitalet Glostrup, Denmark
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20
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Thurin NH, Bosco-Levy P, Blin P, Rouyer M, Jové J, Lamarque S, Lignot S, Lassalle R, Abouelfath A, Bignon E, Diez P, Gross-Goupil M, Soulié M, Roumiguié M, Le Moulec S, Debouverie M, Brochet B, Guillemin F, Louapre C, Maillart E, Heinzlef O, Moore N, Droz-Perroteau C. Intra-database validation of case-identifying algorithms using reconstituted electronic health records from healthcare claims data. BMC Med Res Methodol 2021; 21:95. [PMID: 33933001 PMCID: PMC8088022 DOI: 10.1186/s12874-021-01285-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 04/15/2021] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Diagnosis performances of case-identifying algorithms developed in healthcare database are usually assessed by comparing identified cases with an external data source. When this is not feasible, intra-database validation can present an appropriate alternative. OBJECTIVES To illustrate through two practical examples how to perform intra-database validations of case-identifying algorithms using reconstituted Electronic Health Records (rEHRs). METHODS Patients with 1) multiple sclerosis (MS) relapses and 2) metastatic castration-resistant prostate cancer (mCRPC) were identified in the French nationwide healthcare database (SNDS) using two case-identifying algorithms. A validation study was then conducted to estimate diagnostic performances of these algorithms through the calculation of their positive predictive value (PPV) and negative predictive value (NPV). To that end, anonymized rEHRs were generated based on the overall information captured in the SNDS over time (e.g. procedure, hospital stays, drug dispensing, medical visits) for a random selection of patients identified as cases or non-cases according to the predefined algorithms. For each disease, an independent validation committee reviewed the rEHRs of 100 cases and 100 non-cases in order to adjudicate on the status of the selected patients (true case/ true non-case), blinded with respect to the result of the corresponding algorithm. RESULTS Algorithm for relapses identification in MS showed a 95% PPV and 100% NPV. Algorithm for mCRPC identification showed a 97% PPV and 99% NPV. CONCLUSION The use of rEHRs to conduct an intra-database validation appears to be a valuable tool to estimate the performances of a case-identifying algorithm and assess its validity, in the absence of alternative.
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Affiliation(s)
- Nicolas H. Thurin
- INSERM CIC-P1401, Bordeaux PharmacoEpi, Univ. Bordeaux, Bordeaux, France
| | - Pauline Bosco-Levy
- INSERM CIC-P1401, Bordeaux PharmacoEpi, Univ. Bordeaux, Bordeaux, France
| | - Patrick Blin
- INSERM CIC-P1401, Bordeaux PharmacoEpi, Univ. Bordeaux, Bordeaux, France
| | - Magali Rouyer
- INSERM CIC-P1401, Bordeaux PharmacoEpi, Univ. Bordeaux, Bordeaux, France
| | - Jérémy Jové
- INSERM CIC-P1401, Bordeaux PharmacoEpi, Univ. Bordeaux, Bordeaux, France
| | - Stéphanie Lamarque
- INSERM CIC-P1401, Bordeaux PharmacoEpi, Univ. Bordeaux, Bordeaux, France
| | - Séverine Lignot
- INSERM CIC-P1401, Bordeaux PharmacoEpi, Univ. Bordeaux, Bordeaux, France
| | - Régis Lassalle
- INSERM CIC-P1401, Bordeaux PharmacoEpi, Univ. Bordeaux, Bordeaux, France
| | | | - Emmanuelle Bignon
- INSERM CIC-P1401, Bordeaux PharmacoEpi, Univ. Bordeaux, Bordeaux, France
| | - Pauline Diez
- INSERM CIC-P1401, Bordeaux PharmacoEpi, Univ. Bordeaux, Bordeaux, France
| | - Marine Gross-Goupil
- Department of Medical Oncology, Hôpital Saint André, CHU de Bordeaux, Bordeaux, France
| | - Michel Soulié
- Department of Urology, University Hospital of Rangueil, CHU de Toulouse, Toulouse, France
| | - Mathieu Roumiguié
- Department of Urology, University Hospital of Rangueil, CHU de Toulouse, Toulouse, France
| | | | - Marc Debouverie
- Department of Neurology, CHRU de Nancy, Nancy, France
- Université de Lorraine, EA 4360 APEMAC, Nancy, France
| | - Bruno Brochet
- CRC SEP, Neurology Department, CHU de Bordeaux, Bordeaux, France
- INSERM U1215, Neurocentre Magendie, Univ. Bordeaux, Bordeaux, France
| | - Francis Guillemin
- Université de Lorraine, EA 4360 APEMAC, Nancy, France
- INSERM CIC 1433 Epidémiologie Clinique, CHRU de Nancy, Nancy, France
| | - Céline Louapre
- Sorbonne Université, Institut du cerveau, ICM, Hôpital de la Pitié Salpêtrière, INSERM UMR S 1127, CNRS UMR 7225, Paris, France
- Neurology Department, Hôpital de la Pitié Salpêtrière, APHP, Paris, France
| | - Elisabeth Maillart
- Neurology Department, Hôpital de la Pitié Salpêtrière, APHP, Paris, France
| | - Olivier Heinzlef
- Department of Neurology, Hôpital CHI de Poissy/Saint-Germain-en-Laye, Paris, France
| | - Nicholas Moore
- INSERM CIC-P1401, Bordeaux PharmacoEpi, Univ. Bordeaux, Bordeaux, France
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21
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Moisset X, Fouchard AA, Pereira B, Taithe F, Mathey G, Edan G, Ciron J, Brochet B, De Sèze J, Papeix C, Vermersch P, Labauge P, Defer G, Lebrun-Frenay C, Moreau T, Laplaud D, Berger E, Pelletier J, Stankoff B, Gout O, Thouvenot E, Heinzlef O, Al-Khedr A, Bourre B, Casez O, Cabre P, Montcuquet A, Créange A, Camdessanché JP, Bakchine S, Maurousset A, Hankiewicz K, Pottier C, Maubeuge N, Dimitri Boulos D, Nifle C, Vukusic S, Clavelou P. Untreated patients with multiple sclerosis: A study of French expert centers. Eur J Neurol 2021; 28:2026-2036. [PMID: 33650261 DOI: 10.1111/ene.14790] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 02/11/2021] [Accepted: 02/25/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND PURPOSE Disease-modifying therapies (DMTs) have an impact on relapses and disease progression. Nonetheless, many patients with multiple sclerosis (MS) remain untreated. The objectives of the present study were to determine the proportion of untreated patients with MS followed in expert centers in France and to determine the predictive factors of nontreatment. METHODS We conducted a retrospective cohort study. Data were extracted from the 38 centers participating in the European Database for Multiple Sclerosis (EDMUS) on December 15, 2018, and patients with MS seen at least once during the study period (from June 15, 2016 to June 14, 2017) were included. RESULTS Of the 21,189 patients with MS (age 47.1 ± 13.1 years; Expanded Disability Status Scale (EDSS) score 3.4 ± 2.4), 6,631 (31.3%; 95% confidence interval [CI] 30.7-31.9) were not receiving any DMT. Although patients with a relapsing-remitting course (n = 11,693) were the most likely to receive DMT, 14.8% (95% CI 14.2-15.4) were still untreated (6.8% never treated). After multivariate analysis among patients with relapsing-remitting MS, the main factors explaining never having been treated were: not having ≥9 lesions on brain magnetic resonance imaging (odds ratio [OR] 0.52 [95% CI 0.44-0.61]) and lower EDSS score (OR 0.78 [95% CI 0.74-0.82]). Most patients with progressive MS (50.4% for secondary and 64.2% for primary progressive MS) did not receive any DMT during the study period, while 11.6% of patients with secondary and 34.0% of patients with primary progressive MS had never received any DMT. CONCLUSION A significant proportion of patients with MS did not receive any DMT, even though such treatments are reimbursed by the healthcare system for French patients. This result highlights the unmet need for current DMTs for a large subgroup of patients with MS.
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Affiliation(s)
- Xavier Moisset
- Neuro-Dol, Université Clermont Auvergne, CHU de Clermont-Ferrand, Inserm, Clermont-Ferrand, France
| | - Audrey-Anne Fouchard
- Neuro-Dol, Université Clermont Auvergne, CHU de Clermont-Ferrand, Inserm, Clermont-Ferrand, France
| | - Bruno Pereira
- Neuro-Dol, Université Clermont Auvergne, CHU de Clermont-Ferrand, Inserm, Clermont-Ferrand, France
| | - Frédéric Taithe
- Neuro-Dol, Université Clermont Auvergne, CHU de Clermont-Ferrand, Inserm, Clermont-Ferrand, France
| | - Guillaume Mathey
- Department of Neurology, Nancy University Hospital, Nancy, France.,EA 4360 APEMAC, Université de Lorraine, Vandoeuvre-Lès-Nancy, France
| | - Gilles Edan
- CIC1414 INSERM, CHU Pontchaillou, Rennes, France
| | - Jonathan Ciron
- Department of Neurology, CHU de Toulouse, CRC-SEP, Toulouse, France
| | - Bruno Brochet
- University of Bordeaux, Bordeaux, France.,INSERM U1215, Neurocentre Magendie, Bordeaux, France.,CHU de Bordeaux, CIC Bordeaux CIC1401, Bordeaux, France
| | - Jérôme De Sèze
- Department of Neurology and Clinical Investigation Center, CHU de Strasbourg, INSERM 1434, Strasbourg, France
| | - Caroline Papeix
- Department of Neurology, APHP, Pitié-Salpêtrière Hospital, Paris, France
| | - Patrick Vermersch
- University of Lille, INSERM UMR-S1172, CHU Lille, FHU Imminent, Lille, France
| | - Pierre Labauge
- MS Unit, CHU de Montpellier, Montpellier Cedex 5, France.,University of Montpellier (MUSE), Montpellier, France
| | - Gilles Defer
- Department of Neurology, CHU de la Côte de Nacre, Caen, France
| | - Christine Lebrun-Frenay
- CHU de Nice; UR2CA, Nice Cote d'Azur University, CRCSEP Nice, Pasteur2 Hospital, Nice, France
| | - Thibault Moreau
- Department of Neurology, CHU de Dijon, EA4184, Dijon, France
| | - David Laplaud
- Service de Neurologie & CIC015 INSERM, CHU de Nantes, Nantes, France.,INSERM CR1064, Nantes, France
| | - Eric Berger
- Service de Neurologie, CHU de Besançon, Besançon, France
| | - Jean Pelletier
- Service de Neurologie, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Aix Marseille University, APHM, Marseille, France
| | - Bruno Stankoff
- Service de Neurologie, Assistance publique des hôpitaux de Paris, Hôpital Saint-Antoine, Paris, France
| | - Olivier Gout
- Department of Neurology, Fondation Rotschild, Paris, France
| | - Eric Thouvenot
- Department of Neurology, Nîmes University Hospital, Nîmes, France.,Institut de Génomique Fonctionnelle, Université de Montpellier, CNRS, INSERM, Montpellier, France
| | - Olivier Heinzlef
- Department of Neurology, Poissy Hôpital de Poissy, Poissy, France
| | - Abdullatif Al-Khedr
- Service de Neurologie, Centre Hospitalier Universitaire d'Amiens Picardie, Site Sud, Amiens, France
| | - Bertrand Bourre
- CHU de Rouen, Rouen, France.,Rouen University Hospital, Rouen, France
| | - Olivier Casez
- Service de Neurologie, Centre Hospitalier Universitaire Grenoble-Alpes, Site Nord, Grenoble/La Tronche, France
| | - Philippe Cabre
- Service de Neurologie, Hôpital Pierre Zobda-Quitman, Centre Hospitalier Universitaire de Martinique, Fort-de-France, France
| | - Alexis Montcuquet
- Department of Neurology, CHU de Limoges, Hôpital Dupuytren, Limoges, France
| | - Alain Créange
- Service de Neurologie, Assistance Publique des Hôpitaux de Paris, Hôpital Henri Mondor, Créteil, France
| | | | - Serge Bakchine
- Service de Neurologie, Hôpital Maison-Blanche, Centre Hospitalier Universitaire de Reims, Reims, France
| | - Aude Maurousset
- CRC SEP and Department of Neurology, Hôpital Bretonneau, CHU de Tours, Tours, France
| | - Karolina Hankiewicz
- Service de Neurologie, Centre Hospitalier de Saint-Denis, Saint-Denis, France
| | - Corinne Pottier
- Service de Neurologie, Centre Hospitalier de Pontoise, Pontoise, France
| | - Nicolas Maubeuge
- Site de la Milétrie, Service de Neurologie, Centre Hospitalier Universitaire de Poitiers, Poitiers, France
| | - Dalia Dimitri Boulos
- Service de Neurologie, Assistance publique des hôpitaux de Paris, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Chantal Nifle
- Service de Neurologie, Centre Hospitalier de Versailles, Hôpital André-Mignot, Le Chesnay, France
| | - Sandra Vukusic
- Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-Inflammation, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon/Bron, France.,Centre des Neurosciences de Lyon, Observatoire Français de la Sclérose en Plaques, INSERM 1028 et CNRS UMR5292, Lyon, France.,Faculté de Médecine Lyon Est, Université Claude Bernard Lyon 1, Lyon, France
| | - Pierre Clavelou
- Neuro-Dol, Université Clermont Auvergne, CHU de Clermont-Ferrand, Inserm, Clermont-Ferrand, France
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22
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Mhanna E, Nouchi A, Louapre C, De Paz R, Heinzlef O, Bodini B, Assouad R, Chochon F, Lubetzki C, Papeix C, Pourcher V, Maillart E. Human papillomavirus lesions in 16 MS patients treated with fingolimod: Outcomes and vaccination. Mult Scler 2021; 27:1794-1798. [PMID: 33629615 DOI: 10.1177/1352458521991433] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Few cases of human papillomavirus (HPV) diseases have been reported in multiple sclerosis (MS) patients treated with fingolimod. We describe a case series of 16 MS patients (11 women, 5 men) developing HPV lesions after the onset of fingolimod, without previous HPV history. Fingolimod had to be discontinued in six patients. Six patients received vaccination for HPV, with good tolerance. Our report highlights that systematic HPV screening and discussion about HPV vaccination before fingolimod onset are crucial. In case of occurrence of HPV lesions during fingolimod treatment, a comprehensive workup of HPV disease is necessary, with discussion of HPV vaccination to prevent secondary lesions. Prevalence studies of HPV lesions are needed in MS patients with the different disease-modifying therapies.
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Affiliation(s)
- Elsa Mhanna
- Centre de Ressources et de Compétences Sclérose en plaques. AP-HP, Department of Neurology, Hôpital Pitié-Salpêtrière, Paris, France
| | - Agathe Nouchi
- Department of Infectious Diseases, Hôpital Pitié-Salpêtrière, AP-HP, Paris, France
| | - Céline Louapre
- Centre de Ressources et de Compétences Sclérose en plaques. AP-HP, Department of Neurology, Hôpital Pitié-Salpêtrière, Paris, France
| | - Raphael De Paz
- Centre de Ressources et de Compétences Sclérose en plaques. AP-HP, Department of Neurology, Hôpital Pitié-Salpêtrière, Paris, France
| | | | - Benedetta Bodini
- Department of Neurology, Hôpital Saint-Antoine, AP-HP, Paris, France
| | - Rana Assouad
- Centre de Ressources et de Compétences Sclérose en plaques. AP-HP, Department of Neurology, Hôpital Pitié-Salpêtrière, Paris, France
| | - Florence Chochon
- Centre de Ressources et de Compétences Sclérose en plaques. AP-HP, Department of Neurology, Hôpital Pitié-Salpêtrière, Paris, France
| | - Catherine Lubetzki
- Centre de Ressources et de Compétences Sclérose en plaques. AP-HP, Department of Neurology, Hôpital Pitié-Salpêtrière, Paris, France
| | - Caroline Papeix
- Centre de Ressources et de Compétences Sclérose en plaques. AP-HP, Department of Neurology, Hôpital Pitié-Salpêtrière, Paris, France
| | - Valérie Pourcher
- Department of Infectious Diseases, Hôpital Pitié-Salpêtrière, AP-HP, Paris, France/Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France
| | - Elisabeth Maillart
- Centre de Ressources et de Compétences Sclérose en plaques. AP-HP, Department of Neurology, Hôpital Pitié-Salpêtrière, Paris, France
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23
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Roos I, Leray E, Frascoli F, Casey R, Brown JWL, Horakova D, Havrdova EK, Debouverie M, Trojano M, Patti F, Izquierdo G, Eichau S, Edan G, Prat A, Girard M, Duquette P, Onofrj M, Lugaresi A, Grammond P, Ciron J, Ruet A, Ozakbas S, De Seze J, Louapre C, Zephir H, Sá MJ, Sola P, Ferraro D, Labauge P, Defer G, Bergamaschi R, Lebrun-Frenay C, Boz C, Cartechini E, Moreau T, Laplaud D, Lechner-Scott J, Grand'Maison F, Gerlach O, Terzi M, Granella F, Alroughani R, Iuliano G, Van Pesch V, Van Wijmeersch B, Spitaleri DLA, Soysal A, Berger E, Prevost J, Aguera-Morales E, McCombe P, Castillo Triviño T, Clavelou P, Pelletier J, Turkoglu R, Stankoff B, Gout O, Thouvenot E, Heinzlef O, Sidhom Y, Gouider R, Csepany T, Bourre B, Al Khedr A, Casez O, Cabre P, Montcuquet A, Wahab A, Camdessanche JP, Maurousset A, Patry I, Hankiewicz K, Pottier C, Maubeuge N, Labeyrie C, Nifle C, Coles A, Malpas CB, Vukusic S, Butzkueven H, Kalincik T. Determinants of therapeutic lag in multiple sclerosis. Mult Scler 2021; 27:1838-1851. [PMID: 33423618 DOI: 10.1177/1352458520981300] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND A delayed onset of treatment effect, termed therapeutic lag, may influence the assessment of treatment response in some patient subgroups. OBJECTIVES The objective of this study is to explore the associations of patient and disease characteristics with therapeutic lag on relapses and disability accumulation. METHODS Data from MSBase, a multinational multiple sclerosis (MS) registry, and OFSEP, the French MS registry, were used. Patients diagnosed with MS, minimum 1 year of exposure to MS treatment and 3 years of pre-treatment follow-up, were included in the analysis. Studied outcomes were incidence of relapses and disability accumulation. Therapeutic lag was calculated using an objective, validated method in subgroups stratified by patient and disease characteristics. Therapeutic lag under specific circumstances was then estimated in subgroups defined by combinations of clinical and demographic determinants. RESULTS High baseline disability scores, annualised relapse rate (ARR) ⩾ 1 and male sex were associated with longer therapeutic lag on disability progression in sufficiently populated groups: females with expanded disability status scale (EDSS) < 6 and ARR < 1 had mean lag of 26.6 weeks (95% CI = 18.2-34.9), males with EDSS < 6 and ARR < 1 31.0 weeks (95% CI = 25.3-36.8), females with EDSS < 6 and ARR ⩾ 1 44.8 weeks (95% CI = 24.5-65.1), and females with EDSS ⩾ 6 and ARR < 1 54.3 weeks (95% CI = 47.2-61.5). CONCLUSIONS Pre-treatment EDSS and ARR are the most important determinants of therapeutic lag.
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Affiliation(s)
- Izanne Roos
- CORe, Department of Medicine, University of Melbourne, Melbourne, VIC, Australia/Melbourne MS Centre, Department of Neurology, Royal Melbourne Hospital, Melbourne, VIC, Australia
| | - Emmanuelle Leray
- Rennes University, EHESP, REPERES - EA 7449, Rennes, France/Rennes University, CHU Rennes, Inserm, CIC 1414 [(Centre d'Investigation Clinique de Rennes)], Rennes, France
| | - Federico Frascoli
- Faculty of Science, Engineering and Technology, School of Science, Department of Mathematics, Swinburne University of Technology, Melbourne, VIC, Australia
| | - Romain Casey
- Université de Lyon, Université Claude Bernard Lyon 1, Lyon, France/Hospices Civils de Lyon, Service de Neurologie, sclérose en plaques, pathologies de la myéline et neuro-inflammation, Bron, France/Observatoire Français de la Sclérose en Plaques, Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR 5292, Lyon, France/EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis, State-Approved Foundation, Bron, France
| | - J William L Brown
- CORe, Department of Medicine, University of Melbourne, Melbourne, VIC, Australia/Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Dana Horakova
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University in Prague and General University Hospital, Prague, Czech Republic
| | - Eva Kubala Havrdova
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University in Prague and General University Hospital, Prague, Czech Republic
| | - Marc Debouverie
- Department of Neurology, Nancy University Hospital, Nancy, France/Université de Lorraine, APEMAC, Nancy, France
| | - Maria Trojano
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari, Bari, Italy
| | - Francesco Patti
- GF Ingrassia Department, University of Catania, Catania, Italy/Policlinico G Rodolico, Catania, Italy
| | | | - Sara Eichau
- Hospital Universitario Virgen Macarena, Sevilla, Spain
| | - Gilles Edan
- Centre hospitalier universitaire de Rennes, Hôpital Pontchaillou, Service de neurologie, CIC1414 INSERM, Rennes, France
| | - Alexandre Prat
- CHUM MS Center and Universite de Montreal, Montreal, QC, Canada
| | - Marc Girard
- CHUM MS Center and Universite de Montreal, Montreal, QC, Canada
| | - Pierre Duquette
- CHUM MS Center and Universite de Montreal, Montreal, QC, Canada
| | - Marco Onofrj
- Department of Neuroscience, Imaging, and Clinical Sciences, University G. d'Annunzio, Chieti, Italy
| | - Alessandra Lugaresi
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italia/Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna, Bologna, Italia
| | | | - Jonathan Ciron
- Hôpital Pierre-Paul Riquet, Department of Neurology, CHU de Toulouse, CRC-SEP, Toulouse, France
| | - Aurélie Ruet
- University Bordeaux, Bordeaux, France/INSERM U1215, Neurocentre Magendie, Bordeaux, France/Department of Neurology, CHU de Bordeaux, CIC Bordeaux CIC1401, Bordeaux, France
| | | | - Jérôme De Seze
- CHU de Strasbourg, Department of Neurology and Clinical Investigation Center, CIC (centre d'investigation clinique) INSERM 1434, Strasbourg, France
| | - Céline Louapre
- Sorbonne Université, Institut du Cerveau, ICM, Assistance Publique Hôpitaux de Paris APHP, Département de neurologie, Hôpital de la Pitié Salpêtrière, Paris, France
| | - Hélène Zephir
- CHU Lille, CRCSEP Lille, Univ Lille, U1172, Lille, France
| | - Maria José Sá
- Centro Hospitalar Universitário de São João and Universidade Fernando Pessoa, Porto, Portugal
| | - Patrizia Sola
- Department of Neuroscience, Azienda Ospedaliera Universitaria, Modena, Italy
| | - Diana Ferraro
- Department of Biomedical, Metabolic and Neurosciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Pierre Labauge
- CHU de Montpellier, MS Unit, Montpellier, France/University of Montpellier (MUSE), Montpellier, France
| | - Gilles Defer
- CHU de Caen, MS Expert Centre, Department of Neurology, avenue de la Côte-de-Nacre, Normandy University, Caen, France
| | | | - Christine Lebrun-Frenay
- CRCSEP Nice, UR2CA, Université Nice Cote d'Azur, Centre hospitalier universitaire de Nice, Hopital Pasteur 2, Nice, France
| | - Cavit Boz
- KTU Medical Faculty Farabi Hospital, Trabzon, Turkey
| | | | - Thibault Moreau
- CHU de Dijon, Department of Neurology, EA4184, Dijon, France
| | - David Laplaud
- CHU de Nantes, Service de Neurologie & CIC015 INSERM, Nantes, France/CRTI-Inserm U1064, Nantes, France
| | - Jeannette Lechner-Scott
- School of Medicine and Public Health, University Newcastle, Newcastle, NSW, Australia/Department of Neurology, John Hunter Hospital, Hunter New England Health, Newcastle, NSW, Australia
| | | | - Oliver Gerlach
- Department of Neurology, Zuyderland Medical Center, Sittard-Geleen, The Netherlands
| | - Murat Terzi
- Medical Faculty, 19 Mayis University, Samsun, Turkey
| | - Franco Granella
- Department of Medicine and Surgery, University of Parma, Parma, Italy/Department of General Medicine, Parma University Hospital, Parma, Italy
| | - Raed Alroughani
- Division of Neurology, Department of Medicine, Amiri Hospital, Sharq, Kuwait
| | | | | | - Bart Van Wijmeersch
- Rehabilitation and MS-Centre Overpelt and Hasselt University, Hasselt, Belgium
| | | | - Aysun Soysal
- Bakirkoy Education and Research Hospital for Psychiatric and Neurological Diseases, Istanbul, Turkey
| | - Eric Berger
- CHU de Besançon, Department of Neurology, Besançon, France
| | | | | | - Pamela McCombe
- University of Queensland, Brisbane, QLD, Australia/Royal Brisbane and Women's Hospital, Herston, QLD, Australia
| | - Tamara Castillo Triviño
- Instituto de Investigación Sanitaria Biodonostia, Hospital Universitario Donostia, San Sebastian, Spain
| | - Pierre Clavelou
- CHU Clermont-Ferrand, Department of Neurology, Clermont-Ferrand, France/Université Clermont Auvergne, Inserm, Neuro-Dol, Clermont-Ferrand, France
| | - Jean Pelletier
- Aix Marseille Univ, APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, Marseille, France
| | - Recai Turkoglu
- Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
| | - Bruno Stankoff
- Sorbonne Universités, UPMC Paris 06, Brain and Spine Institute, ICM, Hôpital de la Pitié Salpêtrière, Inserm UMR S 1127, CNRS UMR 7225, Pars, France/Department of Neurology, AP-HP, Saint-Antoine Hospital, Paris, France
| | - Olivier Gout
- Fondation Adolphe de Rothschild de l'œil et du cerveau, Department of Neurology, Paris, France
| | - Eric Thouvenot
- CHU de Nîmes, Department of Neurology, Nîmes, France/Institut de Génomique Fonctionnelle, UMR5203, INSERM 1191, Université de Montpellier, Montpellier, France
| | - Olivier Heinzlef
- Centre hospitalier intercommunal de Poissy Saint-Germain-en-Laye, Departement of Neurology, Poissy, France
| | - Youssef Sidhom
- Department of Neurology - LR 18 SP03 - CIC Neurosciences, Razi Hospital, La Manouba, Tunisia
| | - Riadh Gouider
- Department of Neurology - LR 18 SP03 - CIC Neurosciences, Razi Hospital, La Manouba, Tunisia/Faculty of Medicine, UTM, Tunis, Tunisia
| | - Tunde Csepany
- Department of Neurology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Bertrand Bourre
- Centre hospitalier universitaire Rouen Normandie, Hôpital Charles-Nicolle, Departement of Neurology, Rouen, France
| | - Abdullatif Al Khedr
- Amiens University Hospital, Department of Neurology, place Victor Pauchet, Amiens, France
| | - Olivier Casez
- Department of Neurology, Centre hospitalier universitaire Grenoble-Alpes, La Tronche/Grenoble, France
| | - Philippe Cabre
- Centre hospitalier universitaire de Martinique, Department of Neurology, Hôpital Pierre Zobda-Quitman, Fort-de-France, France
| | - Alexis Montcuquet
- Centre hospitalier universitaire Limoges, Department of Neurology, Hôpital Dupuytren, Limoges, France
| | - Abir Wahab
- Assistance publique des hôpitaux de Paris, Department of Neurology, Hôpital Henri Mondor, Créteil, France
| | - Jean-Philippe Camdessanche
- Centre hospitalier universitaire de Saint-Étienne, Department of Neurology, Hôpital Nord, Saint-Étienne, France
| | - Aude Maurousset
- Centre hospitalier régional universitaire de Tours, Department of Neurology, Hôpital Bretonneau, CRCSEP, Tours, France
| | - Ivania Patry
- Department of Neurology, Centre Hospitalier Sud Francilien, Corbeil Essonnes, France
| | - Karolina Hankiewicz
- Department of Neurology, Hôpital Pierre Delafontaine, Centre Hospitalier de Saint-Denis, Saint-Denis, France
| | - Corinne Pottier
- Department of Neurology, Centre hospitalier de Pontoise, Hôpital René Dubos, Pontoise, France
| | - Nicolas Maubeuge
- CHU La Milétrie, Hôpital Jean Bernard, Department of Neurology, Poitiers, France
| | - Céline Labeyrie
- Assistance publique des hôpitaux de Paris, Hôpital Bicêtre, Department of Neurology, Le Kremlin Bicêtre, France
| | - Chantal Nifle
- Hopital Andre Mignot, Department of Neurology, 177 Rue de Versailles, Le Chesnay, France
| | - Alasdair Coles
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Charles B Malpas
- CORe, Department of Medicine, University of Melbourne, Melbourne, VIC, Australia/Melbourne MS Centre, Department of Neurology, Royal Melbourne Hospital, Melbourne, VIC, Australia
| | - Sandra Vukusic
- Service de neurologie, sclérose en plaques, pathologies de la myéline et neuro-inflammation, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon/Bron, France/Centre des Neurosciences de Lyon, Observatoire Français de la Sclérose en Plaques, INSERM 1028 et CNRS UMR5292, Lyon, France/Université Claude Bernard Lyon 1, Faculté de médecine Lyon Est, Lyon, France
| | - Helmut Butzkueven
- Central Clinical School, Monash University, Melbourne, Australia/Department of Neurology, The Alfred Hospital, Melbourne, VIC, Australia/Department of Neurology, Box Hill Hospital, Monash University, Melbourne, VIC, Australia
| | - Tomas Kalincik
- CORe, Department of Medicine, University of Melbourne, Melbourne, VIC, Australia/Melbourne MS Centre, Department of Neurology, Royal Melbourne Hospital, Melbourne, VIC, Australia
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Mathais S, Moisset X, Pereira B, Taithe F, Ciron J, Labauge P, Dulau C, Laplaud D, De Seze J, Pelletier J, Berger E, Lebrun-Frenay C, Castelnovo G, Edan G, Defer G, Vermersch P, Bourre B, Camdessanche JP, Magy L, Guennoc AM, Mathey G, Moreau T, Gout O, Heinzlef O, Maillart E, Vukusic S, Clavelou P. Relapses in Patients Treated with High-Dose Biotin for Progressive Multiple Sclerosis. Neurotherapeutics 2021; 18:378-386. [PMID: 32964402 PMCID: PMC8116391 DOI: 10.1007/s13311-020-00926-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/31/2020] [Indexed: 12/26/2022] Open
Abstract
High-dose biotin (HDB) is a therapy used in non-active progressive multiple sclerosis (PMS). Several reports have suggested that HDB treatment may be associated with an increased risk of relapse. We aimed to determine whether HDB increases the risk of clinical relapse in PMS and describe the characteristics of the patients who experience it. We conducted a French, multicenter, retrospective study, comparing a group of PMS patients treated with HDB to a matched control group. Poisson regression was applied to model the specific statistical distribution of the annualized relapse rate (ARR). A propensity score (PS), based on the inverse probability of treatment weighting (IPTW), was used to adjust for indication bias and included the following variables: gender, primary PMS or not, age, EDSS, time since the last relapse, and co-prescription of a DMT. Two thousand six hundred twenty-eight patients treated with HDB and 654 controls were analyzed with a follow-up of 17 ± 8 months. Among them, 148 validated relapses were observed in the group treated with biotin and 38 in the control group (p = 0.62). After adjustment based on the PS, the ARR was 0.044 ± 0.23 for the biotin-treated group and 0.028 ± 0.16 for the control group (p = 0.18). The more relapses there were before biotin, the higher the risk of relapse during treatment, independently from the use of HDB. While the number of relapses reported for patients with no previous inflammatory activity receiving biotin has gradually increased, the present retrospective study is adequately powered to exclude an elevated risk of relapse for patients with PMS treated with HDB.
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Affiliation(s)
- Sophie Mathais
- CHU de Clermont-Ferrand, F-63000, Clermont-Ferrand, France
| | - Xavier Moisset
- CHU de Clermont-Ferrand, F-63000, Clermont-Ferrand, France.
- Université Clermont Auvergne, INSERM, Neuro-Dol, F-63000, Clermont-Ferrand, France.
| | - Bruno Pereira
- CHU de Clermont-Ferrand, F-63000, Clermont-Ferrand, France
| | | | - Jonathan Ciron
- Department of Neurology, CHU de Toulouse, CRC-SEP, F-31000, Toulouse, France
| | - Pierre Labauge
- CHU de Montpellier, MS Unit, F-34295, Montpellier Cedex 5, France
- University of Montpellier (MUSE), F-34000, Montpellier, France
| | - Cécile Dulau
- University Bordeaux, F-33000, Bordeaux, France
- INSERM U1215, Neurocentre Magendie, F-33000, Bordeaux, France
- CHU de Bordeaux, CIC Bordeaux CIC1401, F-33000, Bordeaux, France
| | - David Laplaud
- Service de Neurologie & CIC015 INSERM, CHU de Nantes, F-44093, Nantes, France
- INSERM CR1064, F-44000, Nantes, France
| | - Jérôme De Seze
- Department of Neurology and Clinical Investigation Center, CHU de Strasbourg, INSERM 1434, F-67000, Strasbourg, France
| | - Jean Pelletier
- APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, Marseille, France
| | - Eric Berger
- Department of Neurology, CHU de Besançon, F-25000, Besançon, France
| | - Christine Lebrun-Frenay
- CHU de Nice, F-06000, Nice, France
- CRCSEP Nice, Pasteur2 Hospital, UR2CA, Nice Cote d'Azur University, F-06000, Nice, France
| | | | - Gilles Edan
- CHU Pontchaillou, CIC1414 INSERM, F-35000, Rennes, France
| | - Gilles Defer
- Department of Neurology, CHU de la Côte de Nacre, F-14000, Caen, France
| | - Patrick Vermersch
- Univ. Lille, INSERM UMR-S1172, CHU Lille, FHU Imminent, F-59000, Lille, France
| | - Bertrand Bourre
- CHU de Rouen / Rouen University Hospital, F-76000, Rouen, France
| | - Jean-Philippe Camdessanche
- Department of Neurology, CHU de Saint-Étienne, Hôpital Nord, CHU de Saint-Étienne, Hôpital Nord, F-42055, Saint-Étienne Cedex 2, France
| | - Laurent Magy
- Department of Neurology, CHU de Limoges, Hôpital Dupuytren, F-87042, Limoges, France
| | - Anne-Marie Guennoc
- CRC SEP and Department of Neurology, CHU de Tours, Hôpital Bretonneau, F-37000, Tours, France
| | - Guillaume Mathey
- Department of Neurology, Nancy University Hospital, F-54035, Nancy, France
- Université de Lorraine, APEMAC, F-54500 Vandoeuvre-Lès-, 4360, Nancy, EA, France
| | - Thibault Moreau
- Department of Neurology, CHU de Dijon, EA4184, F-21000, Dijon, France
| | - Olivier Gout
- Department of Neurology, Fondation Rotschild, F-75000, Paris, France
| | - Olivier Heinzlef
- Departement of Neurology, Hôpital de Poissy, F-78300, Poissy, France
| | - Elisabeth Maillart
- Department of Neurology, APHP, Pitié-Salpêtrière Hospital, F-75013, Paris, France
| | - Sandra Vukusic
- Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-Inflammation, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, 69677, Lyon/Bron, France
- Centre des Neurosciences de Lyon, Observatoire Français de la Sclérose en Plaques, INSERM 1028 et CNRS UMR5292, 69003, Lyon, France
- Faculté de Médecine Lyon Est, Université Claude Bernard Lyon 1, F-69000, Lyon, France
| | - Pierre Clavelou
- CHU de Clermont-Ferrand, F-63000, Clermont-Ferrand, France
- Université Clermont Auvergne, INSERM, Neuro-Dol, F-63000, Clermont-Ferrand, France
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25
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Vukusic S, Ionescu I, Cornu C, Bossard N, Durand-Dubief F, Cotton F, Durelli L, Marignier R, Gignoux L, Laplaud DA, Moreau T, Clavelou P, De Seze J, Debouverie M, Brassat D, Pelletier J, Lebrun-Frenay C, Le Page E, Castelnovo G, Berger E, Hautecoeur P, Heinzlef O, Trojano M, Patti F, Baulieu EE, Remontet L, El-Etr M. Oral nomegestrol acetate and transdermal 17-beta-estradiol for preventing post-partum relapses in multiple sclerosis: The POPARTMUS study. Mult Scler 2020; 27:1458-1463. [DOI: 10.1177/1352458520978218] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Sex steroids could explain the course of multiple sclerosis (MS) in pregnancy. Objective: To compare the annualized relapse rate (ARR) 12 weeks post-partum in women treated with nomegestrol acetate (NOMAc) and 17-beta-estradiol (E2) versus placebo. Methods: POPARTMUS is a randomized, proof-of-concept trial in women with MS, receiving oral NOMAc 10 mg/day and transdermal estradiol 75 µg/week, or placebo. Results: Recruitment was stopped prematurely due to slow inclusions ( n = 202). No treatment effect was observed on ARR after 12 weeks (sex steroids = 0.90 (0.58–1.39), placebo = 0.97 (0.63–1.50) ( p = 0.79)). Conclusion: POPARTMUS failed showing efficacy of a NOMAc–E2 combination in preventing post-partum relapses.
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Affiliation(s)
- Sandra Vukusic
- Service de neurologie, sclérose en plaques, pathologies de la myéline et neuro-inflammation et Fondation Eugène Devic EDMUS pour la Sclérose en Plaques, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon-Bron, France/Centre des Neurosciences de Lyon, INSERM 1028 et CNRS UMR5292, Observatoire Français de la Sclérose en Plaques, Lyon, France/Université Claude Bernard Lyon 1, Villeurbanne, France
| | - Iuliana Ionescu
- Service de neurologie, sclérose en plaques, pathologies de la myéline et neuro-inflammation et Fondation Eugène Devic EDMUS pour la Sclérose en Plaques, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon-Bron, France
| | - Catherine Cornu
- Centre d’Investigation Clinique INSERM1407, Hospices Civils de Lyon, Lyon, France/Service de Pharmaco-toxicologie, Lyon, France/UMR5558, Claude Bernard University, Lyon, France
| | - Nadine Bossard
- Hospices Civils de Lyon, Pôle Santé Publique, Service de Biostatistique–Bioinformatique, Lyon, France/Université de Lyon, Université Lyon 1, CNRS, UMR 5558, Laboratoire de Biométrie et Biologie Évolutive, Équipe Biostatistique-Santé, Villeurbanne, France
| | - Françoise Durand-Dubief
- Service de neurologie, sclérose en plaques, pathologies de la myéline et neuro-inflammation et Fondation Eugène Devic EDMUS pour la Sclérose en Plaques, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon-Bron, France/CREATIS, UMR 5220 CNRS & U1044 Inserm, Université Claude Bernard Lyon1, Université de Lyon, Villeurbanne, France
| | - François Cotton
- CREATIS, UMR 5220 CNRS & U1044 Inserm, Université Claude Bernard Lyon1, Université de Lyon, Villeurbanne, France/Service de Radiologie, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, Lyon, France
| | - Luca Durelli
- Clinical and Biological Sciences Department, University of Torino, Turin, Italy
| | - Romain Marignier
- Service de neurologie, sclérose en plaques, pathologies de la myéline et neuro-inflammation et Fondation Eugène Devic EDMUS pour la Sclérose en Plaques, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon-Bron, France/Université Claude Bernard Lyon 1, Villeurbanne, France/Centre des Neurosciences de Lyon, INSERM 1028 et CNRS UMR5292, Fluid team, Lyon, France
| | - Laurence Gignoux
- Service de neurologie, sclérose en plaques, pathologies de la myéline et neuro-inflammation et Fondation Eugène Devic EDMUS pour la Sclérose en Plaques, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon-Bron, France
| | - David-Axel Laplaud
- CHU de Nantes, Service de Neurologie & CIC015 INSERM, Nantes, France, INSERM CR1064, Nantes, France
| | - Thibault Moreau
- Department of Neurology, EA4184, University Hospital of Dijon, Dijon, France
| | - Pierre Clavelou
- Service de Neurologie, CHU Clermont-Ferrand, Clermont-Ferrand, France/Inserm U1107, Clermont Université, Université d’Auvergne, Neuro-Dol, Clermont-Ferrand, France
| | - Jérôme De Seze
- Department of Neurology and Clinical Investigation Center, CHU de Strasbourg, INSERM, Strasbourg, France
| | - Marc Debouverie
- EA 4360 Apemac, Lorraine University, Nancy, France/Department of Neurology, Nancy University Hospital, Nancy, France
| | - David Brassat
- Pôle Neurosciences, CHU Toulouse Purpan, Toulouse, France/INSERM U1043-CNRS UMR 5282, Université Toulouse III, Toulouse, France
| | - Jean Pelletier
- Aix Marseille Univ, APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, Marseille, France
| | | | - Emmanuelle Le Page
- Clinical Neuroscience Centre, CIC-P 1414 INSERM, Rennes University Hospital, Rennes, France
| | | | - Eric Berger
- Department of Neurology, CHU Besançon, Besançon, France
| | - Patrick Hautecoeur
- Service de Neurologie, Groupe Hospitalier de l’Institut Catholique de Lille, Lille Cedex, France
| | - Olivier Heinzlef
- Neurology Department, Hospital of Poissy-St-Germain en Laye, Paris, France
| | - Maria Trojano
- Department of Basic Medical Sciences, Neurosciences and Sense Organs, University of Bari, Bari, Italy
| | - Francesco Patti
- Department of Medical and Surgical Sciences, and Advanced Technologies, GF Ingrassia, Multiple Sclerosis Center, University of Catania, Catania, Italy
| | | | - Laurent Remontet
- Hospices Civils de Lyon, Pôle Santé Publique, Service de Biostatistique–Bioinformatique, Lyon, France/Université de Lyon, Université Lyon 1, CNRS, UMR 5558, Laboratoire de Biométrie et Biologie Évolutive, Équipe Biostatistique-Santé, Villeurbanne, France
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26
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Heinzlef O, Molinier G, van Hille B, Radoszycki L, Dourgnon P, Longin J. Economic Burden of the Out-of-Pocket Expenses for People with Multiple Sclerosis in France. Pharmacoecon Open 2020; 4:593-603. [PMID: 32043229 PMCID: PMC7688762 DOI: 10.1007/s41669-020-00199-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
BACKGROUND People with chronic diseases in France frequently incur out-of-pocket expenses (OOPE) related to their medical care. OBJECTIVE The objective of this study was to evaluate OOPE incurred by people with multiple sclerosis (MS) with respect to direct non-medical and medical expenditure. METHODS Data were collected through a web-based survey using an online patient community platform (Carenity). The survey questionnaire contained 87 questions (numerical response or Likert scale) and took less than 30 min to complete. Participants rated their disability on a ten-point scale. RESULTS In total, 376 patients, with a mean age of 48.3 years (95% confidence interval [CI] 47.2-49.5), participated in the survey. Participants estimated that they spent an average of €127 each month on OOPE for their MS, principally on physician consultations (mean annual expenditure of €75 by 183 participants), non-physician consultations (€358 by 135 participants) and non-prescription medication (mean expense of €67 per pharmacy visit by 234 patients). In total, 77% of participants who needed adaptations to their home or vehicle because of their MS contributed to the cost. No obvious relationship between OOPE and self-rated disability was observed. A total of 61.4% of participants reported that they had to choose between spending money on MS care or on their family and social life. CONCLUSIONS Most patients with MS incurred significant OOPE linked to consultations, non-prescription medications or home equipment and medical equipment. These outlays could lead to dilemmas when choosing between spending on MS care or family or social life.
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Affiliation(s)
- Olivier Heinzlef
- Neurology Department, Hôpital De Poissy, 10 Rue Du Champ Gaillard, 78300, Poissy, France
- Ligue Française contre la Sclérose En Plaques (LFSEP), 40 rue Duranton, 75015, Paris, France
| | - Guillaume Molinier
- Ligue Française contre la Sclérose En Plaques (LFSEP), 40 rue Duranton, 75015, Paris, France
| | - Benoît van Hille
- Medical Affairs Department, Merck S.A.S., 37 rue Saint Romain, 69008, Lyon, France.
| | | | - Paul Dourgnon
- Institut de Recherche et Documentation en Economie de la Santé (IRDES), 10 rue Vauvenargues, 75018, Paris, France
| | - Juliette Longin
- Medical Affairs Department, Merck S.A.S., 37 rue Saint Romain, 69008, Lyon, France
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27
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Vukusic S, Rollot F, Casey R, Pique J, Marignier R, Mathey G, Edan G, Brassat D, Ruet A, De Sèze J, Maillart E, Zéphir H, Labauge P, Derache N, Lebrun-Frenay C, Moreau T, Wiertlewski S, Berger E, Moisset X, Rico-Lamy A, Stankoff B, Bensa C, Thouvenot E, Heinzlef O, Al-Khedr A, Bourre B, Vaillant M, Cabre P, Montcuquet A, Wahab A, Camdessanché JP, Tourbah A, Guennoc AM, Hankiewicz K, Patry I, Nifle C, Maubeuge N, Labeyrie C, Vermersch P, Laplaud DA. Progressive Multifocal Leukoencephalopathy Incidence and Risk Stratification Among Natalizumab Users in France. JAMA Neurol 2020; 77:94-102. [PMID: 31479149 DOI: 10.1001/jamaneurol.2019.2670] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Importance Risk of developing progressive multifocal leukoencephalopathy (PML) is the major barrier to using natalizumab for patients with multiple sclerosis (MS). To date, the association of risk stratification with PML incidence has not been evaluated. Objective To describe the temporal evolution of PML incidence in France before and after introduction of risk minimization recommendations in 2013. Design, Setting, and Participants This observational study used data in the MS registry OFSEP (Observatoire Français de la Sclérose en Plaques) collected between April 15, 2007, and December 31, 2016, by participating MS expert centers and MS-dedicated networks of neurologists in France. Patients with an MS diagnosis according to current criteria, regardless of age, were eligible, and those exposed to at least 1 natalizumab infusion (n = 6318) were included in the at-risk population. A questionnaire was sent to all centers, asking for a description of their practice regarding PML risk stratification. Data were analyzed in July 2018. Exposures Time from the first natalizumab infusion to the occurrence of PML, natalizumab discontinuation plus 6 months, or the last clinical evaluation. Main Outcomes and Measures Incidence was the number of PML cases reported relative to the person-years exposed to natalizumab. A Poisson regression model for the 2007 to 2016 period estimated the annual variation in incidence and incidence rate ratio (IRR), adjusted for sex and age at treatment initiation and stratified by period (2007-2013 and 2013-2016). Results In total, 6318 patients were exposed to natalizumab during the study period, of whom 4682 (74.1%) were female, with a mean (SD [range]) age at MS onset of 28.5 (9.1 [1.1-72.4]) years; 45 confirmed incident cases of PML were diagnosed in 22 414 person-years of exposure. The crude incidence rate for the whole 2007 to 2016 period was 2.00 (95% CI, 1.46-2.69) per 1000 patient-years. Incidence significantly increased by 45.3% (IRR, 1.45; 95% CI, 1.15-1.83; P = .001) each year before 2013 and decreased by 23.0% (IRR, 0.77; 95% CI, 0.61-0.97; P = .03) each year from 2013 to 2016. Conclusions and Relevance The results of this study suggest, for the first time, a decrease in natalizumab-associated PML incidence since 2013 in France that may be associated with a generalized use of John Cunningham virus serologic test results; this finding appears to support the continuation and reinforcement of educational activities and risk-minimization strategies in the management of disease-modifying therapies for multiple sclerosis.
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Affiliation(s)
- Sandra Vukusic
- Université Claude Bernard Lyon 1, Faculté de Médecine Lyon Est, Lyon, France.,Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-Inflammation, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon/Bron, France.,Centre des Neurosciences de Lyon, Observatoire Français de la Sclérose en Plaques, INSERM 1028 et CNRS UMR5292, Lyon, France
| | - Fabien Rollot
- Université Claude Bernard Lyon 1, Faculté de Médecine Lyon Est, Lyon, France.,Université Claude Bernard Lyon 1, Lyon, France.,Hospices Civils de Lyon, Lyon, France.,EDMUS Foundation, Lyon/Bron, France
| | - Romain Casey
- Université Claude Bernard Lyon 1, Faculté de Médecine Lyon Est, Lyon, France.,Université Claude Bernard Lyon 1, Lyon, France.,Hospices Civils de Lyon, Lyon, France.,EDMUS Foundation, Lyon/Bron, France
| | - Julie Pique
- Université Claude Bernard Lyon 1, Faculté de Médecine Lyon Est, Lyon, France.,Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-Inflammation, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon/Bron, France
| | - Romain Marignier
- Université Claude Bernard Lyon 1, Faculté de Médecine Lyon Est, Lyon, France.,Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-Inflammation, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon/Bron, France.,Centre des Neurosciences de Lyon, FLUID Team, INSERM 1028 et CNRS UMR5292, Lyon, France
| | - Guillaume Mathey
- Department of Neurology, Nancy University Hospital, Nancy, France.,Université de Lorraine, EA 4360 APEMAC, Vandoeuvre-Lès-Nancy, Nancy, France
| | - Gilles Edan
- CHU Pontchaillou, CIC1414 INSERM, Rennes, France
| | - David Brassat
- Department of Neurology, CHU de Toulouse, Toulouse, France
| | - Aurélie Ruet
- University of Bordeaux, Bordeaux, France.,INSERM U1215, Neurocentre Magendie, Bordeaux, France.,CHU de Bordeaux, CIC Bordeaux CIC1401, Bordeaux, France
| | - Jérôme De Sèze
- Clinical Investigation Center, Department of Neurology, CHU de Strasbourg, INSERM 1434, Strasbourg, France
| | - Elisabeth Maillart
- Department of Neurology, Assistance Publique des Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Paris, France
| | - Hélène Zéphir
- LIRIC (Lille Inflammation Research International Center), University of Lille, CHU de Lille, INSERM UMR995, Lille, France
| | - Pierre Labauge
- CHU de Montpellier, MS Unit, Montpellier, France.,University of Montpellier (MUSE), Montpellier, France
| | | | | | - Thibault Moreau
- Department of Neurology, CHU de Dijon, EA4184, Dijon, France
| | - Sandrine Wiertlewski
- CHU de Nantes, Service de Neurologie, CIC015 INSERM, Nantes, France.,INSERM CR1064, Nantes, France
| | - Eric Berger
- Department of Neurology, CHU de Besançon, Besançon, France
| | - Xavier Moisset
- Department of Neurology, Neuro-Dol, CHU Clermont-Ferrand, Université Clermont Auvergne, INSERM U1107, Clermont-Ferrand, France
| | - Audrey Rico-Lamy
- Pôle de Neurosciences Cliniques, Service de Neurologie, APHM, Hôpital de la Timone, Marseille, France.,CRMBM UMR 7339, CNRS, Aix-Marseille Université, Marseille, France
| | - Bruno Stankoff
- Brain and Spine Institute, Sorbonne Universités, UPMC Paris 06, ICM, Hôpital de la Pitié Salpêtrière, INSERM UMR S 1127, CNRS UMR 7225, Paris, France.,Department of Neurology, AP-HP, Saint-Antoine Hospital, Paris, France
| | - Caroline Bensa
- Department of Neurology, Fondation Rothschild, Paris, France
| | - Eric Thouvenot
- Department of Neurology, CHU de Nîmes, Nîmes, France.,Institut de Génomique Fonctionnelle, UMR5203, INSERM 1191, Université de Montpellier, Montpellier, France
| | | | | | | | | | - Philippe Cabre
- Department of Neurology, CHU de la Martinique, Fort-de-France, France
| | - Alexis Montcuquet
- Department of Neurology, CHU de Limoges, Hôpital Dupuytren, Limoges, France
| | - Abir Wahab
- Department of Neurology, Assistance Publique des Hôpitaux de Paris, Hôpital Henri Mondor, Université Paris Est, Créteil, France
| | | | - Ayman Tourbah
- Department of Neurology, CHU de Reims, Faculté de Médecine de Reims, URCA, Reims, France.,LPN EA 2027 Université Paris 8, Saint-Denis, France
| | - Anne-Marie Guennoc
- Department of Neurology, CHU de Tours, Hôpital Bretonneau, CRC SEP, Tours, France
| | - Karolina Hankiewicz
- Department of Neurology, Hôpital Pierre Delafontaine, Centre Hospitalier de Saint-Denis, Saint-Denis, France
| | - Ivania Patry
- Department of Neurology, Hôpital Sud Francilien, Corbeil-Essonnes, France
| | - Chantal Nifle
- Department of Neurology, Centre Hospitalier de Versailles, Le Chesnay, France
| | - Nicolas Maubeuge
- Department of Neurology, CHU de Poitiers, Hôpital La Milétrie, Poitiers, France
| | - Céline Labeyrie
- Department of Neurology, CHU de Bicêtre, Le Kremlin-Bicêtre, France
| | - Patrick Vermersch
- LIRIC (Lille Inflammation Research International Center), University of Lille, CHU de Lille, INSERM UMR995, Lille, France
| | - David-Axel Laplaud
- CHU de Nantes, Service de Neurologie, CIC015 INSERM, Nantes, France.,INSERM CR1064, Nantes, France
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Roos I, Leray E, Frascoli F, Casey R, Brown JWL, Horakova D, Havrdova EK, Trojano M, Patti F, Izquierdo G, Eichau S, Onofrj M, Lugaresi A, Prat A, Girard M, Grammond P, Sola P, Ferraro D, Ozakbas S, Bergamaschi R, Sá MJ, Cartechini E, Boz C, Granella F, Hupperts R, Terzi M, Lechner-Scott J, Spitaleri D, Van Pesch V, Soysal A, Olascoaga J, Prevost J, Aguera-Morales E, Slee M, Csepany T, Turkoglu R, Sidhom Y, Gouider R, Van Wijmeersch B, McCombe P, Macdonell R, Coles A, Malpas CB, Butzkueven H, Vukusic S, Kalincik T, Duquette P, Grand'Maison F, Iuliano G, Ramo-Tello C, Solaro C, Cabrera-Gomez JA, Rio ME, Bolaños RF, Shaygannejad V, Oreja-Guevara C, Sanchez-Menoyo JL, Petersen T, Altintas A, Barnett M, Flechter S, Fragoso Y, Amato MP, Moore F, Ampapa R, Verheul F, Hodgkinson S, Cristiano E, Yamout B, Laureys G, Dominguez JA, Zwanikken C, Deri N, Dobos E, Vrech C, Butler E, Rozsa C, Petkovska-Boskova T, Karabudak R, Rajda C, Alkhaboori J, Saladino ML, Shaw C, Shuey N, Vucic S, Sempere AP, Campbell J, Piroska I, Taylor B, van der Walt A, Kappos L, Roullet E, Gray O, Simo M, Sirbu CA, Brochet B, Cotton F, De Sèze J, Dion A, Douek P, Guillemin F, Laplaud D, Lebrun-Frenay C, Moreau T, Olaiz J, Pelletier J, Rigaud-Bully C, Stankoff B, Marignier R, Debouverie M, Edan G, Ciron J, Ruet A, Collongues N, Lubetzki C, Vermersch P, Labauge P, Defer G, Cohen M, Fromont A, Wiertlewsky S, Berger E, Clavelou P, Audoin B, Giannesini C, Gout O, Thouvenot E, Heinzlef O, Al-Khedr A, Bourre B, Casez O, Cabre P, Montcuquet A, Créange A, Camdessanché JP, Faure J, Maurousset A, Patry I, Hankiewicz K, Pottier C, Maubeuge N, Labeyrie C, Nifle C. Delay from treatment start to full effect of immunotherapies for multiple sclerosis. Brain 2020; 143:2742-2756. [DOI: 10.1093/brain/awaa231] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2020] [Revised: 04/30/2020] [Accepted: 06/01/2020] [Indexed: 01/21/2023] Open
Abstract
Abstract
In multiple sclerosis, treatment start or switch is prompted by evidence of disease activity. Whilst immunomodulatory therapies reduce disease activity, the time required to attain maximal effect is unclear. In this study we aimed to develop a method that allows identification of the time to manifest fully and clinically the effect of multiple sclerosis treatments (‘therapeutic lag’) on clinical disease activity represented by relapses and progression-of-disability events. Data from two multiple sclerosis registries, MSBase (multinational) and OFSEP (French), were used. Patients diagnosed with multiple sclerosis, minimum 1-year exposure to treatment, minimum 3-year pretreatment follow-up and yearly review were included in the analysis. For analysis of disability progression, all events in the subsequent 5-year period were included. Density curves, representing incidence of relapses and 6-month confirmed progression events, were separately constructed for each sufficiently represented therapy. Monte Carlo simulations were performed to identify the first local minimum of the first derivative after treatment start; this point represented the point of stabilization of treatment effect, after the maximum treatment effect was observed. The method was developed in a discovery cohort (MSBase), and externally validated in a separate, non-overlapping cohort (OFSEP). A merged MSBase-OFSEP cohort was used for all subsequent analyses. Annualized relapse rates were compared in the time before treatment start and after the stabilization of treatment effect following commencement of each therapy. We identified 11 180 eligible treatment epochs for analysis of relapses and 4088 treatment epochs for disability progression. External validation was performed in four therapies, with no significant difference in the bootstrapped mean differences in therapeutic lag duration between registries. The duration of therapeutic lag for relapses was calculated for 10 therapies and ranged between 12 and 30 weeks. The duration of therapeutic lag for disability progression was calculated for seven therapies and ranged between 30 and 70 weeks. Significant differences in the pre- versus post-treatment annualized relapse rate were present for all therapies apart from intramuscular interferon beta-1a. In conclusion we have developed, and externally validated, a method to objectively quantify the duration of therapeutic lag on relapses and disability progression in different therapies in patients more than 3 years from multiple sclerosis onset. Objectively defined periods of expected therapeutic lag allows insights into the evaluation of treatment response in randomized clinical trials and may guide clinical decision-making in patients who experience early on-treatment disease activity. This method will subsequently be applied in studies that evaluate the effect of patient and disease characteristics on therapeutic lag.
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Affiliation(s)
- Izanne Roos
- CORe, Department of Medicine, University of Melbourne, Melbourne, 3050, Australia
- Melbourne MS Centre, Department of Neurology, Royal Melbourne Hospital, Melbourne, 3050, Australia
| | - Emmanuelle Leray
- Rennes University, EHESP, REPERES (Pharmaco-epidemiology and Health services research) - EA 7449, Rennes, France
| | - Federico Frascoli
- Faculty of Science, Engineering and Technology, School of Science, Department of Mathematics, Swinburne University of Technology, Melbourne, 3122, Australia
| | - Romain Casey
- University of Lyon, Claude Bernard University Lyon 1, F-69000 Lyon, France
- Hospices Civils de Lyon, Service de Neurologie, sclérose en plaques, pathologies de la myéline et neuro-inflammation, F-69677 Bron, France
- Observatoire Français de la Sclérose en Plaques, Lyon Neuroscience Research Centre, INSERM 1028 et CNRS UMR 5292, F-69003 Lyon, France
- EUGENE DEVIC EDMUS Foundation against multiple sclerosis, state-approved foundation, F-69677 Bron, France
| | - J William L Brown
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, CB2 0QQ, UK
| | - Dana Horakova
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University in Prague and General University Hospital, Prague, 12808, Czech Republic
| | - Eva K Havrdova
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University in Prague and General University Hospital, Prague, 12808, Czech Republic
| | - Maria Trojano
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari, Bari, 70122, Italy
| | - Francesco Patti
- GF Ingrassia Department, University of Catania, Catania, 95123, Italy
- Policlinico G Rodolico, 95123, Catania, Italy
| | | | - Sara Eichau
- Hospital Universitario Virgen Macarena, Sevilla, 41009, Spain
| | - Marco Onofrj
- Department of Neuroscience, Imaging, and Clinical Sciences, University G. d’Annunzio, 66100 Chieti, Italy
| | - Alessandra Lugaresi
- IRCCS Istituto delle Scienze Neurologiche di Bologna, UOSI Riabilitazione Sclerosi Multipla, Bologna, 40139, Italy
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Alexandre Prat
- CHUM MS Center and Universite de Montreal, Montreal, H2L 4M1, Canada
| | - Marc Girard
- CHUM MS Center and Universite de Montreal, Montreal, H2L 4M1, Canada
| | | | - Patrizia Sola
- Department of Neuroscience, Azienda Ospedaliera Universitaria, Modena, 41100, Italy
| | - Diana Ferraro
- Department of Neuroscience, Azienda Ospedaliera Universitaria, Modena, 41100, Italy
| | | | | | - Maria José Sá
- Centro Hospitalar Universitário de São João and Universidade Fernando Pessoa, 4249-004 Porto, Portugal
| | - Elisabetta Cartechini
- UOC Neurologia, Azienda Sanitaria Unica Regionale Marche - AV3, Macerata, 62100, Italy
| | - Cavit Boz
- KTU Medical Faculty Farabi Hospital, Karadeniz Technical University, Trabzon, 61080, Turkey
| | - Franco Granella
- Department of Medicine and Surgery, University of Parma, Parma, 43126, Italy
- Department of General Medicine, Parma University Hospital, Parma, 43126, Italy
| | - Raymond Hupperts
- Zuyderland Ziekenhuis, Sittard, Sittard, 6131 BK, The Netherlands
| | - Murat Terzi
- Medical Faculty, 19 Mayis University, Kurupelit, Samsun, 55160, Turkey
| | - Jeannette Lechner-Scott
- School of Medicine and Public Health, University Newcastle, 2308, Australia
- Department of Neurology, John Hunter Hospital, Hunter New England Health, Newcastle, 2305, Australia
| | - Daniele Spitaleri
- Azienda Ospedaliera di Rilievo Nazionale San Giuseppe Moscati Avellino, Contrada Amoretta, Avellino, 83100, Italy
| | | | - Aysun Soysal
- Bakirkoy Education and Research Hospital for Psychiatric and Neurological Diseases, Istanbul, 34142, Turkey
| | - Javier Olascoaga
- Instituto de Investigación Sanitaria Biodonostia, Hospital Universitario Donostia, San San Sebastián, Spain, 20014, Spain
| | | | | | - Mark Slee
- Flinders University, Adelaide, 5042, Australia
| | - Tunde Csepany
- Department of Neurology, Faculty of Medicine, University of Debrecen, Debrecen, 4032, Hungary
| | - Recai Turkoglu
- Haydarpasa Numune Training and Research Hospital, Selimiye Mahallesi, Istanbul, 34668, Turkey
| | - Youssef Sidhom
- Department of Neurology, Razi Hospital, 2010, Tunis, Manouba, Tunisia
| | - Riadh Gouider
- Department of Neurology, Razi Hospital, 2010, Tunis, Manouba, Tunisia
| | - Bart Van Wijmeersch
- Rehabilitation and MS-Centre Overpelt and Hasselt University, Hasselt, 3900, Belgium
| | - Pamela McCombe
- University of Queensland, St Lucia, 4072, Australia
- Royal Brisbane and Women's Hospital, Herston, 4029, Australia
| | - Richard Macdonell
- Department of Neurology, Austin Health, Heidlberg, 3084, Australia
- Faculty of Medicine and Dental Health Sciences, University of Melbourne, Melbourne, 3050, Australia
| | - Alasdair Coles
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, CB2 0QQ, UK
| | - Charles B Malpas
- CORe, Department of Medicine, University of Melbourne, Melbourne, 3050, Australia
- Melbourne MS Centre, Department of Neurology, Royal Melbourne Hospital, Melbourne, 3050, Australia
| | - Helmut Butzkueven
- Central Clinical School, Monash University, Melbourne, 3004, Australia
- Department of Neurology, The Alfred Hospital, Melbourne, 3004, Australia
- Department of Neurology, Box Hill Hospital, Monash University, Melbourne, 3128, Australia
| | - Sandra Vukusic
- University of Lyon, Claude Bernard University Lyon 1, F-69000 Lyon, France
- Hospices Civils de Lyon, Service de Neurologie, sclérose en plaques, pathologies de la myéline et neuro-inflammation, F-69677 Bron, France
- Observatoire Français de la Sclérose en Plaques, Lyon Neuroscience Research Centre, INSERM 1028 et CNRS UMR 5292, F-69003 Lyon, France
| | - Tomas Kalincik
- CORe, Department of Medicine, University of Melbourne, Melbourne, 3050, Australia
- Melbourne MS Centre, Department of Neurology, Royal Melbourne Hospital, Melbourne, 3050, Australia
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Bosco-Levy P, Blin P, Lignot-Maleyran S, Lassalle R, Abouelfath A, Diez-Andreu P, Debouverie M, Brochet B, Louapre C, Heinzlef O, Maillart E, Moore N, Droz-Perroteau C. Validation d’un algorithme complexe d’identification de poussées dans la sclérose en plaque à partir du Système national des données de santé. Rev Epidemiol Sante Publique 2020. [DOI: 10.1016/j.respe.2020.04.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Louapre C, Collongues N, Stankoff B, Giannesini C, Papeix C, Bensa C, Deschamps R, Créange A, Wahab A, Pelletier J, Heinzlef O, Labauge P, Guilloton L, Ahle G, Goudot M, Bigaut K, Laplaud DA, Vukusic S, Lubetzki C, De Sèze J. Clinical Characteristics and Outcomes in Patients With Coronavirus Disease 2019 and Multiple Sclerosis. JAMA Neurol 2020; 77:1079-1088. [PMID: 32589189 PMCID: PMC7320356 DOI: 10.1001/jamaneurol.2020.2581] [Citation(s) in RCA: 313] [Impact Index Per Article: 78.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Accepted: 05/28/2020] [Indexed: 12/18/2022]
Abstract
Importance Risk factors associated with the severity of coronavirus disease 2019 (COVID-19) in patients with multiple sclerosis (MS) are unknown. Disease-modifying therapies (DMTs) may modify the risk of developing a severe COVID-19 infection, beside identified risk factors such as age and comorbidities. Objective To describe the clinical characteristics and outcomes in patients with MS and COVID-19 and identify factors associated with COVID-19 severity. Design, Setting, and Participants The Covisep registry is a multicenter, retrospective, observational cohort study conducted in MS expert centers and general hospitals and with neurologists collaborating with MS expert centers and members of the Société Francophone de la Sclérose en Plaques. The study included patients with MS presenting with a confirmed or highly suspected diagnosis of COVID-19 between March 1, 2020, and May 21, 2020. Exposures COVID-19 diagnosed with a polymerase chain reaction test on a nasopharyngeal swab, thoracic computed tomography, or typical symptoms. Main Outcomes and Measures The main outcome was COVID-19 severity assessed on a 7-point ordinal scale (ranging from 1 [not hospitalized with no limitations on activities] to 7 [death]) with a cutoff at 3 (hospitalized and not requiring supplemental oxygen). We collected demographics, neurological history, Expanded Disability Severity Scale score (EDSS; ranging from 0 to 10, with cutoffs at 3 and 6), comorbidities, COVID-19 characteristics, and outcomes. Univariate and multivariate logistic regression models were used to estimate the association of collected variables with COVID-19 outcomes. Results A total of 347 patients (mean [SD] age, 44.6 [12.8] years, 249 women; mean [SD] disease duration, 13.5 [10.0] years) were analyzed. Seventy-three patients (21.0%) had a COVID-19 severity score of 3 or more, and 12 patients (3.5%) died of COVID-19. The median EDSS was 2.0 (range, 0-9.5), and 284 patients (81.8%) were receiving DMT. There was a higher proportion of patients with a COVID-19 severity score of 3 or more among patients with no DMT relative to patients receiving DMTs (46.0% vs 15.5%; P < .001). Multivariate logistic regression models determined that age (odds ratio per 10 years: 1.9 [95% CI, 1.4-2.5]), EDSS (OR for EDSS ≥6, 6.3 [95% CI. 2.8-14.4]), and obesity (OR, 3.0 [95% CI, 1.0-8.7]) were independent risk factors for a COVID-19 severity score of 3 or more (indicating hospitalization or higher severity). The EDSS was associated with the highest variability of COVID-19 severe outcome (R2, 0.2), followed by age (R2, 0.06) and obesity (R2, 0.01). Conclusions and Relevance In this registry-based cohort study of patients with MS, age, EDSS, and obesity were independent risk factors for severe COVID-19; there was no association found between DMTs exposure and COVID-19 severity. The identification of these risk factors should provide the rationale for an individual strategy regarding clinical management of patients with MS during the COVID-19 pandemic.
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Affiliation(s)
- Céline Louapre
- Institut du Cerveau et de la Moelle Épinière, Assistance Publique des Hôpitaux de Paris, Hôpital de la Pitié Salpêtrière, Sorbonne Université, Institut National de la Santé et de la Recherche Médicale, Centre National de la Recherche Scientifique, Clinical Investigation Center Neuroscience, Paris, France
| | - Nicolas Collongues
- Service de Neurologie, Clinical Investigation Center Institut National de la Santé et de la Recherche Médicale 1434, Centre Hospitalier Universitaire de Strasbourg, Strasbourg, France
| | - Bruno Stankoff
- Institut du Cerveau et de la Moelle Épinière, Assistance Publique des Hôpitaux de Paris, Hôpital de la Pitié Salpêtrière, Sorbonne Université, Institut National de la Santé et de la Recherche Médicale, Centre National de la Recherche Scientifique, Clinical Investigation Center Neuroscience, Paris, France
- Hôpital St Antoine, Assistance Publique des Hôpitaux de Paris, Paris, France
| | - Claire Giannesini
- Hôpital St Antoine, Assistance Publique des Hôpitaux de Paris, Paris, France
| | - Caroline Papeix
- Institut du Cerveau et de la Moelle Épinière, Assistance Publique des Hôpitaux de Paris, Hôpital de la Pitié Salpêtrière, Sorbonne Université, Institut National de la Santé et de la Recherche Médicale, Centre National de la Recherche Scientifique, Clinical Investigation Center Neuroscience, Paris, France
| | - Caroline Bensa
- Département de Neurologie, Hôpital Fondation Adolphe de Rothschild, Paris, France
| | - Romain Deschamps
- Département de Neurologie, Hôpital Fondation Adolphe de Rothschild, Paris, France
| | - Alain Créange
- Service de Neurologie, Centre de Ressources et de Compétences–Sclérose en Plaques, Assistance Publique des Hôpitaux de Paris, Groupe Hospitalier Henri Mondor, Université Paris-Est Créteil, Créteil, France
| | - Abir Wahab
- Service de Neurologie, Centre de Ressources et de Compétences–Sclérose en Plaques, Assistance Publique des Hôpitaux de Paris, Groupe Hospitalier Henri Mondor, Université Paris-Est Créteil, Créteil, France
| | - Jean Pelletier
- Service de Neurologie, Pôle de Neurosciences Cliniques, Assistance Publique–Hôpitaux de Marseille, Hôpital de la Timone, Aix Marseille Université, Marseille, France
| | - Olivier Heinzlef
- Département de Neurologie, Centre Hospitalier de Poissy, St Germain, France
| | - Pierre Labauge
- Département de Neurologie, Centre Hospitalier Universitaire de Montpellier, Montpellier, France
| | - Laurent Guilloton
- Association des Neurologues Libéraux de Langue Française, Bergerac, France
| | - Guido Ahle
- Département de Neurologie, Hôpitaux Civils de Colmar, Colmar, France
| | - Mathilde Goudot
- Service de Neurologie, Groupe Hospitalier de la Region de Mulhouse, Mulhouse, France
| | - Kevin Bigaut
- Service de Neurologie, Clinical Investigation Center Institut National de la Santé et de la Recherche Médicale 1434, Centre Hospitalier Universitaire de Strasbourg, Strasbourg, France
| | - David-Axel Laplaud
- Centre de Recherche en Transplantation et Immunologie–Institut National de la Santé et de la Recherche Médicale U1064, Service Neurologie, Clinical Investigation Center 1413, Centre Hospitalier Universitaire Nantes, Nantes, France
| | - Sandra Vukusic
- Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon/Bron, France
| | - Catherine Lubetzki
- Institut du Cerveau et de la Moelle Épinière, Assistance Publique des Hôpitaux de Paris, Hôpital de la Pitié Salpêtrière, Sorbonne Université, Institut National de la Santé et de la Recherche Médicale, Centre National de la Recherche Scientifique, Clinical Investigation Center Neuroscience, Paris, France
| | - Jérôme De Sèze
- Service de Neurologie, Clinical Investigation Center Institut National de la Santé et de la Recherche Médicale 1434, Centre Hospitalier Universitaire de Strasbourg, Strasbourg, France
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Ouallet JC, Radat F, Creange A, Abdellaoui M, Heinzlef O, Giannesini C, Hautecoeur P, Lamargue Hamel D, Deloire M, Brochet B, Jean Deleglise AS, Lehert P. Evaluation of emotional disorders before and during treatment with interferon beta in patients with multiple sclerosis. J Neurol Sci 2020; 413:116739. [PMID: 32151852 DOI: 10.1016/j.jns.2020.116739] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 02/14/2020] [Accepted: 02/15/2020] [Indexed: 10/25/2022]
Abstract
BACKGROUND Domains encompassing emotional disorders in relapsing-remitting MS (RRMS) patients are still unclear. METHODS We performed a 24-month, multicenter, single-arm, prospective study. RRMS patients started IFN-β treatment at baseline. The primary endpoint was lack of emotional control, measured using the "Echelle d'HumeurDépressive" (EHD) scale three times at baseline and at 10 post-treatment visits. Secondary endpoints were emotional blunting, irritability, fatigue, depression and anxiety. A linear mixed covariance model assessed change from baseline on an intention-to-treat basis, under the assumption of no mood disorder effect (one-sided 97.5% level), in which autoregressive type of autocorrelation was tested. RESULTS Out of 79 recruited patients, 70 were analyzed: 80% female; mean (SD) age, 37.0 (11.5) years. Mean (SD) lack of emotional control score at baseline and Month 24 was 12.7 (4.4) and 12.6 (5.5), respectively, versus 10.1 (3.2) in a healthy control population matched for age and sex. Stepwise analysis identified younger age, male sex and antidepressant use as significant predictors of higher lack of emotional control values. CONCLUSIONS Based on 24 months of prospective follow-up, the results of this study highlights a broad spectrum of emotional disorders in the MS population at the time of disease modifying drugs initiation but no major IFN-β-related emotional disorders (mood dyscontrol, anxiety, depression) were observed. However, sporadic occurrences of severe mood disorders and suicidality cannot be excluded.
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Affiliation(s)
- Jean-Christophe Ouallet
- Service de Neurologie, Centre Hospitalier Universitaire (CHU) de Bordeaux, Bordeaux, France.
| | - Françoise Radat
- Service de Neurologie, Centre Hospitalier Universitaire (CHU) de Bordeaux, Bordeaux, France
| | - Alain Creange
- Service de Neurologie, Groupe Hospitalier Henri Mondor, APHP, Université Paris Est-Créteil, Creteil, France
| | - Mohamed Abdellaoui
- Service de Neurologie, Groupe Hospitalier Henri Mondor, APHP, Université Paris Est-Créteil, Creteil, France
| | - Olivier Heinzlef
- Service de Neurologie, Centre Hospitalier de Poissy, Poissy, France
| | - Claire Giannesini
- Service de Neurologie, Centre Hospitalier Universitaire St Antoine, APHP, Paris, France
| | | | | | - Mathilde Deloire
- Service de Neurologie, Centre Hospitalier Universitaire (CHU) de Bordeaux, Bordeaux, France
| | - Bruno Brochet
- Service de Neurologie, Centre Hospitalier Universitaire (CHU) de Bordeaux, Bordeaux, France; NeuroCentre Magendie, INSERM U862, University of Bordeaux, Bordeaux, France
| | | | - Philippe Lehert
- Faculty of Economics, Louvain University, Belgium; Faculty of Medicine, University of Melbourne, Australia
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Brisset JC, Kremer S, Hannoun S, Bonneville F, Durand-Dubief F, Tourdias T, Barillot C, Guttmann C, Vukusic S, Dousset V, Cotton F, Ameli R, Anxionnat R, Audoin B, Attye A, Bannier E, Barillot C, Ben Salem D, Boncoeur-Martel MP, Bonhomme G, Bonneville F, Boutet C, Brisset J, Cervenanski F, Claise B, Commowick O, Constans JM, Cotton F, Dardel P, Desal H, Dousset V, Durand-Dubief F, Ferre JC, Gaultier A, Gerardin E, Glattard T, Grand S, Grenier T, Guillevin R, Guttmann C, Krainik A, Kremer S, Lion S, Champfleur NMD, Mondot L, Outteryck O, Pyatigorskaya N, Pruvo JP, Rabaste S, Ranjeva JP, Roch JA, Sadik JC, Sappey-Marinier D, Savatovsky J, Stankoff B, Tanguy JY, Tourbah A, Tourdias T, Brochet B, Casey R, Cotton F, De Sèze J, Douek P, Guillemin F, Laplaud D, Lebrun-Frenay C, Mansuy L, Moreau T, Olaiz J, Pelletier J, Rigaud-Bully C, Stankoff B, Vukusic S, Debouverie M, Edan G, Ciron J, Lubetzki C, Vermersch P, Labauge P, Defer G, Berger E, Clavelou P, Gout O, Thouvenot E, Heinzlef O, Al-Khedr A, Bourre B, Casez O, Cabre P, Montcuquet A, Créange A, Camdessanché JP, Bakchine S, Maurousset A, Patry I, De Broucker T, Pottier C, Neau JP, Labeyrie C, Nifle C. New OFSEP recommendations for MRI assessment of multiple sclerosis patients: Special consideration for gadolinium deposition and frequent acquisitions. J Neuroradiol 2020; 47:250-258. [DOI: 10.1016/j.neurad.2020.01.083] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 01/22/2020] [Accepted: 01/22/2020] [Indexed: 01/04/2023]
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Laplaud DA, Casey R, Barbin L, Debouverie M, De Sèze J, Brassat D, Wiertlewski S, Brochet B, Pelletier J, Vermersch P, Edan G, Lebrun-Frenay C, Clavelou P, Thouvenot E, Camdessanché JP, Tourbah A, Stankoff B, Al Khedr A, Cabre P, Lubetzki C, Papeix C, Berger E, Heinzlef O, Debroucker T, Moreau T, Gout O, Bourre B, Wahab A, Labauge P, Magy L, Defer G, Guennoc AM, Maubeuge N, Labeyrie C, Patry I, Nifle C, Casez O, Michel L, Rollot F, Leray E, Vukusic S, Foucher Y. Comparative effectiveness of teriflunomide vs dimethyl fumarate in multiple sclerosis. Neurology 2019; 93:e635-e646. [PMID: 31300547 PMCID: PMC6715507 DOI: 10.1212/wnl.0000000000007938] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2018] [Accepted: 04/10/2019] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVE In this study, we compared the effectiveness of teriflunomide (TRF) and dimethyl fumarate (DMF) on both clinical and MRI outcomes in patients followed prospectively in the Observatoire Français de la Sclérose en Plaques. METHODS A total of 1,770 patients with relapsing-remitting multiple sclerosis (RRMS) (713 on TRF and 1,057 on DMF) with an available baseline brain MRI were included in intention to treat. The 1- and 2-year postinitiation outcomes were relapses, increase of T2 lesions, increase in Expanded Disability Status Scale score, and reason for treatment discontinuation. Propensity scores (inverse probability weighting) and logistic regressions were estimated. RESULTS The confounder-adjusted proportions of patients were similar in TRF- compared to DMF-treated patients for relapses and disability progression after 1 and 2 years. However, the adjusted proportion of patients with at least one new T2 lesion after 2 years was lower in DMF compared to TRF (60.8% vs 72.2%, odds ratio [OR] 0.60, p < 0.001). Analyses of reasons for treatment withdrawal showed that lack of effectiveness was reported for 8.5% of DMF-treated patients vs 14.5% of TRF-treated patients (OR 0.54, p < 0.001), while adverse events accounted for 16% of TRF-treated patients and 21% of DMF-treated patients after 2 years (OR 1.39, p < 0.001). CONCLUSIONS After 2 years of treatment, we found similar effectiveness of DMF and TRF in terms of clinical outcomes, but with better MRI-based outcomes for DMF-treated patients, resulting in a lower rate of treatment discontinuation due to lack of effectiveness. CLASSIFICATION OF EVIDENCE This study provides Class III evidence that for patients with RRMS, TRF and DMF have similar clinical effectiveness after 2 years of treatment.
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Affiliation(s)
- David-Axel Laplaud
- From INSERM (D.-A.L., L.B.), CIC 0004, Nantes; CRTI-INSERM UMR U1064 (D.-A.L.), Université de Nantes; Service de Neurologie (D.-A.L., S.W., L. Michel), CHU Nantes; Centre des Neurosciences de Lyon (R.C., F.R., S.V.), Observatoire Français de la Sclérose en Plaques, INSERM 1028 and CNRS UMR5292, Lyon; Université Claude Bernard Lyon 1 (R.C., F.R., S.V.), Université de Lyon; Department of Neurology (M.D.), Nancy University Hospital; Université de Lorraine (M.D.), EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology and Clinical Investigation Center (J.D.S.), CHU de Strasbourg, INSERM 1434; Department of Neurology (D.B.), CHU de Toulouse; Service de Neurologie (B. Brochet), CHU de Bordeaux; Service de Neurologie (J.P.), Hôpital de la Timone, CRMBM, CNRS, APHM, Aix Marseille Univ, Marseille; Univ Lille (P.V.), CHU Lille, LIRIC (Lille Inflammation Research International Center), INSERM UMR995; Service de Neurologie (G.E., L. Michel), CHU de Rennes; CRCSEP Nice (C.L.-F.), Neurologie Pasteur 2, Université Nice Cote d'Azur, Nice; Service de Neurologie (P. Clavelou), CHU de Clermont-Ferrand; Service de Neurologie (E.T.), CHU de Nîmes; Department of Neurology (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; Service de Neurologie et Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; Service de Neurologie (B.S.), CHU Saint-Antoine; Service de Neurologie (A.A.K.), CHU d'Amiens; Service de Neurologie (P. Cabre), CHU de Fort de France; Service de Neurologie (C. Lubetzki, C.P.), CHU Pitié-Salpêtrière; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (T.D.), CH de Saint-Denis; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (O.G.), Fondation Rothschild; Service de Neurologie (B. Bourre), CHU de Rouen; Department of Neurology (A.W.), Hôpital Henri Mondor, Créteil; Service de Neurologie (P.L.), CHU de Montpellier; Service de Neurologie (L. Magy), CHU de Limoges; Service de Neurologie (G.D.), CHU de Caen; CRC SEP and Department of Neurology (A.-M.G.), CHU Bretonneau, Tours; Department of Neurology (N.M.), CHU La Milétrie, Poitiers; Department of Neurology (C. Labeyrie), CHU Bicêtre, Le Kremlin Bicêtre; Department of Neurology (I.P.), Hôpital Sud Francilien, Corbeil Essonnes; Department of Neurology (C.N.), CHU Versailles; Department of Neurology (O.C.), CHU de Grenoble; Ecole des Hautes Etudes en Santé Publique (E.L.), Rennes; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation (S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon/Bron; and INSERM (Y.F.), UMR 1246-SPHERE, Nantes University, Tours University, Nantes, France.
| | - Romain Casey
- From INSERM (D.-A.L., L.B.), CIC 0004, Nantes; CRTI-INSERM UMR U1064 (D.-A.L.), Université de Nantes; Service de Neurologie (D.-A.L., S.W., L. Michel), CHU Nantes; Centre des Neurosciences de Lyon (R.C., F.R., S.V.), Observatoire Français de la Sclérose en Plaques, INSERM 1028 and CNRS UMR5292, Lyon; Université Claude Bernard Lyon 1 (R.C., F.R., S.V.), Université de Lyon; Department of Neurology (M.D.), Nancy University Hospital; Université de Lorraine (M.D.), EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology and Clinical Investigation Center (J.D.S.), CHU de Strasbourg, INSERM 1434; Department of Neurology (D.B.), CHU de Toulouse; Service de Neurologie (B. Brochet), CHU de Bordeaux; Service de Neurologie (J.P.), Hôpital de la Timone, CRMBM, CNRS, APHM, Aix Marseille Univ, Marseille; Univ Lille (P.V.), CHU Lille, LIRIC (Lille Inflammation Research International Center), INSERM UMR995; Service de Neurologie (G.E., L. Michel), CHU de Rennes; CRCSEP Nice (C.L.-F.), Neurologie Pasteur 2, Université Nice Cote d'Azur, Nice; Service de Neurologie (P. Clavelou), CHU de Clermont-Ferrand; Service de Neurologie (E.T.), CHU de Nîmes; Department of Neurology (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; Service de Neurologie et Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; Service de Neurologie (B.S.), CHU Saint-Antoine; Service de Neurologie (A.A.K.), CHU d'Amiens; Service de Neurologie (P. Cabre), CHU de Fort de France; Service de Neurologie (C. Lubetzki, C.P.), CHU Pitié-Salpêtrière; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (T.D.), CH de Saint-Denis; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (O.G.), Fondation Rothschild; Service de Neurologie (B. Bourre), CHU de Rouen; Department of Neurology (A.W.), Hôpital Henri Mondor, Créteil; Service de Neurologie (P.L.), CHU de Montpellier; Service de Neurologie (L. Magy), CHU de Limoges; Service de Neurologie (G.D.), CHU de Caen; CRC SEP and Department of Neurology (A.-M.G.), CHU Bretonneau, Tours; Department of Neurology (N.M.), CHU La Milétrie, Poitiers; Department of Neurology (C. Labeyrie), CHU Bicêtre, Le Kremlin Bicêtre; Department of Neurology (I.P.), Hôpital Sud Francilien, Corbeil Essonnes; Department of Neurology (C.N.), CHU Versailles; Department of Neurology (O.C.), CHU de Grenoble; Ecole des Hautes Etudes en Santé Publique (E.L.), Rennes; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation (S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon/Bron; and INSERM (Y.F.), UMR 1246-SPHERE, Nantes University, Tours University, Nantes, France
| | - Laetitia Barbin
- From INSERM (D.-A.L., L.B.), CIC 0004, Nantes; CRTI-INSERM UMR U1064 (D.-A.L.), Université de Nantes; Service de Neurologie (D.-A.L., S.W., L. Michel), CHU Nantes; Centre des Neurosciences de Lyon (R.C., F.R., S.V.), Observatoire Français de la Sclérose en Plaques, INSERM 1028 and CNRS UMR5292, Lyon; Université Claude Bernard Lyon 1 (R.C., F.R., S.V.), Université de Lyon; Department of Neurology (M.D.), Nancy University Hospital; Université de Lorraine (M.D.), EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology and Clinical Investigation Center (J.D.S.), CHU de Strasbourg, INSERM 1434; Department of Neurology (D.B.), CHU de Toulouse; Service de Neurologie (B. Brochet), CHU de Bordeaux; Service de Neurologie (J.P.), Hôpital de la Timone, CRMBM, CNRS, APHM, Aix Marseille Univ, Marseille; Univ Lille (P.V.), CHU Lille, LIRIC (Lille Inflammation Research International Center), INSERM UMR995; Service de Neurologie (G.E., L. Michel), CHU de Rennes; CRCSEP Nice (C.L.-F.), Neurologie Pasteur 2, Université Nice Cote d'Azur, Nice; Service de Neurologie (P. Clavelou), CHU de Clermont-Ferrand; Service de Neurologie (E.T.), CHU de Nîmes; Department of Neurology (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; Service de Neurologie et Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; Service de Neurologie (B.S.), CHU Saint-Antoine; Service de Neurologie (A.A.K.), CHU d'Amiens; Service de Neurologie (P. Cabre), CHU de Fort de France; Service de Neurologie (C. Lubetzki, C.P.), CHU Pitié-Salpêtrière; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (T.D.), CH de Saint-Denis; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (O.G.), Fondation Rothschild; Service de Neurologie (B. Bourre), CHU de Rouen; Department of Neurology (A.W.), Hôpital Henri Mondor, Créteil; Service de Neurologie (P.L.), CHU de Montpellier; Service de Neurologie (L. Magy), CHU de Limoges; Service de Neurologie (G.D.), CHU de Caen; CRC SEP and Department of Neurology (A.-M.G.), CHU Bretonneau, Tours; Department of Neurology (N.M.), CHU La Milétrie, Poitiers; Department of Neurology (C. Labeyrie), CHU Bicêtre, Le Kremlin Bicêtre; Department of Neurology (I.P.), Hôpital Sud Francilien, Corbeil Essonnes; Department of Neurology (C.N.), CHU Versailles; Department of Neurology (O.C.), CHU de Grenoble; Ecole des Hautes Etudes en Santé Publique (E.L.), Rennes; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation (S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon/Bron; and INSERM (Y.F.), UMR 1246-SPHERE, Nantes University, Tours University, Nantes, France
| | - Marc Debouverie
- From INSERM (D.-A.L., L.B.), CIC 0004, Nantes; CRTI-INSERM UMR U1064 (D.-A.L.), Université de Nantes; Service de Neurologie (D.-A.L., S.W., L. Michel), CHU Nantes; Centre des Neurosciences de Lyon (R.C., F.R., S.V.), Observatoire Français de la Sclérose en Plaques, INSERM 1028 and CNRS UMR5292, Lyon; Université Claude Bernard Lyon 1 (R.C., F.R., S.V.), Université de Lyon; Department of Neurology (M.D.), Nancy University Hospital; Université de Lorraine (M.D.), EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology and Clinical Investigation Center (J.D.S.), CHU de Strasbourg, INSERM 1434; Department of Neurology (D.B.), CHU de Toulouse; Service de Neurologie (B. Brochet), CHU de Bordeaux; Service de Neurologie (J.P.), Hôpital de la Timone, CRMBM, CNRS, APHM, Aix Marseille Univ, Marseille; Univ Lille (P.V.), CHU Lille, LIRIC (Lille Inflammation Research International Center), INSERM UMR995; Service de Neurologie (G.E., L. Michel), CHU de Rennes; CRCSEP Nice (C.L.-F.), Neurologie Pasteur 2, Université Nice Cote d'Azur, Nice; Service de Neurologie (P. Clavelou), CHU de Clermont-Ferrand; Service de Neurologie (E.T.), CHU de Nîmes; Department of Neurology (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; Service de Neurologie et Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; Service de Neurologie (B.S.), CHU Saint-Antoine; Service de Neurologie (A.A.K.), CHU d'Amiens; Service de Neurologie (P. Cabre), CHU de Fort de France; Service de Neurologie (C. Lubetzki, C.P.), CHU Pitié-Salpêtrière; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (T.D.), CH de Saint-Denis; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (O.G.), Fondation Rothschild; Service de Neurologie (B. Bourre), CHU de Rouen; Department of Neurology (A.W.), Hôpital Henri Mondor, Créteil; Service de Neurologie (P.L.), CHU de Montpellier; Service de Neurologie (L. Magy), CHU de Limoges; Service de Neurologie (G.D.), CHU de Caen; CRC SEP and Department of Neurology (A.-M.G.), CHU Bretonneau, Tours; Department of Neurology (N.M.), CHU La Milétrie, Poitiers; Department of Neurology (C. Labeyrie), CHU Bicêtre, Le Kremlin Bicêtre; Department of Neurology (I.P.), Hôpital Sud Francilien, Corbeil Essonnes; Department of Neurology (C.N.), CHU Versailles; Department of Neurology (O.C.), CHU de Grenoble; Ecole des Hautes Etudes en Santé Publique (E.L.), Rennes; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation (S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon/Bron; and INSERM (Y.F.), UMR 1246-SPHERE, Nantes University, Tours University, Nantes, France
| | - Jérôme De Sèze
- From INSERM (D.-A.L., L.B.), CIC 0004, Nantes; CRTI-INSERM UMR U1064 (D.-A.L.), Université de Nantes; Service de Neurologie (D.-A.L., S.W., L. Michel), CHU Nantes; Centre des Neurosciences de Lyon (R.C., F.R., S.V.), Observatoire Français de la Sclérose en Plaques, INSERM 1028 and CNRS UMR5292, Lyon; Université Claude Bernard Lyon 1 (R.C., F.R., S.V.), Université de Lyon; Department of Neurology (M.D.), Nancy University Hospital; Université de Lorraine (M.D.), EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology and Clinical Investigation Center (J.D.S.), CHU de Strasbourg, INSERM 1434; Department of Neurology (D.B.), CHU de Toulouse; Service de Neurologie (B. Brochet), CHU de Bordeaux; Service de Neurologie (J.P.), Hôpital de la Timone, CRMBM, CNRS, APHM, Aix Marseille Univ, Marseille; Univ Lille (P.V.), CHU Lille, LIRIC (Lille Inflammation Research International Center), INSERM UMR995; Service de Neurologie (G.E., L. Michel), CHU de Rennes; CRCSEP Nice (C.L.-F.), Neurologie Pasteur 2, Université Nice Cote d'Azur, Nice; Service de Neurologie (P. Clavelou), CHU de Clermont-Ferrand; Service de Neurologie (E.T.), CHU de Nîmes; Department of Neurology (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; Service de Neurologie et Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; Service de Neurologie (B.S.), CHU Saint-Antoine; Service de Neurologie (A.A.K.), CHU d'Amiens; Service de Neurologie (P. Cabre), CHU de Fort de France; Service de Neurologie (C. Lubetzki, C.P.), CHU Pitié-Salpêtrière; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (T.D.), CH de Saint-Denis; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (O.G.), Fondation Rothschild; Service de Neurologie (B. Bourre), CHU de Rouen; Department of Neurology (A.W.), Hôpital Henri Mondor, Créteil; Service de Neurologie (P.L.), CHU de Montpellier; Service de Neurologie (L. Magy), CHU de Limoges; Service de Neurologie (G.D.), CHU de Caen; CRC SEP and Department of Neurology (A.-M.G.), CHU Bretonneau, Tours; Department of Neurology (N.M.), CHU La Milétrie, Poitiers; Department of Neurology (C. Labeyrie), CHU Bicêtre, Le Kremlin Bicêtre; Department of Neurology (I.P.), Hôpital Sud Francilien, Corbeil Essonnes; Department of Neurology (C.N.), CHU Versailles; Department of Neurology (O.C.), CHU de Grenoble; Ecole des Hautes Etudes en Santé Publique (E.L.), Rennes; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation (S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon/Bron; and INSERM (Y.F.), UMR 1246-SPHERE, Nantes University, Tours University, Nantes, France
| | - David Brassat
- From INSERM (D.-A.L., L.B.), CIC 0004, Nantes; CRTI-INSERM UMR U1064 (D.-A.L.), Université de Nantes; Service de Neurologie (D.-A.L., S.W., L. Michel), CHU Nantes; Centre des Neurosciences de Lyon (R.C., F.R., S.V.), Observatoire Français de la Sclérose en Plaques, INSERM 1028 and CNRS UMR5292, Lyon; Université Claude Bernard Lyon 1 (R.C., F.R., S.V.), Université de Lyon; Department of Neurology (M.D.), Nancy University Hospital; Université de Lorraine (M.D.), EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology and Clinical Investigation Center (J.D.S.), CHU de Strasbourg, INSERM 1434; Department of Neurology (D.B.), CHU de Toulouse; Service de Neurologie (B. Brochet), CHU de Bordeaux; Service de Neurologie (J.P.), Hôpital de la Timone, CRMBM, CNRS, APHM, Aix Marseille Univ, Marseille; Univ Lille (P.V.), CHU Lille, LIRIC (Lille Inflammation Research International Center), INSERM UMR995; Service de Neurologie (G.E., L. Michel), CHU de Rennes; CRCSEP Nice (C.L.-F.), Neurologie Pasteur 2, Université Nice Cote d'Azur, Nice; Service de Neurologie (P. Clavelou), CHU de Clermont-Ferrand; Service de Neurologie (E.T.), CHU de Nîmes; Department of Neurology (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; Service de Neurologie et Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; Service de Neurologie (B.S.), CHU Saint-Antoine; Service de Neurologie (A.A.K.), CHU d'Amiens; Service de Neurologie (P. Cabre), CHU de Fort de France; Service de Neurologie (C. Lubetzki, C.P.), CHU Pitié-Salpêtrière; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (T.D.), CH de Saint-Denis; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (O.G.), Fondation Rothschild; Service de Neurologie (B. Bourre), CHU de Rouen; Department of Neurology (A.W.), Hôpital Henri Mondor, Créteil; Service de Neurologie (P.L.), CHU de Montpellier; Service de Neurologie (L. Magy), CHU de Limoges; Service de Neurologie (G.D.), CHU de Caen; CRC SEP and Department of Neurology (A.-M.G.), CHU Bretonneau, Tours; Department of Neurology (N.M.), CHU La Milétrie, Poitiers; Department of Neurology (C. Labeyrie), CHU Bicêtre, Le Kremlin Bicêtre; Department of Neurology (I.P.), Hôpital Sud Francilien, Corbeil Essonnes; Department of Neurology (C.N.), CHU Versailles; Department of Neurology (O.C.), CHU de Grenoble; Ecole des Hautes Etudes en Santé Publique (E.L.), Rennes; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation (S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon/Bron; and INSERM (Y.F.), UMR 1246-SPHERE, Nantes University, Tours University, Nantes, France
| | - Sandrine Wiertlewski
- From INSERM (D.-A.L., L.B.), CIC 0004, Nantes; CRTI-INSERM UMR U1064 (D.-A.L.), Université de Nantes; Service de Neurologie (D.-A.L., S.W., L. Michel), CHU Nantes; Centre des Neurosciences de Lyon (R.C., F.R., S.V.), Observatoire Français de la Sclérose en Plaques, INSERM 1028 and CNRS UMR5292, Lyon; Université Claude Bernard Lyon 1 (R.C., F.R., S.V.), Université de Lyon; Department of Neurology (M.D.), Nancy University Hospital; Université de Lorraine (M.D.), EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology and Clinical Investigation Center (J.D.S.), CHU de Strasbourg, INSERM 1434; Department of Neurology (D.B.), CHU de Toulouse; Service de Neurologie (B. Brochet), CHU de Bordeaux; Service de Neurologie (J.P.), Hôpital de la Timone, CRMBM, CNRS, APHM, Aix Marseille Univ, Marseille; Univ Lille (P.V.), CHU Lille, LIRIC (Lille Inflammation Research International Center), INSERM UMR995; Service de Neurologie (G.E., L. Michel), CHU de Rennes; CRCSEP Nice (C.L.-F.), Neurologie Pasteur 2, Université Nice Cote d'Azur, Nice; Service de Neurologie (P. Clavelou), CHU de Clermont-Ferrand; Service de Neurologie (E.T.), CHU de Nîmes; Department of Neurology (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; Service de Neurologie et Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; Service de Neurologie (B.S.), CHU Saint-Antoine; Service de Neurologie (A.A.K.), CHU d'Amiens; Service de Neurologie (P. Cabre), CHU de Fort de France; Service de Neurologie (C. Lubetzki, C.P.), CHU Pitié-Salpêtrière; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (T.D.), CH de Saint-Denis; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (O.G.), Fondation Rothschild; Service de Neurologie (B. Bourre), CHU de Rouen; Department of Neurology (A.W.), Hôpital Henri Mondor, Créteil; Service de Neurologie (P.L.), CHU de Montpellier; Service de Neurologie (L. Magy), CHU de Limoges; Service de Neurologie (G.D.), CHU de Caen; CRC SEP and Department of Neurology (A.-M.G.), CHU Bretonneau, Tours; Department of Neurology (N.M.), CHU La Milétrie, Poitiers; Department of Neurology (C. Labeyrie), CHU Bicêtre, Le Kremlin Bicêtre; Department of Neurology (I.P.), Hôpital Sud Francilien, Corbeil Essonnes; Department of Neurology (C.N.), CHU Versailles; Department of Neurology (O.C.), CHU de Grenoble; Ecole des Hautes Etudes en Santé Publique (E.L.), Rennes; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation (S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon/Bron; and INSERM (Y.F.), UMR 1246-SPHERE, Nantes University, Tours University, Nantes, France
| | - Bruno Brochet
- From INSERM (D.-A.L., L.B.), CIC 0004, Nantes; CRTI-INSERM UMR U1064 (D.-A.L.), Université de Nantes; Service de Neurologie (D.-A.L., S.W., L. Michel), CHU Nantes; Centre des Neurosciences de Lyon (R.C., F.R., S.V.), Observatoire Français de la Sclérose en Plaques, INSERM 1028 and CNRS UMR5292, Lyon; Université Claude Bernard Lyon 1 (R.C., F.R., S.V.), Université de Lyon; Department of Neurology (M.D.), Nancy University Hospital; Université de Lorraine (M.D.), EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology and Clinical Investigation Center (J.D.S.), CHU de Strasbourg, INSERM 1434; Department of Neurology (D.B.), CHU de Toulouse; Service de Neurologie (B. Brochet), CHU de Bordeaux; Service de Neurologie (J.P.), Hôpital de la Timone, CRMBM, CNRS, APHM, Aix Marseille Univ, Marseille; Univ Lille (P.V.), CHU Lille, LIRIC (Lille Inflammation Research International Center), INSERM UMR995; Service de Neurologie (G.E., L. Michel), CHU de Rennes; CRCSEP Nice (C.L.-F.), Neurologie Pasteur 2, Université Nice Cote d'Azur, Nice; Service de Neurologie (P. Clavelou), CHU de Clermont-Ferrand; Service de Neurologie (E.T.), CHU de Nîmes; Department of Neurology (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; Service de Neurologie et Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; Service de Neurologie (B.S.), CHU Saint-Antoine; Service de Neurologie (A.A.K.), CHU d'Amiens; Service de Neurologie (P. Cabre), CHU de Fort de France; Service de Neurologie (C. Lubetzki, C.P.), CHU Pitié-Salpêtrière; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (T.D.), CH de Saint-Denis; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (O.G.), Fondation Rothschild; Service de Neurologie (B. Bourre), CHU de Rouen; Department of Neurology (A.W.), Hôpital Henri Mondor, Créteil; Service de Neurologie (P.L.), CHU de Montpellier; Service de Neurologie (L. Magy), CHU de Limoges; Service de Neurologie (G.D.), CHU de Caen; CRC SEP and Department of Neurology (A.-M.G.), CHU Bretonneau, Tours; Department of Neurology (N.M.), CHU La Milétrie, Poitiers; Department of Neurology (C. Labeyrie), CHU Bicêtre, Le Kremlin Bicêtre; Department of Neurology (I.P.), Hôpital Sud Francilien, Corbeil Essonnes; Department of Neurology (C.N.), CHU Versailles; Department of Neurology (O.C.), CHU de Grenoble; Ecole des Hautes Etudes en Santé Publique (E.L.), Rennes; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation (S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon/Bron; and INSERM (Y.F.), UMR 1246-SPHERE, Nantes University, Tours University, Nantes, France
| | - Jean Pelletier
- From INSERM (D.-A.L., L.B.), CIC 0004, Nantes; CRTI-INSERM UMR U1064 (D.-A.L.), Université de Nantes; Service de Neurologie (D.-A.L., S.W., L. Michel), CHU Nantes; Centre des Neurosciences de Lyon (R.C., F.R., S.V.), Observatoire Français de la Sclérose en Plaques, INSERM 1028 and CNRS UMR5292, Lyon; Université Claude Bernard Lyon 1 (R.C., F.R., S.V.), Université de Lyon; Department of Neurology (M.D.), Nancy University Hospital; Université de Lorraine (M.D.), EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology and Clinical Investigation Center (J.D.S.), CHU de Strasbourg, INSERM 1434; Department of Neurology (D.B.), CHU de Toulouse; Service de Neurologie (B. Brochet), CHU de Bordeaux; Service de Neurologie (J.P.), Hôpital de la Timone, CRMBM, CNRS, APHM, Aix Marseille Univ, Marseille; Univ Lille (P.V.), CHU Lille, LIRIC (Lille Inflammation Research International Center), INSERM UMR995; Service de Neurologie (G.E., L. Michel), CHU de Rennes; CRCSEP Nice (C.L.-F.), Neurologie Pasteur 2, Université Nice Cote d'Azur, Nice; Service de Neurologie (P. Clavelou), CHU de Clermont-Ferrand; Service de Neurologie (E.T.), CHU de Nîmes; Department of Neurology (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; Service de Neurologie et Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; Service de Neurologie (B.S.), CHU Saint-Antoine; Service de Neurologie (A.A.K.), CHU d'Amiens; Service de Neurologie (P. Cabre), CHU de Fort de France; Service de Neurologie (C. Lubetzki, C.P.), CHU Pitié-Salpêtrière; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (T.D.), CH de Saint-Denis; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (O.G.), Fondation Rothschild; Service de Neurologie (B. Bourre), CHU de Rouen; Department of Neurology (A.W.), Hôpital Henri Mondor, Créteil; Service de Neurologie (P.L.), CHU de Montpellier; Service de Neurologie (L. Magy), CHU de Limoges; Service de Neurologie (G.D.), CHU de Caen; CRC SEP and Department of Neurology (A.-M.G.), CHU Bretonneau, Tours; Department of Neurology (N.M.), CHU La Milétrie, Poitiers; Department of Neurology (C. Labeyrie), CHU Bicêtre, Le Kremlin Bicêtre; Department of Neurology (I.P.), Hôpital Sud Francilien, Corbeil Essonnes; Department of Neurology (C.N.), CHU Versailles; Department of Neurology (O.C.), CHU de Grenoble; Ecole des Hautes Etudes en Santé Publique (E.L.), Rennes; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation (S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon/Bron; and INSERM (Y.F.), UMR 1246-SPHERE, Nantes University, Tours University, Nantes, France
| | - Patrick Vermersch
- From INSERM (D.-A.L., L.B.), CIC 0004, Nantes; CRTI-INSERM UMR U1064 (D.-A.L.), Université de Nantes; Service de Neurologie (D.-A.L., S.W., L. Michel), CHU Nantes; Centre des Neurosciences de Lyon (R.C., F.R., S.V.), Observatoire Français de la Sclérose en Plaques, INSERM 1028 and CNRS UMR5292, Lyon; Université Claude Bernard Lyon 1 (R.C., F.R., S.V.), Université de Lyon; Department of Neurology (M.D.), Nancy University Hospital; Université de Lorraine (M.D.), EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology and Clinical Investigation Center (J.D.S.), CHU de Strasbourg, INSERM 1434; Department of Neurology (D.B.), CHU de Toulouse; Service de Neurologie (B. Brochet), CHU de Bordeaux; Service de Neurologie (J.P.), Hôpital de la Timone, CRMBM, CNRS, APHM, Aix Marseille Univ, Marseille; Univ Lille (P.V.), CHU Lille, LIRIC (Lille Inflammation Research International Center), INSERM UMR995; Service de Neurologie (G.E., L. Michel), CHU de Rennes; CRCSEP Nice (C.L.-F.), Neurologie Pasteur 2, Université Nice Cote d'Azur, Nice; Service de Neurologie (P. Clavelou), CHU de Clermont-Ferrand; Service de Neurologie (E.T.), CHU de Nîmes; Department of Neurology (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; Service de Neurologie et Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; Service de Neurologie (B.S.), CHU Saint-Antoine; Service de Neurologie (A.A.K.), CHU d'Amiens; Service de Neurologie (P. Cabre), CHU de Fort de France; Service de Neurologie (C. Lubetzki, C.P.), CHU Pitié-Salpêtrière; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (T.D.), CH de Saint-Denis; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (O.G.), Fondation Rothschild; Service de Neurologie (B. Bourre), CHU de Rouen; Department of Neurology (A.W.), Hôpital Henri Mondor, Créteil; Service de Neurologie (P.L.), CHU de Montpellier; Service de Neurologie (L. Magy), CHU de Limoges; Service de Neurologie (G.D.), CHU de Caen; CRC SEP and Department of Neurology (A.-M.G.), CHU Bretonneau, Tours; Department of Neurology (N.M.), CHU La Milétrie, Poitiers; Department of Neurology (C. Labeyrie), CHU Bicêtre, Le Kremlin Bicêtre; Department of Neurology (I.P.), Hôpital Sud Francilien, Corbeil Essonnes; Department of Neurology (C.N.), CHU Versailles; Department of Neurology (O.C.), CHU de Grenoble; Ecole des Hautes Etudes en Santé Publique (E.L.), Rennes; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation (S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon/Bron; and INSERM (Y.F.), UMR 1246-SPHERE, Nantes University, Tours University, Nantes, France
| | - Gilles Edan
- From INSERM (D.-A.L., L.B.), CIC 0004, Nantes; CRTI-INSERM UMR U1064 (D.-A.L.), Université de Nantes; Service de Neurologie (D.-A.L., S.W., L. Michel), CHU Nantes; Centre des Neurosciences de Lyon (R.C., F.R., S.V.), Observatoire Français de la Sclérose en Plaques, INSERM 1028 and CNRS UMR5292, Lyon; Université Claude Bernard Lyon 1 (R.C., F.R., S.V.), Université de Lyon; Department of Neurology (M.D.), Nancy University Hospital; Université de Lorraine (M.D.), EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology and Clinical Investigation Center (J.D.S.), CHU de Strasbourg, INSERM 1434; Department of Neurology (D.B.), CHU de Toulouse; Service de Neurologie (B. Brochet), CHU de Bordeaux; Service de Neurologie (J.P.), Hôpital de la Timone, CRMBM, CNRS, APHM, Aix Marseille Univ, Marseille; Univ Lille (P.V.), CHU Lille, LIRIC (Lille Inflammation Research International Center), INSERM UMR995; Service de Neurologie (G.E., L. Michel), CHU de Rennes; CRCSEP Nice (C.L.-F.), Neurologie Pasteur 2, Université Nice Cote d'Azur, Nice; Service de Neurologie (P. Clavelou), CHU de Clermont-Ferrand; Service de Neurologie (E.T.), CHU de Nîmes; Department of Neurology (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; Service de Neurologie et Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; Service de Neurologie (B.S.), CHU Saint-Antoine; Service de Neurologie (A.A.K.), CHU d'Amiens; Service de Neurologie (P. Cabre), CHU de Fort de France; Service de Neurologie (C. Lubetzki, C.P.), CHU Pitié-Salpêtrière; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (T.D.), CH de Saint-Denis; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (O.G.), Fondation Rothschild; Service de Neurologie (B. Bourre), CHU de Rouen; Department of Neurology (A.W.), Hôpital Henri Mondor, Créteil; Service de Neurologie (P.L.), CHU de Montpellier; Service de Neurologie (L. Magy), CHU de Limoges; Service de Neurologie (G.D.), CHU de Caen; CRC SEP and Department of Neurology (A.-M.G.), CHU Bretonneau, Tours; Department of Neurology (N.M.), CHU La Milétrie, Poitiers; Department of Neurology (C. Labeyrie), CHU Bicêtre, Le Kremlin Bicêtre; Department of Neurology (I.P.), Hôpital Sud Francilien, Corbeil Essonnes; Department of Neurology (C.N.), CHU Versailles; Department of Neurology (O.C.), CHU de Grenoble; Ecole des Hautes Etudes en Santé Publique (E.L.), Rennes; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation (S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon/Bron; and INSERM (Y.F.), UMR 1246-SPHERE, Nantes University, Tours University, Nantes, France
| | - Christine Lebrun-Frenay
- From INSERM (D.-A.L., L.B.), CIC 0004, Nantes; CRTI-INSERM UMR U1064 (D.-A.L.), Université de Nantes; Service de Neurologie (D.-A.L., S.W., L. Michel), CHU Nantes; Centre des Neurosciences de Lyon (R.C., F.R., S.V.), Observatoire Français de la Sclérose en Plaques, INSERM 1028 and CNRS UMR5292, Lyon; Université Claude Bernard Lyon 1 (R.C., F.R., S.V.), Université de Lyon; Department of Neurology (M.D.), Nancy University Hospital; Université de Lorraine (M.D.), EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology and Clinical Investigation Center (J.D.S.), CHU de Strasbourg, INSERM 1434; Department of Neurology (D.B.), CHU de Toulouse; Service de Neurologie (B. Brochet), CHU de Bordeaux; Service de Neurologie (J.P.), Hôpital de la Timone, CRMBM, CNRS, APHM, Aix Marseille Univ, Marseille; Univ Lille (P.V.), CHU Lille, LIRIC (Lille Inflammation Research International Center), INSERM UMR995; Service de Neurologie (G.E., L. Michel), CHU de Rennes; CRCSEP Nice (C.L.-F.), Neurologie Pasteur 2, Université Nice Cote d'Azur, Nice; Service de Neurologie (P. Clavelou), CHU de Clermont-Ferrand; Service de Neurologie (E.T.), CHU de Nîmes; Department of Neurology (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; Service de Neurologie et Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; Service de Neurologie (B.S.), CHU Saint-Antoine; Service de Neurologie (A.A.K.), CHU d'Amiens; Service de Neurologie (P. Cabre), CHU de Fort de France; Service de Neurologie (C. Lubetzki, C.P.), CHU Pitié-Salpêtrière; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (T.D.), CH de Saint-Denis; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (O.G.), Fondation Rothschild; Service de Neurologie (B. Bourre), CHU de Rouen; Department of Neurology (A.W.), Hôpital Henri Mondor, Créteil; Service de Neurologie (P.L.), CHU de Montpellier; Service de Neurologie (L. Magy), CHU de Limoges; Service de Neurologie (G.D.), CHU de Caen; CRC SEP and Department of Neurology (A.-M.G.), CHU Bretonneau, Tours; Department of Neurology (N.M.), CHU La Milétrie, Poitiers; Department of Neurology (C. Labeyrie), CHU Bicêtre, Le Kremlin Bicêtre; Department of Neurology (I.P.), Hôpital Sud Francilien, Corbeil Essonnes; Department of Neurology (C.N.), CHU Versailles; Department of Neurology (O.C.), CHU de Grenoble; Ecole des Hautes Etudes en Santé Publique (E.L.), Rennes; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation (S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon/Bron; and INSERM (Y.F.), UMR 1246-SPHERE, Nantes University, Tours University, Nantes, France
| | - Pierre Clavelou
- From INSERM (D.-A.L., L.B.), CIC 0004, Nantes; CRTI-INSERM UMR U1064 (D.-A.L.), Université de Nantes; Service de Neurologie (D.-A.L., S.W., L. Michel), CHU Nantes; Centre des Neurosciences de Lyon (R.C., F.R., S.V.), Observatoire Français de la Sclérose en Plaques, INSERM 1028 and CNRS UMR5292, Lyon; Université Claude Bernard Lyon 1 (R.C., F.R., S.V.), Université de Lyon; Department of Neurology (M.D.), Nancy University Hospital; Université de Lorraine (M.D.), EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology and Clinical Investigation Center (J.D.S.), CHU de Strasbourg, INSERM 1434; Department of Neurology (D.B.), CHU de Toulouse; Service de Neurologie (B. Brochet), CHU de Bordeaux; Service de Neurologie (J.P.), Hôpital de la Timone, CRMBM, CNRS, APHM, Aix Marseille Univ, Marseille; Univ Lille (P.V.), CHU Lille, LIRIC (Lille Inflammation Research International Center), INSERM UMR995; Service de Neurologie (G.E., L. Michel), CHU de Rennes; CRCSEP Nice (C.L.-F.), Neurologie Pasteur 2, Université Nice Cote d'Azur, Nice; Service de Neurologie (P. Clavelou), CHU de Clermont-Ferrand; Service de Neurologie (E.T.), CHU de Nîmes; Department of Neurology (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; Service de Neurologie et Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; Service de Neurologie (B.S.), CHU Saint-Antoine; Service de Neurologie (A.A.K.), CHU d'Amiens; Service de Neurologie (P. Cabre), CHU de Fort de France; Service de Neurologie (C. Lubetzki, C.P.), CHU Pitié-Salpêtrière; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (T.D.), CH de Saint-Denis; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (O.G.), Fondation Rothschild; Service de Neurologie (B. Bourre), CHU de Rouen; Department of Neurology (A.W.), Hôpital Henri Mondor, Créteil; Service de Neurologie (P.L.), CHU de Montpellier; Service de Neurologie (L. Magy), CHU de Limoges; Service de Neurologie (G.D.), CHU de Caen; CRC SEP and Department of Neurology (A.-M.G.), CHU Bretonneau, Tours; Department of Neurology (N.M.), CHU La Milétrie, Poitiers; Department of Neurology (C. Labeyrie), CHU Bicêtre, Le Kremlin Bicêtre; Department of Neurology (I.P.), Hôpital Sud Francilien, Corbeil Essonnes; Department of Neurology (C.N.), CHU Versailles; Department of Neurology (O.C.), CHU de Grenoble; Ecole des Hautes Etudes en Santé Publique (E.L.), Rennes; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation (S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon/Bron; and INSERM (Y.F.), UMR 1246-SPHERE, Nantes University, Tours University, Nantes, France
| | - Eric Thouvenot
- From INSERM (D.-A.L., L.B.), CIC 0004, Nantes; CRTI-INSERM UMR U1064 (D.-A.L.), Université de Nantes; Service de Neurologie (D.-A.L., S.W., L. Michel), CHU Nantes; Centre des Neurosciences de Lyon (R.C., F.R., S.V.), Observatoire Français de la Sclérose en Plaques, INSERM 1028 and CNRS UMR5292, Lyon; Université Claude Bernard Lyon 1 (R.C., F.R., S.V.), Université de Lyon; Department of Neurology (M.D.), Nancy University Hospital; Université de Lorraine (M.D.), EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology and Clinical Investigation Center (J.D.S.), CHU de Strasbourg, INSERM 1434; Department of Neurology (D.B.), CHU de Toulouse; Service de Neurologie (B. Brochet), CHU de Bordeaux; Service de Neurologie (J.P.), Hôpital de la Timone, CRMBM, CNRS, APHM, Aix Marseille Univ, Marseille; Univ Lille (P.V.), CHU Lille, LIRIC (Lille Inflammation Research International Center), INSERM UMR995; Service de Neurologie (G.E., L. Michel), CHU de Rennes; CRCSEP Nice (C.L.-F.), Neurologie Pasteur 2, Université Nice Cote d'Azur, Nice; Service de Neurologie (P. Clavelou), CHU de Clermont-Ferrand; Service de Neurologie (E.T.), CHU de Nîmes; Department of Neurology (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; Service de Neurologie et Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; Service de Neurologie (B.S.), CHU Saint-Antoine; Service de Neurologie (A.A.K.), CHU d'Amiens; Service de Neurologie (P. Cabre), CHU de Fort de France; Service de Neurologie (C. Lubetzki, C.P.), CHU Pitié-Salpêtrière; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (T.D.), CH de Saint-Denis; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (O.G.), Fondation Rothschild; Service de Neurologie (B. Bourre), CHU de Rouen; Department of Neurology (A.W.), Hôpital Henri Mondor, Créteil; Service de Neurologie (P.L.), CHU de Montpellier; Service de Neurologie (L. Magy), CHU de Limoges; Service de Neurologie (G.D.), CHU de Caen; CRC SEP and Department of Neurology (A.-M.G.), CHU Bretonneau, Tours; Department of Neurology (N.M.), CHU La Milétrie, Poitiers; Department of Neurology (C. Labeyrie), CHU Bicêtre, Le Kremlin Bicêtre; Department of Neurology (I.P.), Hôpital Sud Francilien, Corbeil Essonnes; Department of Neurology (C.N.), CHU Versailles; Department of Neurology (O.C.), CHU de Grenoble; Ecole des Hautes Etudes en Santé Publique (E.L.), Rennes; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation (S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon/Bron; and INSERM (Y.F.), UMR 1246-SPHERE, Nantes University, Tours University, Nantes, France
| | - Jean-Philippe Camdessanché
- From INSERM (D.-A.L., L.B.), CIC 0004, Nantes; CRTI-INSERM UMR U1064 (D.-A.L.), Université de Nantes; Service de Neurologie (D.-A.L., S.W., L. Michel), CHU Nantes; Centre des Neurosciences de Lyon (R.C., F.R., S.V.), Observatoire Français de la Sclérose en Plaques, INSERM 1028 and CNRS UMR5292, Lyon; Université Claude Bernard Lyon 1 (R.C., F.R., S.V.), Université de Lyon; Department of Neurology (M.D.), Nancy University Hospital; Université de Lorraine (M.D.), EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology and Clinical Investigation Center (J.D.S.), CHU de Strasbourg, INSERM 1434; Department of Neurology (D.B.), CHU de Toulouse; Service de Neurologie (B. Brochet), CHU de Bordeaux; Service de Neurologie (J.P.), Hôpital de la Timone, CRMBM, CNRS, APHM, Aix Marseille Univ, Marseille; Univ Lille (P.V.), CHU Lille, LIRIC (Lille Inflammation Research International Center), INSERM UMR995; Service de Neurologie (G.E., L. Michel), CHU de Rennes; CRCSEP Nice (C.L.-F.), Neurologie Pasteur 2, Université Nice Cote d'Azur, Nice; Service de Neurologie (P. Clavelou), CHU de Clermont-Ferrand; Service de Neurologie (E.T.), CHU de Nîmes; Department of Neurology (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; Service de Neurologie et Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; Service de Neurologie (B.S.), CHU Saint-Antoine; Service de Neurologie (A.A.K.), CHU d'Amiens; Service de Neurologie (P. Cabre), CHU de Fort de France; Service de Neurologie (C. Lubetzki, C.P.), CHU Pitié-Salpêtrière; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (T.D.), CH de Saint-Denis; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (O.G.), Fondation Rothschild; Service de Neurologie (B. Bourre), CHU de Rouen; Department of Neurology (A.W.), Hôpital Henri Mondor, Créteil; Service de Neurologie (P.L.), CHU de Montpellier; Service de Neurologie (L. Magy), CHU de Limoges; Service de Neurologie (G.D.), CHU de Caen; CRC SEP and Department of Neurology (A.-M.G.), CHU Bretonneau, Tours; Department of Neurology (N.M.), CHU La Milétrie, Poitiers; Department of Neurology (C. Labeyrie), CHU Bicêtre, Le Kremlin Bicêtre; Department of Neurology (I.P.), Hôpital Sud Francilien, Corbeil Essonnes; Department of Neurology (C.N.), CHU Versailles; Department of Neurology (O.C.), CHU de Grenoble; Ecole des Hautes Etudes en Santé Publique (E.L.), Rennes; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation (S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon/Bron; and INSERM (Y.F.), UMR 1246-SPHERE, Nantes University, Tours University, Nantes, France
| | - Ayman Tourbah
- From INSERM (D.-A.L., L.B.), CIC 0004, Nantes; CRTI-INSERM UMR U1064 (D.-A.L.), Université de Nantes; Service de Neurologie (D.-A.L., S.W., L. Michel), CHU Nantes; Centre des Neurosciences de Lyon (R.C., F.R., S.V.), Observatoire Français de la Sclérose en Plaques, INSERM 1028 and CNRS UMR5292, Lyon; Université Claude Bernard Lyon 1 (R.C., F.R., S.V.), Université de Lyon; Department of Neurology (M.D.), Nancy University Hospital; Université de Lorraine (M.D.), EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology and Clinical Investigation Center (J.D.S.), CHU de Strasbourg, INSERM 1434; Department of Neurology (D.B.), CHU de Toulouse; Service de Neurologie (B. Brochet), CHU de Bordeaux; Service de Neurologie (J.P.), Hôpital de la Timone, CRMBM, CNRS, APHM, Aix Marseille Univ, Marseille; Univ Lille (P.V.), CHU Lille, LIRIC (Lille Inflammation Research International Center), INSERM UMR995; Service de Neurologie (G.E., L. Michel), CHU de Rennes; CRCSEP Nice (C.L.-F.), Neurologie Pasteur 2, Université Nice Cote d'Azur, Nice; Service de Neurologie (P. Clavelou), CHU de Clermont-Ferrand; Service de Neurologie (E.T.), CHU de Nîmes; Department of Neurology (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; Service de Neurologie et Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; Service de Neurologie (B.S.), CHU Saint-Antoine; Service de Neurologie (A.A.K.), CHU d'Amiens; Service de Neurologie (P. Cabre), CHU de Fort de France; Service de Neurologie (C. Lubetzki, C.P.), CHU Pitié-Salpêtrière; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (T.D.), CH de Saint-Denis; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (O.G.), Fondation Rothschild; Service de Neurologie (B. Bourre), CHU de Rouen; Department of Neurology (A.W.), Hôpital Henri Mondor, Créteil; Service de Neurologie (P.L.), CHU de Montpellier; Service de Neurologie (L. Magy), CHU de Limoges; Service de Neurologie (G.D.), CHU de Caen; CRC SEP and Department of Neurology (A.-M.G.), CHU Bretonneau, Tours; Department of Neurology (N.M.), CHU La Milétrie, Poitiers; Department of Neurology (C. Labeyrie), CHU Bicêtre, Le Kremlin Bicêtre; Department of Neurology (I.P.), Hôpital Sud Francilien, Corbeil Essonnes; Department of Neurology (C.N.), CHU Versailles; Department of Neurology (O.C.), CHU de Grenoble; Ecole des Hautes Etudes en Santé Publique (E.L.), Rennes; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation (S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon/Bron; and INSERM (Y.F.), UMR 1246-SPHERE, Nantes University, Tours University, Nantes, France
| | - Bruno Stankoff
- From INSERM (D.-A.L., L.B.), CIC 0004, Nantes; CRTI-INSERM UMR U1064 (D.-A.L.), Université de Nantes; Service de Neurologie (D.-A.L., S.W., L. Michel), CHU Nantes; Centre des Neurosciences de Lyon (R.C., F.R., S.V.), Observatoire Français de la Sclérose en Plaques, INSERM 1028 and CNRS UMR5292, Lyon; Université Claude Bernard Lyon 1 (R.C., F.R., S.V.), Université de Lyon; Department of Neurology (M.D.), Nancy University Hospital; Université de Lorraine (M.D.), EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology and Clinical Investigation Center (J.D.S.), CHU de Strasbourg, INSERM 1434; Department of Neurology (D.B.), CHU de Toulouse; Service de Neurologie (B. Brochet), CHU de Bordeaux; Service de Neurologie (J.P.), Hôpital de la Timone, CRMBM, CNRS, APHM, Aix Marseille Univ, Marseille; Univ Lille (P.V.), CHU Lille, LIRIC (Lille Inflammation Research International Center), INSERM UMR995; Service de Neurologie (G.E., L. Michel), CHU de Rennes; CRCSEP Nice (C.L.-F.), Neurologie Pasteur 2, Université Nice Cote d'Azur, Nice; Service de Neurologie (P. Clavelou), CHU de Clermont-Ferrand; Service de Neurologie (E.T.), CHU de Nîmes; Department of Neurology (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; Service de Neurologie et Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; Service de Neurologie (B.S.), CHU Saint-Antoine; Service de Neurologie (A.A.K.), CHU d'Amiens; Service de Neurologie (P. Cabre), CHU de Fort de France; Service de Neurologie (C. Lubetzki, C.P.), CHU Pitié-Salpêtrière; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (T.D.), CH de Saint-Denis; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (O.G.), Fondation Rothschild; Service de Neurologie (B. Bourre), CHU de Rouen; Department of Neurology (A.W.), Hôpital Henri Mondor, Créteil; Service de Neurologie (P.L.), CHU de Montpellier; Service de Neurologie (L. Magy), CHU de Limoges; Service de Neurologie (G.D.), CHU de Caen; CRC SEP and Department of Neurology (A.-M.G.), CHU Bretonneau, Tours; Department of Neurology (N.M.), CHU La Milétrie, Poitiers; Department of Neurology (C. Labeyrie), CHU Bicêtre, Le Kremlin Bicêtre; Department of Neurology (I.P.), Hôpital Sud Francilien, Corbeil Essonnes; Department of Neurology (C.N.), CHU Versailles; Department of Neurology (O.C.), CHU de Grenoble; Ecole des Hautes Etudes en Santé Publique (E.L.), Rennes; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation (S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon/Bron; and INSERM (Y.F.), UMR 1246-SPHERE, Nantes University, Tours University, Nantes, France
| | - Abdullatif Al Khedr
- From INSERM (D.-A.L., L.B.), CIC 0004, Nantes; CRTI-INSERM UMR U1064 (D.-A.L.), Université de Nantes; Service de Neurologie (D.-A.L., S.W., L. Michel), CHU Nantes; Centre des Neurosciences de Lyon (R.C., F.R., S.V.), Observatoire Français de la Sclérose en Plaques, INSERM 1028 and CNRS UMR5292, Lyon; Université Claude Bernard Lyon 1 (R.C., F.R., S.V.), Université de Lyon; Department of Neurology (M.D.), Nancy University Hospital; Université de Lorraine (M.D.), EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology and Clinical Investigation Center (J.D.S.), CHU de Strasbourg, INSERM 1434; Department of Neurology (D.B.), CHU de Toulouse; Service de Neurologie (B. Brochet), CHU de Bordeaux; Service de Neurologie (J.P.), Hôpital de la Timone, CRMBM, CNRS, APHM, Aix Marseille Univ, Marseille; Univ Lille (P.V.), CHU Lille, LIRIC (Lille Inflammation Research International Center), INSERM UMR995; Service de Neurologie (G.E., L. Michel), CHU de Rennes; CRCSEP Nice (C.L.-F.), Neurologie Pasteur 2, Université Nice Cote d'Azur, Nice; Service de Neurologie (P. Clavelou), CHU de Clermont-Ferrand; Service de Neurologie (E.T.), CHU de Nîmes; Department of Neurology (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; Service de Neurologie et Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; Service de Neurologie (B.S.), CHU Saint-Antoine; Service de Neurologie (A.A.K.), CHU d'Amiens; Service de Neurologie (P. Cabre), CHU de Fort de France; Service de Neurologie (C. Lubetzki, C.P.), CHU Pitié-Salpêtrière; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (T.D.), CH de Saint-Denis; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (O.G.), Fondation Rothschild; Service de Neurologie (B. Bourre), CHU de Rouen; Department of Neurology (A.W.), Hôpital Henri Mondor, Créteil; Service de Neurologie (P.L.), CHU de Montpellier; Service de Neurologie (L. Magy), CHU de Limoges; Service de Neurologie (G.D.), CHU de Caen; CRC SEP and Department of Neurology (A.-M.G.), CHU Bretonneau, Tours; Department of Neurology (N.M.), CHU La Milétrie, Poitiers; Department of Neurology (C. Labeyrie), CHU Bicêtre, Le Kremlin Bicêtre; Department of Neurology (I.P.), Hôpital Sud Francilien, Corbeil Essonnes; Department of Neurology (C.N.), CHU Versailles; Department of Neurology (O.C.), CHU de Grenoble; Ecole des Hautes Etudes en Santé Publique (E.L.), Rennes; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation (S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon/Bron; and INSERM (Y.F.), UMR 1246-SPHERE, Nantes University, Tours University, Nantes, France
| | - Philippe Cabre
- From INSERM (D.-A.L., L.B.), CIC 0004, Nantes; CRTI-INSERM UMR U1064 (D.-A.L.), Université de Nantes; Service de Neurologie (D.-A.L., S.W., L. Michel), CHU Nantes; Centre des Neurosciences de Lyon (R.C., F.R., S.V.), Observatoire Français de la Sclérose en Plaques, INSERM 1028 and CNRS UMR5292, Lyon; Université Claude Bernard Lyon 1 (R.C., F.R., S.V.), Université de Lyon; Department of Neurology (M.D.), Nancy University Hospital; Université de Lorraine (M.D.), EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology and Clinical Investigation Center (J.D.S.), CHU de Strasbourg, INSERM 1434; Department of Neurology (D.B.), CHU de Toulouse; Service de Neurologie (B. Brochet), CHU de Bordeaux; Service de Neurologie (J.P.), Hôpital de la Timone, CRMBM, CNRS, APHM, Aix Marseille Univ, Marseille; Univ Lille (P.V.), CHU Lille, LIRIC (Lille Inflammation Research International Center), INSERM UMR995; Service de Neurologie (G.E., L. Michel), CHU de Rennes; CRCSEP Nice (C.L.-F.), Neurologie Pasteur 2, Université Nice Cote d'Azur, Nice; Service de Neurologie (P. Clavelou), CHU de Clermont-Ferrand; Service de Neurologie (E.T.), CHU de Nîmes; Department of Neurology (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; Service de Neurologie et Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; Service de Neurologie (B.S.), CHU Saint-Antoine; Service de Neurologie (A.A.K.), CHU d'Amiens; Service de Neurologie (P. Cabre), CHU de Fort de France; Service de Neurologie (C. Lubetzki, C.P.), CHU Pitié-Salpêtrière; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (T.D.), CH de Saint-Denis; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (O.G.), Fondation Rothschild; Service de Neurologie (B. Bourre), CHU de Rouen; Department of Neurology (A.W.), Hôpital Henri Mondor, Créteil; Service de Neurologie (P.L.), CHU de Montpellier; Service de Neurologie (L. Magy), CHU de Limoges; Service de Neurologie (G.D.), CHU de Caen; CRC SEP and Department of Neurology (A.-M.G.), CHU Bretonneau, Tours; Department of Neurology (N.M.), CHU La Milétrie, Poitiers; Department of Neurology (C. Labeyrie), CHU Bicêtre, Le Kremlin Bicêtre; Department of Neurology (I.P.), Hôpital Sud Francilien, Corbeil Essonnes; Department of Neurology (C.N.), CHU Versailles; Department of Neurology (O.C.), CHU de Grenoble; Ecole des Hautes Etudes en Santé Publique (E.L.), Rennes; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation (S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon/Bron; and INSERM (Y.F.), UMR 1246-SPHERE, Nantes University, Tours University, Nantes, France
| | - Catherine Lubetzki
- From INSERM (D.-A.L., L.B.), CIC 0004, Nantes; CRTI-INSERM UMR U1064 (D.-A.L.), Université de Nantes; Service de Neurologie (D.-A.L., S.W., L. Michel), CHU Nantes; Centre des Neurosciences de Lyon (R.C., F.R., S.V.), Observatoire Français de la Sclérose en Plaques, INSERM 1028 and CNRS UMR5292, Lyon; Université Claude Bernard Lyon 1 (R.C., F.R., S.V.), Université de Lyon; Department of Neurology (M.D.), Nancy University Hospital; Université de Lorraine (M.D.), EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology and Clinical Investigation Center (J.D.S.), CHU de Strasbourg, INSERM 1434; Department of Neurology (D.B.), CHU de Toulouse; Service de Neurologie (B. Brochet), CHU de Bordeaux; Service de Neurologie (J.P.), Hôpital de la Timone, CRMBM, CNRS, APHM, Aix Marseille Univ, Marseille; Univ Lille (P.V.), CHU Lille, LIRIC (Lille Inflammation Research International Center), INSERM UMR995; Service de Neurologie (G.E., L. Michel), CHU de Rennes; CRCSEP Nice (C.L.-F.), Neurologie Pasteur 2, Université Nice Cote d'Azur, Nice; Service de Neurologie (P. Clavelou), CHU de Clermont-Ferrand; Service de Neurologie (E.T.), CHU de Nîmes; Department of Neurology (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; Service de Neurologie et Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; Service de Neurologie (B.S.), CHU Saint-Antoine; Service de Neurologie (A.A.K.), CHU d'Amiens; Service de Neurologie (P. Cabre), CHU de Fort de France; Service de Neurologie (C. Lubetzki, C.P.), CHU Pitié-Salpêtrière; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (T.D.), CH de Saint-Denis; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (O.G.), Fondation Rothschild; Service de Neurologie (B. Bourre), CHU de Rouen; Department of Neurology (A.W.), Hôpital Henri Mondor, Créteil; Service de Neurologie (P.L.), CHU de Montpellier; Service de Neurologie (L. Magy), CHU de Limoges; Service de Neurologie (G.D.), CHU de Caen; CRC SEP and Department of Neurology (A.-M.G.), CHU Bretonneau, Tours; Department of Neurology (N.M.), CHU La Milétrie, Poitiers; Department of Neurology (C. Labeyrie), CHU Bicêtre, Le Kremlin Bicêtre; Department of Neurology (I.P.), Hôpital Sud Francilien, Corbeil Essonnes; Department of Neurology (C.N.), CHU Versailles; Department of Neurology (O.C.), CHU de Grenoble; Ecole des Hautes Etudes en Santé Publique (E.L.), Rennes; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation (S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon/Bron; and INSERM (Y.F.), UMR 1246-SPHERE, Nantes University, Tours University, Nantes, France
| | - Caroline Papeix
- From INSERM (D.-A.L., L.B.), CIC 0004, Nantes; CRTI-INSERM UMR U1064 (D.-A.L.), Université de Nantes; Service de Neurologie (D.-A.L., S.W., L. Michel), CHU Nantes; Centre des Neurosciences de Lyon (R.C., F.R., S.V.), Observatoire Français de la Sclérose en Plaques, INSERM 1028 and CNRS UMR5292, Lyon; Université Claude Bernard Lyon 1 (R.C., F.R., S.V.), Université de Lyon; Department of Neurology (M.D.), Nancy University Hospital; Université de Lorraine (M.D.), EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology and Clinical Investigation Center (J.D.S.), CHU de Strasbourg, INSERM 1434; Department of Neurology (D.B.), CHU de Toulouse; Service de Neurologie (B. Brochet), CHU de Bordeaux; Service de Neurologie (J.P.), Hôpital de la Timone, CRMBM, CNRS, APHM, Aix Marseille Univ, Marseille; Univ Lille (P.V.), CHU Lille, LIRIC (Lille Inflammation Research International Center), INSERM UMR995; Service de Neurologie (G.E., L. Michel), CHU de Rennes; CRCSEP Nice (C.L.-F.), Neurologie Pasteur 2, Université Nice Cote d'Azur, Nice; Service de Neurologie (P. Clavelou), CHU de Clermont-Ferrand; Service de Neurologie (E.T.), CHU de Nîmes; Department of Neurology (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; Service de Neurologie et Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; Service de Neurologie (B.S.), CHU Saint-Antoine; Service de Neurologie (A.A.K.), CHU d'Amiens; Service de Neurologie (P. Cabre), CHU de Fort de France; Service de Neurologie (C. Lubetzki, C.P.), CHU Pitié-Salpêtrière; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (T.D.), CH de Saint-Denis; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (O.G.), Fondation Rothschild; Service de Neurologie (B. Bourre), CHU de Rouen; Department of Neurology (A.W.), Hôpital Henri Mondor, Créteil; Service de Neurologie (P.L.), CHU de Montpellier; Service de Neurologie (L. Magy), CHU de Limoges; Service de Neurologie (G.D.), CHU de Caen; CRC SEP and Department of Neurology (A.-M.G.), CHU Bretonneau, Tours; Department of Neurology (N.M.), CHU La Milétrie, Poitiers; Department of Neurology (C. Labeyrie), CHU Bicêtre, Le Kremlin Bicêtre; Department of Neurology (I.P.), Hôpital Sud Francilien, Corbeil Essonnes; Department of Neurology (C.N.), CHU Versailles; Department of Neurology (O.C.), CHU de Grenoble; Ecole des Hautes Etudes en Santé Publique (E.L.), Rennes; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation (S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon/Bron; and INSERM (Y.F.), UMR 1246-SPHERE, Nantes University, Tours University, Nantes, France
| | - Eric Berger
- From INSERM (D.-A.L., L.B.), CIC 0004, Nantes; CRTI-INSERM UMR U1064 (D.-A.L.), Université de Nantes; Service de Neurologie (D.-A.L., S.W., L. Michel), CHU Nantes; Centre des Neurosciences de Lyon (R.C., F.R., S.V.), Observatoire Français de la Sclérose en Plaques, INSERM 1028 and CNRS UMR5292, Lyon; Université Claude Bernard Lyon 1 (R.C., F.R., S.V.), Université de Lyon; Department of Neurology (M.D.), Nancy University Hospital; Université de Lorraine (M.D.), EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology and Clinical Investigation Center (J.D.S.), CHU de Strasbourg, INSERM 1434; Department of Neurology (D.B.), CHU de Toulouse; Service de Neurologie (B. Brochet), CHU de Bordeaux; Service de Neurologie (J.P.), Hôpital de la Timone, CRMBM, CNRS, APHM, Aix Marseille Univ, Marseille; Univ Lille (P.V.), CHU Lille, LIRIC (Lille Inflammation Research International Center), INSERM UMR995; Service de Neurologie (G.E., L. Michel), CHU de Rennes; CRCSEP Nice (C.L.-F.), Neurologie Pasteur 2, Université Nice Cote d'Azur, Nice; Service de Neurologie (P. Clavelou), CHU de Clermont-Ferrand; Service de Neurologie (E.T.), CHU de Nîmes; Department of Neurology (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; Service de Neurologie et Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; Service de Neurologie (B.S.), CHU Saint-Antoine; Service de Neurologie (A.A.K.), CHU d'Amiens; Service de Neurologie (P. Cabre), CHU de Fort de France; Service de Neurologie (C. Lubetzki, C.P.), CHU Pitié-Salpêtrière; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (T.D.), CH de Saint-Denis; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (O.G.), Fondation Rothschild; Service de Neurologie (B. Bourre), CHU de Rouen; Department of Neurology (A.W.), Hôpital Henri Mondor, Créteil; Service de Neurologie (P.L.), CHU de Montpellier; Service de Neurologie (L. Magy), CHU de Limoges; Service de Neurologie (G.D.), CHU de Caen; CRC SEP and Department of Neurology (A.-M.G.), CHU Bretonneau, Tours; Department of Neurology (N.M.), CHU La Milétrie, Poitiers; Department of Neurology (C. Labeyrie), CHU Bicêtre, Le Kremlin Bicêtre; Department of Neurology (I.P.), Hôpital Sud Francilien, Corbeil Essonnes; Department of Neurology (C.N.), CHU Versailles; Department of Neurology (O.C.), CHU de Grenoble; Ecole des Hautes Etudes en Santé Publique (E.L.), Rennes; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation (S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon/Bron; and INSERM (Y.F.), UMR 1246-SPHERE, Nantes University, Tours University, Nantes, France
| | - Olivier Heinzlef
- From INSERM (D.-A.L., L.B.), CIC 0004, Nantes; CRTI-INSERM UMR U1064 (D.-A.L.), Université de Nantes; Service de Neurologie (D.-A.L., S.W., L. Michel), CHU Nantes; Centre des Neurosciences de Lyon (R.C., F.R., S.V.), Observatoire Français de la Sclérose en Plaques, INSERM 1028 and CNRS UMR5292, Lyon; Université Claude Bernard Lyon 1 (R.C., F.R., S.V.), Université de Lyon; Department of Neurology (M.D.), Nancy University Hospital; Université de Lorraine (M.D.), EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology and Clinical Investigation Center (J.D.S.), CHU de Strasbourg, INSERM 1434; Department of Neurology (D.B.), CHU de Toulouse; Service de Neurologie (B. Brochet), CHU de Bordeaux; Service de Neurologie (J.P.), Hôpital de la Timone, CRMBM, CNRS, APHM, Aix Marseille Univ, Marseille; Univ Lille (P.V.), CHU Lille, LIRIC (Lille Inflammation Research International Center), INSERM UMR995; Service de Neurologie (G.E., L. Michel), CHU de Rennes; CRCSEP Nice (C.L.-F.), Neurologie Pasteur 2, Université Nice Cote d'Azur, Nice; Service de Neurologie (P. Clavelou), CHU de Clermont-Ferrand; Service de Neurologie (E.T.), CHU de Nîmes; Department of Neurology (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; Service de Neurologie et Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; Service de Neurologie (B.S.), CHU Saint-Antoine; Service de Neurologie (A.A.K.), CHU d'Amiens; Service de Neurologie (P. Cabre), CHU de Fort de France; Service de Neurologie (C. Lubetzki, C.P.), CHU Pitié-Salpêtrière; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (T.D.), CH de Saint-Denis; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (O.G.), Fondation Rothschild; Service de Neurologie (B. Bourre), CHU de Rouen; Department of Neurology (A.W.), Hôpital Henri Mondor, Créteil; Service de Neurologie (P.L.), CHU de Montpellier; Service de Neurologie (L. Magy), CHU de Limoges; Service de Neurologie (G.D.), CHU de Caen; CRC SEP and Department of Neurology (A.-M.G.), CHU Bretonneau, Tours; Department of Neurology (N.M.), CHU La Milétrie, Poitiers; Department of Neurology (C. Labeyrie), CHU Bicêtre, Le Kremlin Bicêtre; Department of Neurology (I.P.), Hôpital Sud Francilien, Corbeil Essonnes; Department of Neurology (C.N.), CHU Versailles; Department of Neurology (O.C.), CHU de Grenoble; Ecole des Hautes Etudes en Santé Publique (E.L.), Rennes; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation (S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon/Bron; and INSERM (Y.F.), UMR 1246-SPHERE, Nantes University, Tours University, Nantes, France
| | - Thomas Debroucker
- From INSERM (D.-A.L., L.B.), CIC 0004, Nantes; CRTI-INSERM UMR U1064 (D.-A.L.), Université de Nantes; Service de Neurologie (D.-A.L., S.W., L. Michel), CHU Nantes; Centre des Neurosciences de Lyon (R.C., F.R., S.V.), Observatoire Français de la Sclérose en Plaques, INSERM 1028 and CNRS UMR5292, Lyon; Université Claude Bernard Lyon 1 (R.C., F.R., S.V.), Université de Lyon; Department of Neurology (M.D.), Nancy University Hospital; Université de Lorraine (M.D.), EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology and Clinical Investigation Center (J.D.S.), CHU de Strasbourg, INSERM 1434; Department of Neurology (D.B.), CHU de Toulouse; Service de Neurologie (B. Brochet), CHU de Bordeaux; Service de Neurologie (J.P.), Hôpital de la Timone, CRMBM, CNRS, APHM, Aix Marseille Univ, Marseille; Univ Lille (P.V.), CHU Lille, LIRIC (Lille Inflammation Research International Center), INSERM UMR995; Service de Neurologie (G.E., L. Michel), CHU de Rennes; CRCSEP Nice (C.L.-F.), Neurologie Pasteur 2, Université Nice Cote d'Azur, Nice; Service de Neurologie (P. Clavelou), CHU de Clermont-Ferrand; Service de Neurologie (E.T.), CHU de Nîmes; Department of Neurology (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; Service de Neurologie et Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; Service de Neurologie (B.S.), CHU Saint-Antoine; Service de Neurologie (A.A.K.), CHU d'Amiens; Service de Neurologie (P. Cabre), CHU de Fort de France; Service de Neurologie (C. Lubetzki, C.P.), CHU Pitié-Salpêtrière; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (T.D.), CH de Saint-Denis; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (O.G.), Fondation Rothschild; Service de Neurologie (B. Bourre), CHU de Rouen; Department of Neurology (A.W.), Hôpital Henri Mondor, Créteil; Service de Neurologie (P.L.), CHU de Montpellier; Service de Neurologie (L. Magy), CHU de Limoges; Service de Neurologie (G.D.), CHU de Caen; CRC SEP and Department of Neurology (A.-M.G.), CHU Bretonneau, Tours; Department of Neurology (N.M.), CHU La Milétrie, Poitiers; Department of Neurology (C. Labeyrie), CHU Bicêtre, Le Kremlin Bicêtre; Department of Neurology (I.P.), Hôpital Sud Francilien, Corbeil Essonnes; Department of Neurology (C.N.), CHU Versailles; Department of Neurology (O.C.), CHU de Grenoble; Ecole des Hautes Etudes en Santé Publique (E.L.), Rennes; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation (S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon/Bron; and INSERM (Y.F.), UMR 1246-SPHERE, Nantes University, Tours University, Nantes, France
| | - Thibault Moreau
- From INSERM (D.-A.L., L.B.), CIC 0004, Nantes; CRTI-INSERM UMR U1064 (D.-A.L.), Université de Nantes; Service de Neurologie (D.-A.L., S.W., L. Michel), CHU Nantes; Centre des Neurosciences de Lyon (R.C., F.R., S.V.), Observatoire Français de la Sclérose en Plaques, INSERM 1028 and CNRS UMR5292, Lyon; Université Claude Bernard Lyon 1 (R.C., F.R., S.V.), Université de Lyon; Department of Neurology (M.D.), Nancy University Hospital; Université de Lorraine (M.D.), EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology and Clinical Investigation Center (J.D.S.), CHU de Strasbourg, INSERM 1434; Department of Neurology (D.B.), CHU de Toulouse; Service de Neurologie (B. Brochet), CHU de Bordeaux; Service de Neurologie (J.P.), Hôpital de la Timone, CRMBM, CNRS, APHM, Aix Marseille Univ, Marseille; Univ Lille (P.V.), CHU Lille, LIRIC (Lille Inflammation Research International Center), INSERM UMR995; Service de Neurologie (G.E., L. Michel), CHU de Rennes; CRCSEP Nice (C.L.-F.), Neurologie Pasteur 2, Université Nice Cote d'Azur, Nice; Service de Neurologie (P. Clavelou), CHU de Clermont-Ferrand; Service de Neurologie (E.T.), CHU de Nîmes; Department of Neurology (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; Service de Neurologie et Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; Service de Neurologie (B.S.), CHU Saint-Antoine; Service de Neurologie (A.A.K.), CHU d'Amiens; Service de Neurologie (P. Cabre), CHU de Fort de France; Service de Neurologie (C. Lubetzki, C.P.), CHU Pitié-Salpêtrière; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (T.D.), CH de Saint-Denis; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (O.G.), Fondation Rothschild; Service de Neurologie (B. Bourre), CHU de Rouen; Department of Neurology (A.W.), Hôpital Henri Mondor, Créteil; Service de Neurologie (P.L.), CHU de Montpellier; Service de Neurologie (L. Magy), CHU de Limoges; Service de Neurologie (G.D.), CHU de Caen; CRC SEP and Department of Neurology (A.-M.G.), CHU Bretonneau, Tours; Department of Neurology (N.M.), CHU La Milétrie, Poitiers; Department of Neurology (C. Labeyrie), CHU Bicêtre, Le Kremlin Bicêtre; Department of Neurology (I.P.), Hôpital Sud Francilien, Corbeil Essonnes; Department of Neurology (C.N.), CHU Versailles; Department of Neurology (O.C.), CHU de Grenoble; Ecole des Hautes Etudes en Santé Publique (E.L.), Rennes; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation (S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon/Bron; and INSERM (Y.F.), UMR 1246-SPHERE, Nantes University, Tours University, Nantes, France
| | - Olivier Gout
- From INSERM (D.-A.L., L.B.), CIC 0004, Nantes; CRTI-INSERM UMR U1064 (D.-A.L.), Université de Nantes; Service de Neurologie (D.-A.L., S.W., L. Michel), CHU Nantes; Centre des Neurosciences de Lyon (R.C., F.R., S.V.), Observatoire Français de la Sclérose en Plaques, INSERM 1028 and CNRS UMR5292, Lyon; Université Claude Bernard Lyon 1 (R.C., F.R., S.V.), Université de Lyon; Department of Neurology (M.D.), Nancy University Hospital; Université de Lorraine (M.D.), EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology and Clinical Investigation Center (J.D.S.), CHU de Strasbourg, INSERM 1434; Department of Neurology (D.B.), CHU de Toulouse; Service de Neurologie (B. Brochet), CHU de Bordeaux; Service de Neurologie (J.P.), Hôpital de la Timone, CRMBM, CNRS, APHM, Aix Marseille Univ, Marseille; Univ Lille (P.V.), CHU Lille, LIRIC (Lille Inflammation Research International Center), INSERM UMR995; Service de Neurologie (G.E., L. Michel), CHU de Rennes; CRCSEP Nice (C.L.-F.), Neurologie Pasteur 2, Université Nice Cote d'Azur, Nice; Service de Neurologie (P. Clavelou), CHU de Clermont-Ferrand; Service de Neurologie (E.T.), CHU de Nîmes; Department of Neurology (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; Service de Neurologie et Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; Service de Neurologie (B.S.), CHU Saint-Antoine; Service de Neurologie (A.A.K.), CHU d'Amiens; Service de Neurologie (P. Cabre), CHU de Fort de France; Service de Neurologie (C. Lubetzki, C.P.), CHU Pitié-Salpêtrière; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (T.D.), CH de Saint-Denis; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (O.G.), Fondation Rothschild; Service de Neurologie (B. Bourre), CHU de Rouen; Department of Neurology (A.W.), Hôpital Henri Mondor, Créteil; Service de Neurologie (P.L.), CHU de Montpellier; Service de Neurologie (L. Magy), CHU de Limoges; Service de Neurologie (G.D.), CHU de Caen; CRC SEP and Department of Neurology (A.-M.G.), CHU Bretonneau, Tours; Department of Neurology (N.M.), CHU La Milétrie, Poitiers; Department of Neurology (C. Labeyrie), CHU Bicêtre, Le Kremlin Bicêtre; Department of Neurology (I.P.), Hôpital Sud Francilien, Corbeil Essonnes; Department of Neurology (C.N.), CHU Versailles; Department of Neurology (O.C.), CHU de Grenoble; Ecole des Hautes Etudes en Santé Publique (E.L.), Rennes; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation (S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon/Bron; and INSERM (Y.F.), UMR 1246-SPHERE, Nantes University, Tours University, Nantes, France
| | - Bertrand Bourre
- From INSERM (D.-A.L., L.B.), CIC 0004, Nantes; CRTI-INSERM UMR U1064 (D.-A.L.), Université de Nantes; Service de Neurologie (D.-A.L., S.W., L. Michel), CHU Nantes; Centre des Neurosciences de Lyon (R.C., F.R., S.V.), Observatoire Français de la Sclérose en Plaques, INSERM 1028 and CNRS UMR5292, Lyon; Université Claude Bernard Lyon 1 (R.C., F.R., S.V.), Université de Lyon; Department of Neurology (M.D.), Nancy University Hospital; Université de Lorraine (M.D.), EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology and Clinical Investigation Center (J.D.S.), CHU de Strasbourg, INSERM 1434; Department of Neurology (D.B.), CHU de Toulouse; Service de Neurologie (B. Brochet), CHU de Bordeaux; Service de Neurologie (J.P.), Hôpital de la Timone, CRMBM, CNRS, APHM, Aix Marseille Univ, Marseille; Univ Lille (P.V.), CHU Lille, LIRIC (Lille Inflammation Research International Center), INSERM UMR995; Service de Neurologie (G.E., L. Michel), CHU de Rennes; CRCSEP Nice (C.L.-F.), Neurologie Pasteur 2, Université Nice Cote d'Azur, Nice; Service de Neurologie (P. Clavelou), CHU de Clermont-Ferrand; Service de Neurologie (E.T.), CHU de Nîmes; Department of Neurology (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; Service de Neurologie et Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; Service de Neurologie (B.S.), CHU Saint-Antoine; Service de Neurologie (A.A.K.), CHU d'Amiens; Service de Neurologie (P. Cabre), CHU de Fort de France; Service de Neurologie (C. Lubetzki, C.P.), CHU Pitié-Salpêtrière; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (T.D.), CH de Saint-Denis; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (O.G.), Fondation Rothschild; Service de Neurologie (B. Bourre), CHU de Rouen; Department of Neurology (A.W.), Hôpital Henri Mondor, Créteil; Service de Neurologie (P.L.), CHU de Montpellier; Service de Neurologie (L. Magy), CHU de Limoges; Service de Neurologie (G.D.), CHU de Caen; CRC SEP and Department of Neurology (A.-M.G.), CHU Bretonneau, Tours; Department of Neurology (N.M.), CHU La Milétrie, Poitiers; Department of Neurology (C. Labeyrie), CHU Bicêtre, Le Kremlin Bicêtre; Department of Neurology (I.P.), Hôpital Sud Francilien, Corbeil Essonnes; Department of Neurology (C.N.), CHU Versailles; Department of Neurology (O.C.), CHU de Grenoble; Ecole des Hautes Etudes en Santé Publique (E.L.), Rennes; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation (S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon/Bron; and INSERM (Y.F.), UMR 1246-SPHERE, Nantes University, Tours University, Nantes, France
| | - Abir Wahab
- From INSERM (D.-A.L., L.B.), CIC 0004, Nantes; CRTI-INSERM UMR U1064 (D.-A.L.), Université de Nantes; Service de Neurologie (D.-A.L., S.W., L. Michel), CHU Nantes; Centre des Neurosciences de Lyon (R.C., F.R., S.V.), Observatoire Français de la Sclérose en Plaques, INSERM 1028 and CNRS UMR5292, Lyon; Université Claude Bernard Lyon 1 (R.C., F.R., S.V.), Université de Lyon; Department of Neurology (M.D.), Nancy University Hospital; Université de Lorraine (M.D.), EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology and Clinical Investigation Center (J.D.S.), CHU de Strasbourg, INSERM 1434; Department of Neurology (D.B.), CHU de Toulouse; Service de Neurologie (B. Brochet), CHU de Bordeaux; Service de Neurologie (J.P.), Hôpital de la Timone, CRMBM, CNRS, APHM, Aix Marseille Univ, Marseille; Univ Lille (P.V.), CHU Lille, LIRIC (Lille Inflammation Research International Center), INSERM UMR995; Service de Neurologie (G.E., L. Michel), CHU de Rennes; CRCSEP Nice (C.L.-F.), Neurologie Pasteur 2, Université Nice Cote d'Azur, Nice; Service de Neurologie (P. Clavelou), CHU de Clermont-Ferrand; Service de Neurologie (E.T.), CHU de Nîmes; Department of Neurology (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; Service de Neurologie et Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; Service de Neurologie (B.S.), CHU Saint-Antoine; Service de Neurologie (A.A.K.), CHU d'Amiens; Service de Neurologie (P. Cabre), CHU de Fort de France; Service de Neurologie (C. Lubetzki, C.P.), CHU Pitié-Salpêtrière; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (T.D.), CH de Saint-Denis; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (O.G.), Fondation Rothschild; Service de Neurologie (B. Bourre), CHU de Rouen; Department of Neurology (A.W.), Hôpital Henri Mondor, Créteil; Service de Neurologie (P.L.), CHU de Montpellier; Service de Neurologie (L. Magy), CHU de Limoges; Service de Neurologie (G.D.), CHU de Caen; CRC SEP and Department of Neurology (A.-M.G.), CHU Bretonneau, Tours; Department of Neurology (N.M.), CHU La Milétrie, Poitiers; Department of Neurology (C. Labeyrie), CHU Bicêtre, Le Kremlin Bicêtre; Department of Neurology (I.P.), Hôpital Sud Francilien, Corbeil Essonnes; Department of Neurology (C.N.), CHU Versailles; Department of Neurology (O.C.), CHU de Grenoble; Ecole des Hautes Etudes en Santé Publique (E.L.), Rennes; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation (S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon/Bron; and INSERM (Y.F.), UMR 1246-SPHERE, Nantes University, Tours University, Nantes, France
| | - Pierre Labauge
- From INSERM (D.-A.L., L.B.), CIC 0004, Nantes; CRTI-INSERM UMR U1064 (D.-A.L.), Université de Nantes; Service de Neurologie (D.-A.L., S.W., L. Michel), CHU Nantes; Centre des Neurosciences de Lyon (R.C., F.R., S.V.), Observatoire Français de la Sclérose en Plaques, INSERM 1028 and CNRS UMR5292, Lyon; Université Claude Bernard Lyon 1 (R.C., F.R., S.V.), Université de Lyon; Department of Neurology (M.D.), Nancy University Hospital; Université de Lorraine (M.D.), EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology and Clinical Investigation Center (J.D.S.), CHU de Strasbourg, INSERM 1434; Department of Neurology (D.B.), CHU de Toulouse; Service de Neurologie (B. Brochet), CHU de Bordeaux; Service de Neurologie (J.P.), Hôpital de la Timone, CRMBM, CNRS, APHM, Aix Marseille Univ, Marseille; Univ Lille (P.V.), CHU Lille, LIRIC (Lille Inflammation Research International Center), INSERM UMR995; Service de Neurologie (G.E., L. Michel), CHU de Rennes; CRCSEP Nice (C.L.-F.), Neurologie Pasteur 2, Université Nice Cote d'Azur, Nice; Service de Neurologie (P. Clavelou), CHU de Clermont-Ferrand; Service de Neurologie (E.T.), CHU de Nîmes; Department of Neurology (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; Service de Neurologie et Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; Service de Neurologie (B.S.), CHU Saint-Antoine; Service de Neurologie (A.A.K.), CHU d'Amiens; Service de Neurologie (P. Cabre), CHU de Fort de France; Service de Neurologie (C. Lubetzki, C.P.), CHU Pitié-Salpêtrière; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (T.D.), CH de Saint-Denis; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (O.G.), Fondation Rothschild; Service de Neurologie (B. Bourre), CHU de Rouen; Department of Neurology (A.W.), Hôpital Henri Mondor, Créteil; Service de Neurologie (P.L.), CHU de Montpellier; Service de Neurologie (L. Magy), CHU de Limoges; Service de Neurologie (G.D.), CHU de Caen; CRC SEP and Department of Neurology (A.-M.G.), CHU Bretonneau, Tours; Department of Neurology (N.M.), CHU La Milétrie, Poitiers; Department of Neurology (C. Labeyrie), CHU Bicêtre, Le Kremlin Bicêtre; Department of Neurology (I.P.), Hôpital Sud Francilien, Corbeil Essonnes; Department of Neurology (C.N.), CHU Versailles; Department of Neurology (O.C.), CHU de Grenoble; Ecole des Hautes Etudes en Santé Publique (E.L.), Rennes; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation (S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon/Bron; and INSERM (Y.F.), UMR 1246-SPHERE, Nantes University, Tours University, Nantes, France
| | - Laurent Magy
- From INSERM (D.-A.L., L.B.), CIC 0004, Nantes; CRTI-INSERM UMR U1064 (D.-A.L.), Université de Nantes; Service de Neurologie (D.-A.L., S.W., L. Michel), CHU Nantes; Centre des Neurosciences de Lyon (R.C., F.R., S.V.), Observatoire Français de la Sclérose en Plaques, INSERM 1028 and CNRS UMR5292, Lyon; Université Claude Bernard Lyon 1 (R.C., F.R., S.V.), Université de Lyon; Department of Neurology (M.D.), Nancy University Hospital; Université de Lorraine (M.D.), EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology and Clinical Investigation Center (J.D.S.), CHU de Strasbourg, INSERM 1434; Department of Neurology (D.B.), CHU de Toulouse; Service de Neurologie (B. Brochet), CHU de Bordeaux; Service de Neurologie (J.P.), Hôpital de la Timone, CRMBM, CNRS, APHM, Aix Marseille Univ, Marseille; Univ Lille (P.V.), CHU Lille, LIRIC (Lille Inflammation Research International Center), INSERM UMR995; Service de Neurologie (G.E., L. Michel), CHU de Rennes; CRCSEP Nice (C.L.-F.), Neurologie Pasteur 2, Université Nice Cote d'Azur, Nice; Service de Neurologie (P. Clavelou), CHU de Clermont-Ferrand; Service de Neurologie (E.T.), CHU de Nîmes; Department of Neurology (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; Service de Neurologie et Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; Service de Neurologie (B.S.), CHU Saint-Antoine; Service de Neurologie (A.A.K.), CHU d'Amiens; Service de Neurologie (P. Cabre), CHU de Fort de France; Service de Neurologie (C. Lubetzki, C.P.), CHU Pitié-Salpêtrière; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (T.D.), CH de Saint-Denis; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (O.G.), Fondation Rothschild; Service de Neurologie (B. Bourre), CHU de Rouen; Department of Neurology (A.W.), Hôpital Henri Mondor, Créteil; Service de Neurologie (P.L.), CHU de Montpellier; Service de Neurologie (L. Magy), CHU de Limoges; Service de Neurologie (G.D.), CHU de Caen; CRC SEP and Department of Neurology (A.-M.G.), CHU Bretonneau, Tours; Department of Neurology (N.M.), CHU La Milétrie, Poitiers; Department of Neurology (C. Labeyrie), CHU Bicêtre, Le Kremlin Bicêtre; Department of Neurology (I.P.), Hôpital Sud Francilien, Corbeil Essonnes; Department of Neurology (C.N.), CHU Versailles; Department of Neurology (O.C.), CHU de Grenoble; Ecole des Hautes Etudes en Santé Publique (E.L.), Rennes; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation (S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon/Bron; and INSERM (Y.F.), UMR 1246-SPHERE, Nantes University, Tours University, Nantes, France
| | - Gilles Defer
- From INSERM (D.-A.L., L.B.), CIC 0004, Nantes; CRTI-INSERM UMR U1064 (D.-A.L.), Université de Nantes; Service de Neurologie (D.-A.L., S.W., L. Michel), CHU Nantes; Centre des Neurosciences de Lyon (R.C., F.R., S.V.), Observatoire Français de la Sclérose en Plaques, INSERM 1028 and CNRS UMR5292, Lyon; Université Claude Bernard Lyon 1 (R.C., F.R., S.V.), Université de Lyon; Department of Neurology (M.D.), Nancy University Hospital; Université de Lorraine (M.D.), EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology and Clinical Investigation Center (J.D.S.), CHU de Strasbourg, INSERM 1434; Department of Neurology (D.B.), CHU de Toulouse; Service de Neurologie (B. Brochet), CHU de Bordeaux; Service de Neurologie (J.P.), Hôpital de la Timone, CRMBM, CNRS, APHM, Aix Marseille Univ, Marseille; Univ Lille (P.V.), CHU Lille, LIRIC (Lille Inflammation Research International Center), INSERM UMR995; Service de Neurologie (G.E., L. Michel), CHU de Rennes; CRCSEP Nice (C.L.-F.), Neurologie Pasteur 2, Université Nice Cote d'Azur, Nice; Service de Neurologie (P. Clavelou), CHU de Clermont-Ferrand; Service de Neurologie (E.T.), CHU de Nîmes; Department of Neurology (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; Service de Neurologie et Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; Service de Neurologie (B.S.), CHU Saint-Antoine; Service de Neurologie (A.A.K.), CHU d'Amiens; Service de Neurologie (P. Cabre), CHU de Fort de France; Service de Neurologie (C. Lubetzki, C.P.), CHU Pitié-Salpêtrière; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (T.D.), CH de Saint-Denis; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (O.G.), Fondation Rothschild; Service de Neurologie (B. Bourre), CHU de Rouen; Department of Neurology (A.W.), Hôpital Henri Mondor, Créteil; Service de Neurologie (P.L.), CHU de Montpellier; Service de Neurologie (L. Magy), CHU de Limoges; Service de Neurologie (G.D.), CHU de Caen; CRC SEP and Department of Neurology (A.-M.G.), CHU Bretonneau, Tours; Department of Neurology (N.M.), CHU La Milétrie, Poitiers; Department of Neurology (C. Labeyrie), CHU Bicêtre, Le Kremlin Bicêtre; Department of Neurology (I.P.), Hôpital Sud Francilien, Corbeil Essonnes; Department of Neurology (C.N.), CHU Versailles; Department of Neurology (O.C.), CHU de Grenoble; Ecole des Hautes Etudes en Santé Publique (E.L.), Rennes; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation (S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon/Bron; and INSERM (Y.F.), UMR 1246-SPHERE, Nantes University, Tours University, Nantes, France
| | - Anne-Marie Guennoc
- From INSERM (D.-A.L., L.B.), CIC 0004, Nantes; CRTI-INSERM UMR U1064 (D.-A.L.), Université de Nantes; Service de Neurologie (D.-A.L., S.W., L. Michel), CHU Nantes; Centre des Neurosciences de Lyon (R.C., F.R., S.V.), Observatoire Français de la Sclérose en Plaques, INSERM 1028 and CNRS UMR5292, Lyon; Université Claude Bernard Lyon 1 (R.C., F.R., S.V.), Université de Lyon; Department of Neurology (M.D.), Nancy University Hospital; Université de Lorraine (M.D.), EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology and Clinical Investigation Center (J.D.S.), CHU de Strasbourg, INSERM 1434; Department of Neurology (D.B.), CHU de Toulouse; Service de Neurologie (B. Brochet), CHU de Bordeaux; Service de Neurologie (J.P.), Hôpital de la Timone, CRMBM, CNRS, APHM, Aix Marseille Univ, Marseille; Univ Lille (P.V.), CHU Lille, LIRIC (Lille Inflammation Research International Center), INSERM UMR995; Service de Neurologie (G.E., L. Michel), CHU de Rennes; CRCSEP Nice (C.L.-F.), Neurologie Pasteur 2, Université Nice Cote d'Azur, Nice; Service de Neurologie (P. Clavelou), CHU de Clermont-Ferrand; Service de Neurologie (E.T.), CHU de Nîmes; Department of Neurology (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; Service de Neurologie et Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; Service de Neurologie (B.S.), CHU Saint-Antoine; Service de Neurologie (A.A.K.), CHU d'Amiens; Service de Neurologie (P. Cabre), CHU de Fort de France; Service de Neurologie (C. Lubetzki, C.P.), CHU Pitié-Salpêtrière; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (T.D.), CH de Saint-Denis; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (O.G.), Fondation Rothschild; Service de Neurologie (B. Bourre), CHU de Rouen; Department of Neurology (A.W.), Hôpital Henri Mondor, Créteil; Service de Neurologie (P.L.), CHU de Montpellier; Service de Neurologie (L. Magy), CHU de Limoges; Service de Neurologie (G.D.), CHU de Caen; CRC SEP and Department of Neurology (A.-M.G.), CHU Bretonneau, Tours; Department of Neurology (N.M.), CHU La Milétrie, Poitiers; Department of Neurology (C. Labeyrie), CHU Bicêtre, Le Kremlin Bicêtre; Department of Neurology (I.P.), Hôpital Sud Francilien, Corbeil Essonnes; Department of Neurology (C.N.), CHU Versailles; Department of Neurology (O.C.), CHU de Grenoble; Ecole des Hautes Etudes en Santé Publique (E.L.), Rennes; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation (S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon/Bron; and INSERM (Y.F.), UMR 1246-SPHERE, Nantes University, Tours University, Nantes, France
| | - Nicolas Maubeuge
- From INSERM (D.-A.L., L.B.), CIC 0004, Nantes; CRTI-INSERM UMR U1064 (D.-A.L.), Université de Nantes; Service de Neurologie (D.-A.L., S.W., L. Michel), CHU Nantes; Centre des Neurosciences de Lyon (R.C., F.R., S.V.), Observatoire Français de la Sclérose en Plaques, INSERM 1028 and CNRS UMR5292, Lyon; Université Claude Bernard Lyon 1 (R.C., F.R., S.V.), Université de Lyon; Department of Neurology (M.D.), Nancy University Hospital; Université de Lorraine (M.D.), EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology and Clinical Investigation Center (J.D.S.), CHU de Strasbourg, INSERM 1434; Department of Neurology (D.B.), CHU de Toulouse; Service de Neurologie (B. Brochet), CHU de Bordeaux; Service de Neurologie (J.P.), Hôpital de la Timone, CRMBM, CNRS, APHM, Aix Marseille Univ, Marseille; Univ Lille (P.V.), CHU Lille, LIRIC (Lille Inflammation Research International Center), INSERM UMR995; Service de Neurologie (G.E., L. Michel), CHU de Rennes; CRCSEP Nice (C.L.-F.), Neurologie Pasteur 2, Université Nice Cote d'Azur, Nice; Service de Neurologie (P. Clavelou), CHU de Clermont-Ferrand; Service de Neurologie (E.T.), CHU de Nîmes; Department of Neurology (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; Service de Neurologie et Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; Service de Neurologie (B.S.), CHU Saint-Antoine; Service de Neurologie (A.A.K.), CHU d'Amiens; Service de Neurologie (P. Cabre), CHU de Fort de France; Service de Neurologie (C. Lubetzki, C.P.), CHU Pitié-Salpêtrière; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (T.D.), CH de Saint-Denis; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (O.G.), Fondation Rothschild; Service de Neurologie (B. Bourre), CHU de Rouen; Department of Neurology (A.W.), Hôpital Henri Mondor, Créteil; Service de Neurologie (P.L.), CHU de Montpellier; Service de Neurologie (L. Magy), CHU de Limoges; Service de Neurologie (G.D.), CHU de Caen; CRC SEP and Department of Neurology (A.-M.G.), CHU Bretonneau, Tours; Department of Neurology (N.M.), CHU La Milétrie, Poitiers; Department of Neurology (C. Labeyrie), CHU Bicêtre, Le Kremlin Bicêtre; Department of Neurology (I.P.), Hôpital Sud Francilien, Corbeil Essonnes; Department of Neurology (C.N.), CHU Versailles; Department of Neurology (O.C.), CHU de Grenoble; Ecole des Hautes Etudes en Santé Publique (E.L.), Rennes; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation (S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon/Bron; and INSERM (Y.F.), UMR 1246-SPHERE, Nantes University, Tours University, Nantes, France
| | - Céline Labeyrie
- From INSERM (D.-A.L., L.B.), CIC 0004, Nantes; CRTI-INSERM UMR U1064 (D.-A.L.), Université de Nantes; Service de Neurologie (D.-A.L., S.W., L. Michel), CHU Nantes; Centre des Neurosciences de Lyon (R.C., F.R., S.V.), Observatoire Français de la Sclérose en Plaques, INSERM 1028 and CNRS UMR5292, Lyon; Université Claude Bernard Lyon 1 (R.C., F.R., S.V.), Université de Lyon; Department of Neurology (M.D.), Nancy University Hospital; Université de Lorraine (M.D.), EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology and Clinical Investigation Center (J.D.S.), CHU de Strasbourg, INSERM 1434; Department of Neurology (D.B.), CHU de Toulouse; Service de Neurologie (B. Brochet), CHU de Bordeaux; Service de Neurologie (J.P.), Hôpital de la Timone, CRMBM, CNRS, APHM, Aix Marseille Univ, Marseille; Univ Lille (P.V.), CHU Lille, LIRIC (Lille Inflammation Research International Center), INSERM UMR995; Service de Neurologie (G.E., L. Michel), CHU de Rennes; CRCSEP Nice (C.L.-F.), Neurologie Pasteur 2, Université Nice Cote d'Azur, Nice; Service de Neurologie (P. Clavelou), CHU de Clermont-Ferrand; Service de Neurologie (E.T.), CHU de Nîmes; Department of Neurology (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; Service de Neurologie et Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; Service de Neurologie (B.S.), CHU Saint-Antoine; Service de Neurologie (A.A.K.), CHU d'Amiens; Service de Neurologie (P. Cabre), CHU de Fort de France; Service de Neurologie (C. Lubetzki, C.P.), CHU Pitié-Salpêtrière; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (T.D.), CH de Saint-Denis; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (O.G.), Fondation Rothschild; Service de Neurologie (B. Bourre), CHU de Rouen; Department of Neurology (A.W.), Hôpital Henri Mondor, Créteil; Service de Neurologie (P.L.), CHU de Montpellier; Service de Neurologie (L. Magy), CHU de Limoges; Service de Neurologie (G.D.), CHU de Caen; CRC SEP and Department of Neurology (A.-M.G.), CHU Bretonneau, Tours; Department of Neurology (N.M.), CHU La Milétrie, Poitiers; Department of Neurology (C. Labeyrie), CHU Bicêtre, Le Kremlin Bicêtre; Department of Neurology (I.P.), Hôpital Sud Francilien, Corbeil Essonnes; Department of Neurology (C.N.), CHU Versailles; Department of Neurology (O.C.), CHU de Grenoble; Ecole des Hautes Etudes en Santé Publique (E.L.), Rennes; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation (S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon/Bron; and INSERM (Y.F.), UMR 1246-SPHERE, Nantes University, Tours University, Nantes, France
| | - Ivania Patry
- From INSERM (D.-A.L., L.B.), CIC 0004, Nantes; CRTI-INSERM UMR U1064 (D.-A.L.), Université de Nantes; Service de Neurologie (D.-A.L., S.W., L. Michel), CHU Nantes; Centre des Neurosciences de Lyon (R.C., F.R., S.V.), Observatoire Français de la Sclérose en Plaques, INSERM 1028 and CNRS UMR5292, Lyon; Université Claude Bernard Lyon 1 (R.C., F.R., S.V.), Université de Lyon; Department of Neurology (M.D.), Nancy University Hospital; Université de Lorraine (M.D.), EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology and Clinical Investigation Center (J.D.S.), CHU de Strasbourg, INSERM 1434; Department of Neurology (D.B.), CHU de Toulouse; Service de Neurologie (B. Brochet), CHU de Bordeaux; Service de Neurologie (J.P.), Hôpital de la Timone, CRMBM, CNRS, APHM, Aix Marseille Univ, Marseille; Univ Lille (P.V.), CHU Lille, LIRIC (Lille Inflammation Research International Center), INSERM UMR995; Service de Neurologie (G.E., L. Michel), CHU de Rennes; CRCSEP Nice (C.L.-F.), Neurologie Pasteur 2, Université Nice Cote d'Azur, Nice; Service de Neurologie (P. Clavelou), CHU de Clermont-Ferrand; Service de Neurologie (E.T.), CHU de Nîmes; Department of Neurology (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; Service de Neurologie et Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; Service de Neurologie (B.S.), CHU Saint-Antoine; Service de Neurologie (A.A.K.), CHU d'Amiens; Service de Neurologie (P. Cabre), CHU de Fort de France; Service de Neurologie (C. Lubetzki, C.P.), CHU Pitié-Salpêtrière; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (T.D.), CH de Saint-Denis; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (O.G.), Fondation Rothschild; Service de Neurologie (B. Bourre), CHU de Rouen; Department of Neurology (A.W.), Hôpital Henri Mondor, Créteil; Service de Neurologie (P.L.), CHU de Montpellier; Service de Neurologie (L. Magy), CHU de Limoges; Service de Neurologie (G.D.), CHU de Caen; CRC SEP and Department of Neurology (A.-M.G.), CHU Bretonneau, Tours; Department of Neurology (N.M.), CHU La Milétrie, Poitiers; Department of Neurology (C. Labeyrie), CHU Bicêtre, Le Kremlin Bicêtre; Department of Neurology (I.P.), Hôpital Sud Francilien, Corbeil Essonnes; Department of Neurology (C.N.), CHU Versailles; Department of Neurology (O.C.), CHU de Grenoble; Ecole des Hautes Etudes en Santé Publique (E.L.), Rennes; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation (S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon/Bron; and INSERM (Y.F.), UMR 1246-SPHERE, Nantes University, Tours University, Nantes, France
| | - Chantal Nifle
- From INSERM (D.-A.L., L.B.), CIC 0004, Nantes; CRTI-INSERM UMR U1064 (D.-A.L.), Université de Nantes; Service de Neurologie (D.-A.L., S.W., L. Michel), CHU Nantes; Centre des Neurosciences de Lyon (R.C., F.R., S.V.), Observatoire Français de la Sclérose en Plaques, INSERM 1028 and CNRS UMR5292, Lyon; Université Claude Bernard Lyon 1 (R.C., F.R., S.V.), Université de Lyon; Department of Neurology (M.D.), Nancy University Hospital; Université de Lorraine (M.D.), EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology and Clinical Investigation Center (J.D.S.), CHU de Strasbourg, INSERM 1434; Department of Neurology (D.B.), CHU de Toulouse; Service de Neurologie (B. Brochet), CHU de Bordeaux; Service de Neurologie (J.P.), Hôpital de la Timone, CRMBM, CNRS, APHM, Aix Marseille Univ, Marseille; Univ Lille (P.V.), CHU Lille, LIRIC (Lille Inflammation Research International Center), INSERM UMR995; Service de Neurologie (G.E., L. Michel), CHU de Rennes; CRCSEP Nice (C.L.-F.), Neurologie Pasteur 2, Université Nice Cote d'Azur, Nice; Service de Neurologie (P. Clavelou), CHU de Clermont-Ferrand; Service de Neurologie (E.T.), CHU de Nîmes; Department of Neurology (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; Service de Neurologie et Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; Service de Neurologie (B.S.), CHU Saint-Antoine; Service de Neurologie (A.A.K.), CHU d'Amiens; Service de Neurologie (P. Cabre), CHU de Fort de France; Service de Neurologie (C. Lubetzki, C.P.), CHU Pitié-Salpêtrière; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (T.D.), CH de Saint-Denis; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (O.G.), Fondation Rothschild; Service de Neurologie (B. Bourre), CHU de Rouen; Department of Neurology (A.W.), Hôpital Henri Mondor, Créteil; Service de Neurologie (P.L.), CHU de Montpellier; Service de Neurologie (L. Magy), CHU de Limoges; Service de Neurologie (G.D.), CHU de Caen; CRC SEP and Department of Neurology (A.-M.G.), CHU Bretonneau, Tours; Department of Neurology (N.M.), CHU La Milétrie, Poitiers; Department of Neurology (C. Labeyrie), CHU Bicêtre, Le Kremlin Bicêtre; Department of Neurology (I.P.), Hôpital Sud Francilien, Corbeil Essonnes; Department of Neurology (C.N.), CHU Versailles; Department of Neurology (O.C.), CHU de Grenoble; Ecole des Hautes Etudes en Santé Publique (E.L.), Rennes; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation (S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon/Bron; and INSERM (Y.F.), UMR 1246-SPHERE, Nantes University, Tours University, Nantes, France
| | - Olivier Casez
- From INSERM (D.-A.L., L.B.), CIC 0004, Nantes; CRTI-INSERM UMR U1064 (D.-A.L.), Université de Nantes; Service de Neurologie (D.-A.L., S.W., L. Michel), CHU Nantes; Centre des Neurosciences de Lyon (R.C., F.R., S.V.), Observatoire Français de la Sclérose en Plaques, INSERM 1028 and CNRS UMR5292, Lyon; Université Claude Bernard Lyon 1 (R.C., F.R., S.V.), Université de Lyon; Department of Neurology (M.D.), Nancy University Hospital; Université de Lorraine (M.D.), EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology and Clinical Investigation Center (J.D.S.), CHU de Strasbourg, INSERM 1434; Department of Neurology (D.B.), CHU de Toulouse; Service de Neurologie (B. Brochet), CHU de Bordeaux; Service de Neurologie (J.P.), Hôpital de la Timone, CRMBM, CNRS, APHM, Aix Marseille Univ, Marseille; Univ Lille (P.V.), CHU Lille, LIRIC (Lille Inflammation Research International Center), INSERM UMR995; Service de Neurologie (G.E., L. Michel), CHU de Rennes; CRCSEP Nice (C.L.-F.), Neurologie Pasteur 2, Université Nice Cote d'Azur, Nice; Service de Neurologie (P. Clavelou), CHU de Clermont-Ferrand; Service de Neurologie (E.T.), CHU de Nîmes; Department of Neurology (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; Service de Neurologie et Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; Service de Neurologie (B.S.), CHU Saint-Antoine; Service de Neurologie (A.A.K.), CHU d'Amiens; Service de Neurologie (P. Cabre), CHU de Fort de France; Service de Neurologie (C. Lubetzki, C.P.), CHU Pitié-Salpêtrière; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (T.D.), CH de Saint-Denis; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (O.G.), Fondation Rothschild; Service de Neurologie (B. Bourre), CHU de Rouen; Department of Neurology (A.W.), Hôpital Henri Mondor, Créteil; Service de Neurologie (P.L.), CHU de Montpellier; Service de Neurologie (L. Magy), CHU de Limoges; Service de Neurologie (G.D.), CHU de Caen; CRC SEP and Department of Neurology (A.-M.G.), CHU Bretonneau, Tours; Department of Neurology (N.M.), CHU La Milétrie, Poitiers; Department of Neurology (C. Labeyrie), CHU Bicêtre, Le Kremlin Bicêtre; Department of Neurology (I.P.), Hôpital Sud Francilien, Corbeil Essonnes; Department of Neurology (C.N.), CHU Versailles; Department of Neurology (O.C.), CHU de Grenoble; Ecole des Hautes Etudes en Santé Publique (E.L.), Rennes; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation (S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon/Bron; and INSERM (Y.F.), UMR 1246-SPHERE, Nantes University, Tours University, Nantes, France
| | - Laure Michel
- From INSERM (D.-A.L., L.B.), CIC 0004, Nantes; CRTI-INSERM UMR U1064 (D.-A.L.), Université de Nantes; Service de Neurologie (D.-A.L., S.W., L. Michel), CHU Nantes; Centre des Neurosciences de Lyon (R.C., F.R., S.V.), Observatoire Français de la Sclérose en Plaques, INSERM 1028 and CNRS UMR5292, Lyon; Université Claude Bernard Lyon 1 (R.C., F.R., S.V.), Université de Lyon; Department of Neurology (M.D.), Nancy University Hospital; Université de Lorraine (M.D.), EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology and Clinical Investigation Center (J.D.S.), CHU de Strasbourg, INSERM 1434; Department of Neurology (D.B.), CHU de Toulouse; Service de Neurologie (B. Brochet), CHU de Bordeaux; Service de Neurologie (J.P.), Hôpital de la Timone, CRMBM, CNRS, APHM, Aix Marseille Univ, Marseille; Univ Lille (P.V.), CHU Lille, LIRIC (Lille Inflammation Research International Center), INSERM UMR995; Service de Neurologie (G.E., L. Michel), CHU de Rennes; CRCSEP Nice (C.L.-F.), Neurologie Pasteur 2, Université Nice Cote d'Azur, Nice; Service de Neurologie (P. Clavelou), CHU de Clermont-Ferrand; Service de Neurologie (E.T.), CHU de Nîmes; Department of Neurology (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; Service de Neurologie et Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; Service de Neurologie (B.S.), CHU Saint-Antoine; Service de Neurologie (A.A.K.), CHU d'Amiens; Service de Neurologie (P. Cabre), CHU de Fort de France; Service de Neurologie (C. Lubetzki, C.P.), CHU Pitié-Salpêtrière; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (T.D.), CH de Saint-Denis; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (O.G.), Fondation Rothschild; Service de Neurologie (B. Bourre), CHU de Rouen; Department of Neurology (A.W.), Hôpital Henri Mondor, Créteil; Service de Neurologie (P.L.), CHU de Montpellier; Service de Neurologie (L. Magy), CHU de Limoges; Service de Neurologie (G.D.), CHU de Caen; CRC SEP and Department of Neurology (A.-M.G.), CHU Bretonneau, Tours; Department of Neurology (N.M.), CHU La Milétrie, Poitiers; Department of Neurology (C. Labeyrie), CHU Bicêtre, Le Kremlin Bicêtre; Department of Neurology (I.P.), Hôpital Sud Francilien, Corbeil Essonnes; Department of Neurology (C.N.), CHU Versailles; Department of Neurology (O.C.), CHU de Grenoble; Ecole des Hautes Etudes en Santé Publique (E.L.), Rennes; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation (S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon/Bron; and INSERM (Y.F.), UMR 1246-SPHERE, Nantes University, Tours University, Nantes, France
| | - Fabien Rollot
- From INSERM (D.-A.L., L.B.), CIC 0004, Nantes; CRTI-INSERM UMR U1064 (D.-A.L.), Université de Nantes; Service de Neurologie (D.-A.L., S.W., L. Michel), CHU Nantes; Centre des Neurosciences de Lyon (R.C., F.R., S.V.), Observatoire Français de la Sclérose en Plaques, INSERM 1028 and CNRS UMR5292, Lyon; Université Claude Bernard Lyon 1 (R.C., F.R., S.V.), Université de Lyon; Department of Neurology (M.D.), Nancy University Hospital; Université de Lorraine (M.D.), EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology and Clinical Investigation Center (J.D.S.), CHU de Strasbourg, INSERM 1434; Department of Neurology (D.B.), CHU de Toulouse; Service de Neurologie (B. Brochet), CHU de Bordeaux; Service de Neurologie (J.P.), Hôpital de la Timone, CRMBM, CNRS, APHM, Aix Marseille Univ, Marseille; Univ Lille (P.V.), CHU Lille, LIRIC (Lille Inflammation Research International Center), INSERM UMR995; Service de Neurologie (G.E., L. Michel), CHU de Rennes; CRCSEP Nice (C.L.-F.), Neurologie Pasteur 2, Université Nice Cote d'Azur, Nice; Service de Neurologie (P. Clavelou), CHU de Clermont-Ferrand; Service de Neurologie (E.T.), CHU de Nîmes; Department of Neurology (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; Service de Neurologie et Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; Service de Neurologie (B.S.), CHU Saint-Antoine; Service de Neurologie (A.A.K.), CHU d'Amiens; Service de Neurologie (P. Cabre), CHU de Fort de France; Service de Neurologie (C. Lubetzki, C.P.), CHU Pitié-Salpêtrière; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (T.D.), CH de Saint-Denis; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (O.G.), Fondation Rothschild; Service de Neurologie (B. Bourre), CHU de Rouen; Department of Neurology (A.W.), Hôpital Henri Mondor, Créteil; Service de Neurologie (P.L.), CHU de Montpellier; Service de Neurologie (L. Magy), CHU de Limoges; Service de Neurologie (G.D.), CHU de Caen; CRC SEP and Department of Neurology (A.-M.G.), CHU Bretonneau, Tours; Department of Neurology (N.M.), CHU La Milétrie, Poitiers; Department of Neurology (C. Labeyrie), CHU Bicêtre, Le Kremlin Bicêtre; Department of Neurology (I.P.), Hôpital Sud Francilien, Corbeil Essonnes; Department of Neurology (C.N.), CHU Versailles; Department of Neurology (O.C.), CHU de Grenoble; Ecole des Hautes Etudes en Santé Publique (E.L.), Rennes; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation (S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon/Bron; and INSERM (Y.F.), UMR 1246-SPHERE, Nantes University, Tours University, Nantes, France
| | - Emmanuelle Leray
- From INSERM (D.-A.L., L.B.), CIC 0004, Nantes; CRTI-INSERM UMR U1064 (D.-A.L.), Université de Nantes; Service de Neurologie (D.-A.L., S.W., L. Michel), CHU Nantes; Centre des Neurosciences de Lyon (R.C., F.R., S.V.), Observatoire Français de la Sclérose en Plaques, INSERM 1028 and CNRS UMR5292, Lyon; Université Claude Bernard Lyon 1 (R.C., F.R., S.V.), Université de Lyon; Department of Neurology (M.D.), Nancy University Hospital; Université de Lorraine (M.D.), EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology and Clinical Investigation Center (J.D.S.), CHU de Strasbourg, INSERM 1434; Department of Neurology (D.B.), CHU de Toulouse; Service de Neurologie (B. Brochet), CHU de Bordeaux; Service de Neurologie (J.P.), Hôpital de la Timone, CRMBM, CNRS, APHM, Aix Marseille Univ, Marseille; Univ Lille (P.V.), CHU Lille, LIRIC (Lille Inflammation Research International Center), INSERM UMR995; Service de Neurologie (G.E., L. Michel), CHU de Rennes; CRCSEP Nice (C.L.-F.), Neurologie Pasteur 2, Université Nice Cote d'Azur, Nice; Service de Neurologie (P. Clavelou), CHU de Clermont-Ferrand; Service de Neurologie (E.T.), CHU de Nîmes; Department of Neurology (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; Service de Neurologie et Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; Service de Neurologie (B.S.), CHU Saint-Antoine; Service de Neurologie (A.A.K.), CHU d'Amiens; Service de Neurologie (P. Cabre), CHU de Fort de France; Service de Neurologie (C. Lubetzki, C.P.), CHU Pitié-Salpêtrière; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (T.D.), CH de Saint-Denis; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (O.G.), Fondation Rothschild; Service de Neurologie (B. Bourre), CHU de Rouen; Department of Neurology (A.W.), Hôpital Henri Mondor, Créteil; Service de Neurologie (P.L.), CHU de Montpellier; Service de Neurologie (L. Magy), CHU de Limoges; Service de Neurologie (G.D.), CHU de Caen; CRC SEP and Department of Neurology (A.-M.G.), CHU Bretonneau, Tours; Department of Neurology (N.M.), CHU La Milétrie, Poitiers; Department of Neurology (C. Labeyrie), CHU Bicêtre, Le Kremlin Bicêtre; Department of Neurology (I.P.), Hôpital Sud Francilien, Corbeil Essonnes; Department of Neurology (C.N.), CHU Versailles; Department of Neurology (O.C.), CHU de Grenoble; Ecole des Hautes Etudes en Santé Publique (E.L.), Rennes; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation (S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon/Bron; and INSERM (Y.F.), UMR 1246-SPHERE, Nantes University, Tours University, Nantes, France
| | - Sandra Vukusic
- From INSERM (D.-A.L., L.B.), CIC 0004, Nantes; CRTI-INSERM UMR U1064 (D.-A.L.), Université de Nantes; Service de Neurologie (D.-A.L., S.W., L. Michel), CHU Nantes; Centre des Neurosciences de Lyon (R.C., F.R., S.V.), Observatoire Français de la Sclérose en Plaques, INSERM 1028 and CNRS UMR5292, Lyon; Université Claude Bernard Lyon 1 (R.C., F.R., S.V.), Université de Lyon; Department of Neurology (M.D.), Nancy University Hospital; Université de Lorraine (M.D.), EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology and Clinical Investigation Center (J.D.S.), CHU de Strasbourg, INSERM 1434; Department of Neurology (D.B.), CHU de Toulouse; Service de Neurologie (B. Brochet), CHU de Bordeaux; Service de Neurologie (J.P.), Hôpital de la Timone, CRMBM, CNRS, APHM, Aix Marseille Univ, Marseille; Univ Lille (P.V.), CHU Lille, LIRIC (Lille Inflammation Research International Center), INSERM UMR995; Service de Neurologie (G.E., L. Michel), CHU de Rennes; CRCSEP Nice (C.L.-F.), Neurologie Pasteur 2, Université Nice Cote d'Azur, Nice; Service de Neurologie (P. Clavelou), CHU de Clermont-Ferrand; Service de Neurologie (E.T.), CHU de Nîmes; Department of Neurology (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; Service de Neurologie et Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; Service de Neurologie (B.S.), CHU Saint-Antoine; Service de Neurologie (A.A.K.), CHU d'Amiens; Service de Neurologie (P. Cabre), CHU de Fort de France; Service de Neurologie (C. Lubetzki, C.P.), CHU Pitié-Salpêtrière; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (T.D.), CH de Saint-Denis; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (O.G.), Fondation Rothschild; Service de Neurologie (B. Bourre), CHU de Rouen; Department of Neurology (A.W.), Hôpital Henri Mondor, Créteil; Service de Neurologie (P.L.), CHU de Montpellier; Service de Neurologie (L. Magy), CHU de Limoges; Service de Neurologie (G.D.), CHU de Caen; CRC SEP and Department of Neurology (A.-M.G.), CHU Bretonneau, Tours; Department of Neurology (N.M.), CHU La Milétrie, Poitiers; Department of Neurology (C. Labeyrie), CHU Bicêtre, Le Kremlin Bicêtre; Department of Neurology (I.P.), Hôpital Sud Francilien, Corbeil Essonnes; Department of Neurology (C.N.), CHU Versailles; Department of Neurology (O.C.), CHU de Grenoble; Ecole des Hautes Etudes en Santé Publique (E.L.), Rennes; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation (S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon/Bron; and INSERM (Y.F.), UMR 1246-SPHERE, Nantes University, Tours University, Nantes, France
| | - Yohann Foucher
- From INSERM (D.-A.L., L.B.), CIC 0004, Nantes; CRTI-INSERM UMR U1064 (D.-A.L.), Université de Nantes; Service de Neurologie (D.-A.L., S.W., L. Michel), CHU Nantes; Centre des Neurosciences de Lyon (R.C., F.R., S.V.), Observatoire Français de la Sclérose en Plaques, INSERM 1028 and CNRS UMR5292, Lyon; Université Claude Bernard Lyon 1 (R.C., F.R., S.V.), Université de Lyon; Department of Neurology (M.D.), Nancy University Hospital; Université de Lorraine (M.D.), EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology and Clinical Investigation Center (J.D.S.), CHU de Strasbourg, INSERM 1434; Department of Neurology (D.B.), CHU de Toulouse; Service de Neurologie (B. Brochet), CHU de Bordeaux; Service de Neurologie (J.P.), Hôpital de la Timone, CRMBM, CNRS, APHM, Aix Marseille Univ, Marseille; Univ Lille (P.V.), CHU Lille, LIRIC (Lille Inflammation Research International Center), INSERM UMR995; Service de Neurologie (G.E., L. Michel), CHU de Rennes; CRCSEP Nice (C.L.-F.), Neurologie Pasteur 2, Université Nice Cote d'Azur, Nice; Service de Neurologie (P. Clavelou), CHU de Clermont-Ferrand; Service de Neurologie (E.T.), CHU de Nîmes; Department of Neurology (J.-P.C.), Hôpital Nord, CHU Saint-Étienne; Service de Neurologie et Faculté de Médecine de Reims (A.T.), CHU de Reims, URCA; Service de Neurologie (B.S.), CHU Saint-Antoine; Service de Neurologie (A.A.K.), CHU d'Amiens; Service de Neurologie (P. Cabre), CHU de Fort de France; Service de Neurologie (C. Lubetzki, C.P.), CHU Pitié-Salpêtrière; Service de Neurologie (E.B.), CHU de Besançon; Service de Neurologie (O.H.), CH de Poissy; Service de Neurologie (T.D.), CH de Saint-Denis; Service de Neurologie (T.M.), CHU de Dijon; Service de Neurologie (O.G.), Fondation Rothschild; Service de Neurologie (B. Bourre), CHU de Rouen; Department of Neurology (A.W.), Hôpital Henri Mondor, Créteil; Service de Neurologie (P.L.), CHU de Montpellier; Service de Neurologie (L. Magy), CHU de Limoges; Service de Neurologie (G.D.), CHU de Caen; CRC SEP and Department of Neurology (A.-M.G.), CHU Bretonneau, Tours; Department of Neurology (N.M.), CHU La Milétrie, Poitiers; Department of Neurology (C. Labeyrie), CHU Bicêtre, Le Kremlin Bicêtre; Department of Neurology (I.P.), Hôpital Sud Francilien, Corbeil Essonnes; Department of Neurology (C.N.), CHU Versailles; Department of Neurology (O.C.), CHU de Grenoble; Ecole des Hautes Etudes en Santé Publique (E.L.), Rennes; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation (S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon/Bron; and INSERM (Y.F.), UMR 1246-SPHERE, Nantes University, Tours University, Nantes, France
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Lebrun C, Vukusic S, Abadie V, Achour C, Ader F, Alchaar H, Alkhedr A, Andreux F, Androdias G, Arjmand R, Audoin B, Audry D, Aufauvre D, Autreaux C, Ayrignac X, Bailbe M, Benazet M, Bensa C, Bensmail D, Berger E, Bernady P, Bertagna Y, Biotti D, Blanchard-Dauphin A, Bonenfant J, Bonnan M, Bonnemain B, Borgel F, Botelho-Nevers E, Boucly S, Bourre B, Boutière C, Branger P, Brassat D, Bresch S, Breuil V, Brochet B, Brugeilles H, Bugnon P, Cabre P, Camdessanché JP, Carra-Dalière C, Casez O, Chamouard JM, Chassande B, Chataignier P, Chbicheb M, Chenet A, Ciron J, Clavelou P, Cohen M, Colamarino R, Collongues N, Coman I, Corail PR, Courtois S, Coustans M, Creange A, Creisson E, Daluzeau N, Davenas C, De Seze J, Debouverie M, Depaz R, Derache N, Divio L, Douay X, Dulau C, Durand-Dubief F, Edan G, Elias Z, Fagniez O, Faucher M, Faucheux JM, Fournier M, Gagneux-Brunon A, Gaida P, Galli P, Gallien P, Gaudelus J, Gault D, Gayou A, Genevray M, Gentil A, Gere J, Gignoux L, Giroux M, Givron P, Gout O, Grimaud J, Guennoc AM, Hadhoum N, Hautecoeur P, Heinzlef O, Jaeger M, Jeannin S, Kremer L, Kwiatkowski A, Labauge P, Labeyrie C, Lachaud S, Laffont I, Lanctin-Garcia C, Lannoy J, Lanotte L, Laplaud D, Latombe D, Lauxerois M, Le Page E, Lebrun-Frenay C, Lejeune P, Lejoyeux P, Lemonnier B, Leray E, Loche CM, Louapre C, Lubetzki C, Maarouf A, Mada B, Magy L, Maillart E, Manchon E, Marignier R, Marque P, Mathey G, Maurousset A, Mekies C, Merienne M, Michel L, Milor AM, Moisset X, Montcuquet A, Moreau T, Morel N, Moussa M, Naudillon JP, Normand M, Olive P, Ouallet JC, Outteryck O, Pacault C, Papeix C, Patry I, Peaureaux D, Pelletier J, Pichon B, Pittion S, Planque E, Pouget MC, Pourcher V, Radot C, Robert I, Rocher F, Ruet A, Ruet A, Saint-Val C, Salle JY, Salmon A, Sartori E, Schaeffer S, Stankhof B, Taithe F, Thouvenot E, Tizon C, Tourbah A, Tourniaire P, Vaillant M, Vermersch P, Vidil S, Wahab A, Warter MH, Wiertlewski S, Wiplosz B, Wittwer B, Zaenker C, Zephir H. Immunization and multiple sclerosis: Recommendations from the French Multiple Sclerosis Society. Rev Neurol (Paris) 2019; 175:341-357. [DOI: 10.1016/j.neurol.2019.04.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Revised: 03/31/2019] [Accepted: 04/11/2019] [Indexed: 10/26/2022]
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Gay MC, Baker R, Vrignaud P, Thomas P, Heinzlef O, Haag P, Banovic I, Thomas S. Cross-cultural validation of a French version of the Emotional Processing Scale (EPS-25). European Review of Applied Psychology 2019. [DOI: 10.1016/j.erap.2019.05.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Mamadou Z, Toudou Daouda M, Assadeck H, Heinzlef O. Épidémiologie de la sclérose en plaques en Afrique Subsaharienne : revue systématique. Rev Neurol (Paris) 2019. [DOI: 10.1016/j.neurol.2019.01.237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Tourbah A, Gout O, Vighetto A, Deburghgraeve V, Pelletier J, Papeix C, Lebrun-Frenay C, Labauge P, Brassat D, Toosy A, Laplaud DA, Outteryck O, Moreau T, Debouverie M, Clavelou P, Heinzlef O, De Sèze J, Defer G, Sedel F, Arndt C. MD1003 (High-Dose Pharmaceutical-Grade Biotin) for the Treatment of Chronic Visual Loss Related to Optic Neuritis in Multiple Sclerosis: A Randomized, Double-Blind, Placebo-Controlled Study. CNS Drugs 2018; 32:661-672. [PMID: 29808469 PMCID: PMC6061426 DOI: 10.1007/s40263-018-0528-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Chronic visual loss is a disabling feature in patients with multiple sclerosis (MS). It was recently shown that MD1003 (high-dose pharmaceutical-grade biotin or hdPB) may improve disability in patients with progressive MS. OBJECTIVE The aim of this study was to evaluate whether MD1003 improves vision compared with placebo in MS patients with chronic visual loss. METHODS The MS-ON was a 6-month, randomized, double-blind, placebo-controlled study with a 6-month open-label extension phase. Adult patients with MS-related chronic visual loss of at least one eye [visual acuity (VA) below 0.5 decimal chart] were randomized 2:1 to oral MD1003 300 mg/day or placebo. The selected eye had to show worsening of VA within the past 3 years following either acute optic neuritis (AON) or slowly progressive optic neuropathy (PON). The primary endpoint was the mean change from baseline to month 6 in VA measured in logarithm of the minimum angle of resolution (logMAR) at 100% contrast of the selected eye. Visually evoked potentials, visual field, retinal nerve fiber layer (RNFL) thickness, and health outcomes were also assessed. RESULTS Ninety-three patients received MD1003 (n = 65) or placebo (n = 28). The study did not meet its primary endpoint, as the mean change in the primary endpoint was nonsignificantly larger (p = 0.66) with MD1003 (- 0.061 logMAR, + 3.1 letters) than with placebo (- 0.036 logMAR, + 1.8 letters). Pre-planned subgroup analyses showed that 100% contrast VA improved by a mean of + 2.8 letters (- 0.058 logMAR) with MD1003 and worsened by - 1.5 letters (+ 0.029 logMAR) with placebo (p = 0.45) in the subgroup of patients with PON. MD1003-treated patients also had nonsignificant improvement in logMAR at 5% contrast and in RNFL thickness and health outcome scores when compared with placebo-treated patients. There was no superiority of MD1003 vs placebo in patients with AON. The safety profile of MD1003 was similar to that of placebo. CONCLUSIONS MD1003 did not significantly improve VA compared with placebo in patients with MS experiencing chronic visual loss. An interesting trend favoring MD1003 was observed in the subgroup of patients with PON. Treatment was overall well tolerated. TRIAL REGISTRATION EudraCT identifier 2013-002112-27. ClinicalTrials.gov Identifier: NCT02220244 FUNDING: MedDay Pharmaceuticals.
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Affiliation(s)
- Ayman Tourbah
- Department of Neurology, Faculty of Medicine, CHU de Reims, URCA, Reims, France.
- LPN EA 2027, Université Paris 8, Saint-Denis, France.
| | - Olivier Gout
- Department of Neurology, Fondation Ophtalmologique Adolphe de Rothschild, Paris, France
| | - Alain Vighetto
- Lyon Neuroscience Research Center (CRNL), ImpAct, INSERM U1028, CNRS, UMR5292, Lyon 1 University, Lyon, France
- Department of Neurology, Hopital Neurologigue, Hospices Civils de Lyon, Bron, France
| | | | - Jean Pelletier
- Department of Neurology, APHM, Hôpital de la Timone, Marseille, France
- UMR 7339, CRMBM, CNRS, Aix-Marseille Université, Marseille, France
| | - Caroline Papeix
- Department of Neurology, GH Pitié Salpêtrière, Paris, France
| | | | - Pierre Labauge
- Department of Neurology, CHU de Montpellier, Montpellier, France
| | - David Brassat
- INSERM U1043, Centre de Resource et de Competence SEP, Hopital Pierre Paul Riquet, Université de Toulouse, Toulouse, France
| | - Ahmed Toosy
- Department of Neuroinflammation, UCL Institute of Neurology, Queen Square Multiple Sclerosis Centre, University College London, London, UK
| | - David-Axel Laplaud
- UMR 1064, INSERM, Centre de Recherche en Transplantation et Immunologie, Université de Nantes, Nantes, France
- Service Neurologie, CHU Nantes, Nantes, France
| | - Olivier Outteryck
- Department of Neurology, CHU de Lille, University of Lille, Lille, France
| | - Thibault Moreau
- Department of Neurology, University Hospital of Dijon, Dijon, France
| | | | - Pierre Clavelou
- Department of Neurology, CHU de Clermont-Ferrand, Clermont-Ferrand, France
| | - Olivier Heinzlef
- Department of Neurology, Centre Hospitalier de Poissy, Saint Germain, France
| | - Jérôme De Sèze
- INSERM 1434, Department of Neurology, Clinical Investigation Center, CHU de Strasbourg, Strasbourg, France
| | - Gilles Defer
- Department of Neurology, CHU de Caen, Caen, France
| | | | - Carl Arndt
- Department of Ophthalmology, Faculty of Medicine, CHU de Reims, URCA, Reims, France
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Laplaud DA, Barbin L, Casey R, Debouverie M, Vukusic S, Labauge P, Brassat D, Wiertlewski S, De Seze J, Edan G, Brochet B, Moreau T, Berger E, Clavelou P, Castelnovo G, Ciron J, Pelletier J, Bourre B, Lubetzki C, Al Khedr A, Vermersch P, Lebrun-Frenay C, Defer G, Tourbah A, Camdessanche JP, Stankoff B, Labeyrie C, Patry I, Creange A, Gout O, Heinzlef O, Casez O, Magy L, Guennoc AM, De Broucker T, Nifle C, Dupel-Pottier C, Leray E, Rollot F, Foucher Y. Efficacité comparée du Teriflunomide et du Dimethyl-Fumarate : une étude observationnelle française multicentrique. Rev Epidemiol Sante Publique 2018. [DOI: 10.1016/j.respe.2018.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022] Open
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Dematte E, Slawinski J, Fournier J, Ruffault A, Bensmaïl D, Heinzlef O, de Marco G. Effets de deux soutiens motivationnels sur l’augmentation de l’activité physique chez des patients atteints de SEP : étude préliminaire. Sci Sports 2018. [DOI: 10.1016/j.scispo.2018.03.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Abidi M, Bruce J, Le Blanche A, Bruce A, Jarmolowicz DP, Csillik A, Thai NJ, Lim SL, Heinzlef O, de Marco G. Neural mechanisms associated with treatment decision making: An fMRI study. Behav Brain Res 2018; 349:54-62. [PMID: 29698695 DOI: 10.1016/j.bbr.2018.04.034] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 04/17/2018] [Accepted: 04/20/2018] [Indexed: 02/06/2023]
Abstract
Great progress has been made in understanding how people make financial decisions. However, there is little research on how people make health and treatment choices. Our study aimed to examine how participants weigh benefits (reduction in disease progression) and probability of risk (medications' side effects) when making hypothetical treatment decisions, and to identify the neural networks implicated in this process. Fourteen healthy participants were recruited to perform a treatment decision probability discounting task using MRI. Behavioral responses and skin conductance responses (SCRs) were measured. A whole brain analysis were performed to compare activity changes between "mild" and "severe" medications' side effects conditions. Then, orbitofrontal cortex (OFC), ventral striatum (VS), amygdala and insula were chosen for effective connectivity analysis. Behavioral data showed that participants are more likely to refuse medication when side effects are high and efficacy is low. SCRs values were significantly higher when people made medication decisions in the severe compared to mild condition. Functionally, OFC and VS were activated in the mild condition and were associated with increased likehood of choosing to take medication (higher area under the curve "AUC" side effects/efficacy). These regions also demonstrated an increased effective connectivity when participants valued treatment benefits. By contrast, the OFC, insula and amygdala were activated in the severe condition and were associated with and increased likelihood to refuse treatment. These regions showed enhanced effective connectivity when participants were confronted with increased side effects severity. This is the first study to examine the behavioral and neural bases of medical decision making.
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Affiliation(s)
- Malek Abidi
- Laboratoire CeRSM (EA-2931), UPL, Université Paris Nanterre, F92000, Nanterre, France.
| | - Jared Bruce
- Department of Psychology, University of Missouri-Kansas City, Kansas City, USA; Department of Biomedical and Health Informatics, Unviersity of Missouri - Kansas City
| | - Alain Le Blanche
- Laboratoire CeRSM (EA-2931), UPL, Université Paris Nanterre, F92000, Nanterre, France; Hôpital René-Dubos de Pontoise and Université de Versailles-Saint-Quentin, Simone Veil UFR des Sciences de la Santé, France
| | - Amanda Bruce
- Department of Pediatrics, Center for Children's Healthy Lifestyles & Nutrition, University of Kansas Medical Center, Kansas City, USA
| | - David P Jarmolowicz
- Department of Applied Behavioral Science, University of Kansas, Lawrence, USA
| | - Antonia Csillik
- EA 4430, Clinique Psychanalyse et Développement (CLIPSYD), Paradigme empirique et Thérapies cognitivo-comportementales, Université Paris-Nanterre, 200 avenue de la République, 92000, Nanterre, France
| | - N Jade Thai
- Clinical Research & Imaging Centre (CRIC Bristol), Bristol Medical School, University of Bristol, Bristol, UK
| | - Seung-Lark Lim
- Department of Psychology, University of Missouri-Kansas City, Kansas City, USA
| | | | - Giovanni de Marco
- Laboratoire CeRSM (EA-2931), UPL, Université Paris Nanterre, F92000, Nanterre, France
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Lavie C, Rollot F, Durand-Dubief F, Marignier R, Ionescu I, Casey R, Moreau T, Tourniaire P, Hutchinson M, D’Hooghe MB, Laplaud DA, Clavelou P, De Sèze J, Debouverie M, Brassat D, Pelletier J, Lebrun-Frenay C, Le Page E, Castelnovo G, Berger E, Hautecoeur P, Heinzlef O, Durelli L, Clerico M, Trojano M, Patti F, Vukusic S, Alpérovitch A, Carton H, d’Hooghe M, Hommes O, Hutchinson M, Adeleine P, Biron A, Cortinovis-Tourniaire P, Grimaud J, Hours M, Moreau T, Vukusic S, Confavreux C, Chauplannaz G, Confavreux C, Cortinovis-Tourniaire P, Grimaud J, Latombe D, Moreau T, Clanet M, Lau G, Rumbach L, Goas J, Rouhart F, Mazingue A, Roullet E, Madigand M, Hautecoeur P, Brunet P, Edan G, Allaire C, Riffault G, Leche J, Benoit T, Simonin C, Ziegler F, Baron J, Rivrain Y, Dumas R, Loche D, Bourrin J, Huttin B, Delisse B, Gibert I, Boulay C, Verceletto M, Durand G, Bonneviot G, Gil R, Hedreville M, Belair C, Poitevin R, Devoize J, Wyremblewski P, Delestre F, Setiey A, Comi G, Filippi M, Ghezzi A, Martinelli V, Rossi P, Zaffaroni M, Tola M, Amato M, Fioretti C, Meucci G, Inglese M, Mancardi G, Gambi D, Thomas A, Cavazzuti M, Citterio A, Heltberg A, Hansen H, Fernandez O, Romero F, Arbizu T, Hernandez J, De Andres de Frutos C, Geffner Sclarky D, Aladro Benito Y, Reyes Yanes P, Aguilar M, Burguera J, Yaya R, Bonakim Dib W, Arzua-Mouronte D, d’Hooghe M, Sindic C, Carton H, Medaer R, Roose H, Geens K, Guillaume D, Van Zandycke M, Janssens J, Cornette M, Mol L, Weilbach F, Flachenecker P, Hartung H, Haas J, Tendolkar I, Sindrn E, Kölmel H, Reichel D, Rauch M, Preuss S, Poser S, Mauch E, Strausser-Fuchs S, Kolleger H, Hawkins S, Howell S, Rees J, Thompson A, Johnson M, Boggild M, Gregory R, Bates D, Bone I, Hutchinson M, Polman C, Frequin S, Jongen P, Hommes O, Correia de Sa J, Rio M, Huber S, Lechner-Scott J, Kappos L, Ionescu I, Cornu C, Confavreux C, Vukusic S, El-Etr M, Baulieu E, El-Etr M, Schumacher M, Ionescu I, Confavreux C, Cornu C, Vukusic S, Hartung H, Miller D, Hutchinson M, Pugeat M, d’Archangues C, Conard J, Ménard J, Sitruk-Ware R, Pelissier C, Dat S, Belaïsch-Allard J, Athéa N, Büschsenschutz D, Lyon-Caen O, Gonsette R, Boissel J, Ffrench P, Durand-Dubief F, Cotton F, Pachai C, Bracoud L, Vukusic S, Ionescu I, Androdias G, Marignier R, Chauplannaz G, Laplaud D, Wiertlewski S, Lanctin-Garcia C, Moreau T, Couvreur G, Madinier G, Clavelou P, Taithe F, Aufauvre D, Guy N, Ferrier A, De Sèze J, Collongues N, Debouverie M, Viala F, Brassat D, Gerdelat-Mas A, Henry P, Pelletier J, Rico-Lamy A, Lebrun-Frenay C, Lepage E, Deburghraeve V, Edan G, Castelnovo G, Berger E, Hautecoeur P, Blondiau M, Heinzlef O, Coustans M, Clerc C, Rieu L, Lauxerois M, Hinzelin G, Ouallet J, Minier D, Vion P, Gromaire-Fayolle N, Derache N, Thouvenot E, Sallansonnet-Froment M, Tourniaire P, Toureille L, Borgel F, Stankoff B, Grimaud J, Moroianu C, Guennoc A, Tournier-Gervason C, Peysson S, Trojano M, Patti F, D’Amico E, Motti L, Zaffaroni M, Durelli L, Tavella A. Neuraxial analgesia is not associated with an increased risk of post-partum relapses in MS. Mult Scler 2018; 25:591-600. [DOI: 10.1177/1352458518763080] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: Obstetrical analgesia remains a matter of controversy because of the fear of neurotoxicity of local anesthetics on demyelinated fibers or their potential relationship with subsequent relapses. Objective: To assess the impact of neuraxial analgesia on the risk of relapse during the first 3 months post-partum, with a focus on women who experienced relapses during pregnancy. Methods: We analyzed data of women followed-up prospectively during their pregnancies and at least 3 months post-partum, collected in the Pregnancy in Multiple Sclerosis (PRIMS) and Prevention of Post-Partum Relapses with Progestin and Estradiol in Multiple Sclerosis (POPARTMUS) studies between 1992–1995 and 2005–2012, respectively. The association of neuraxial analgesia with the occurrence of a post-partum relapse was estimated by logistic regression analysis. Results: A total of 389 women were included, 215 from PRIMS and 174 from POPARTMUS. In total, 156 women (40%) had neuraxial analgesia. Overall, 24% experienced a relapse during pregnancy and 25% in the 3 months post-partum. Women with a pregnancy relapse were more likely to have a post-partum relapse (odds ratio (OR) = 1.83, p = 0.02), independently of the use of neuraxial analgesia. There was no association between neuraxial analgesia and post-partum relapse (OR = 1.08, p = 0.78). Conclusion: Neuraxial analgesia was not associated with an increased risk of post-partum relapses, whatever multiple sclerosis (MS) activity during pregnancy.
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Affiliation(s)
- Caroline Lavie
- Service de Neurologie A, Hôpital Pierre Wertheimer,
Hospices Civils de Lyon, Lyon, France
| | - Fabien Rollot
- Observatoire Français de la Sclérose en Plaques (OFSEP),
Lyon, France
| | | | - Romain Marignier
- Service de Neurologie A, Hôpital Pierre Wertheimer,
Hospices Civils de Lyon, Lyon, France/Centre de Recherche en Neurosciences de Lyon,
INSERM U1028, CNRS UMR5292, Equipe Neuro-Oncologie et Neuro-Inflammation, Lyon, France;
Université de Lyon 1, Lyon, France
| | - Iuliana Ionescu
- Service de Neurologie A, Hôpital Pierre Wertheimer,
Hospices Civils de Lyon, Lyon, France
| | - Romain Casey
- Observatoire Français de la Sclérose en Plaques (OFSEP),
Lyon, France
| | - Thibault Moreau
- Department of Neurology, EA4184, University Hospital of
Dijon, Dijon, France
| | | | - Michael Hutchinson
- School of Medicine and Medical Science, University College
Dublin, Dublin, Ireland/Department of Neurology, St Vincent’s University Hospital,
Dublin, Ireland
| | - Marie Béatrice D’Hooghe
- National MS Center Melsbroek, Melsbroek, Belgium; Center
for Neurosciences, Vrije Universiteit Brussel (VUB), Brussel, Belgium
| | - David-Axel Laplaud
- Service de Neurologie, CHU de Nantes, CIC015 INSERM,
Nantes, France/INSERM UMR1064, Nantes, France
| | - Pierre Clavelou
- Service de Neurologie, CHU de Clermont-Ferrand,
Clermont-Ferrand, France/INSERM UMR1107, Clermont Université, Université d’Auvergne,
Neuro-Dol, Clermont-Ferrand, France
| | - Jérôme De Sèze
- Department of Neurology, Clinical Investigation Center
INSERM 1434, Hôpitaux Universitaires de Strasbourg, FMTS INSERM 1119, Strasbourg,
France
| | - Marc Debouverie
- EA 4360 APEMAC, University of Lorraine, Nancy,
France/Department of Neurology, Nancy University Hospital, Nancy, France
| | - David Brassat
- Pôle Neurosciences, CHU Toulouse Purpan, Toulouse,
France/INSERM U1043, CNRS UMR 5282, Université Toulouse III, Toulouse, France
| | - Jean Pelletier
- Service de Neurologie, Hôpital de la Timone, Pôle de
Neurosciences Cliniques, AP-HM, Aix-Marseille Université, Marseille, France/CNRS,
Aix-Marseille Université, CRMBM UMR7339, Marseille, France
| | | | - Emmanuelle Le Page
- Clinical Neuroscience Centre, CIC-P 1414 INSERM, Rennes
University Hospital, Rennes, France
| | | | - Eric Berger
- Department of Neurology, CHU Besançon, Besançon,
France
| | - Patrick Hautecoeur
- Service de Neurologie, Groupement des Hôpitaux de
l’Institut Catholique de Lille, Lille, France
| | - Olivier Heinzlef
- Department of Neurology, Hôpital CHI de
Poissy/Saint-Germain-en-Laye, Paris, France
| | - Luca Durelli
- Division of Neurology, Department of Clinical and
Biological Sciences, University of Torino, San Luigi Gonzaga University Hospital,
Orbassano, Italy
| | - Marinella Clerico
- Division of Neurology, Department of Clinical and
Biological Sciences, University of Torino, San Luigi Gonzaga University Hospital,
Orbassano, Italy
| | - Maria Trojano
- Department of Basic Medical Sciences, Neuroscience and
Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Francesco Patti
- Department of Medical and Surgical Sciences, and Advanced
Technologies, G.F. Ingrassia, Multiple Sclerosis Center, University of Catania, Catania,
Italy
| | - Sandra Vukusic
- Service de Neurologie A, Hôpital Pierre Wertheimer,
Hospices Civils de Lyon, Lyon, France/Observatoire Français de la Sclérose en Plaques
(OFSEP), Lyon, France/Centre de Recherche en Neurosciences de Lyon, INSERM U1028, CNRS
UMR5292, Equipe Neuro-Oncologie et Neuro-Inflammation, Lyon, France/Université de Lyon
1, Lyon, France
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Abstract
BACKGROUND The development of oral treatments for relapsing-remitting multiple sclerosis (RRMS) may alter patient satisfaction and quality of life (QoL). The aim of this survey was to evaluate treatment satisfaction and QoL in patients treated with fingolimod in everyday clinical practice in France. METHODS Neurologists treating MS in France were invited to participate in the survey by telephone. Each physician was expected to recruit up to six patients with RRMS currently being treated with fingolimod. Enrolled patients were asked to complete the Treatment Satisfaction Questionnaire for Medication (TSQM), the 3-level 5-dimension EuroQoL instrument, as well as specific questions on change in QoL since starting fingolimod. Factors associated with the TSQM score were evaluated using multiple logistic regression analysis. RESULTS Two hundred and fourteen patients were recruited by 54 neurologists. The mean age of the patients was 41.6±10.0 years, and 73.4% of them were women. During the hospitalization for initiation of fingolimod treatment, 70.1% of patients had received information on MS, 76.6% had received information on fingolimod, and 20.7% had participated in a therapeutic education program. The two variables with the strongest associations with high TSQM scores (≥75) were a positive perception of initial hospitalization (hazard ratio: 10.27) and receiving information on MS during hospitalization (hazard ratio: 5.70). The mean EQ-visual analog scale score was 71.6±16.8. The mean EQ-visual analog scale score was significantly higher in patients satisfied with their treatment (75.8±15.2) compared to those unsatisfied with treatment (66.6±17.2). The proportion of patients who reported an improvement in their capacity to plan for the future was higher in satisfied (72.6%) than in unsatisfied patients (49.5%). CONCLUSION The majority of patients treated with fingolimod are satisfied with their treatment. Treatment satisfaction is associated with better self-rated QoL and an improvement of QoL since starting treatment.
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Affiliation(s)
- Claude Mékiès
- Clinique des Cèdres, Toulouse
- Correspondence: Claude Mékiès, Clinique des Cèdres, Château d’Alliez, Cornebarrieu-CS 20220, 31705 Blagnac Cedex, France, Tel +33 5 62 13 31 91, Email
| | - Olivier Heinzlef
- Neurology Department, CHI Poissy-Saint-Germain-en-Laye, St Germain-en-Laye
| | | | | | - Pierre Clavelou
- Service de Neurologie, CHU Gabriel Montpied, University of Auvergne, Clermont-Ferrand, France
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van Hille B, Heinzlef O, Dourgnon P, Molinier G, Chekroun M, Longin J. Perception par les patients atteints de sclérose en plaques (SEP), et leurs proches, des coûts indirects liés à la maladie : étude sur une communauté de patients français en 2016. Rev Epidemiol Sante Publique 2017. [DOI: 10.1016/j.respe.2017.04.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Grimaldi-Bensouda L, Rossignol M, Koné-Paut I, Krivitzky A, Lebrun-Frenay C, Clet J, Brassat D, Papeix C, Nicolino M, Benhamou PY, Fain O, Costedoat-Chalumeau N, Courcoux MF, Viallard JF, Godeau B, Papo T, Vermersch P, Bourgault-Villada I, Breart G, Abenhaim L, Abbas F, Abdelmoumni A, Hilliquin P, Requeda E, Adoue D, Brassat D, Agard C, Masseau A, Aladjidi N, Clet J, Fernandes H, Lemasson G, Perel Y, Raymond I, Richer O, Vital A, Allain-Launay E, Bru M, Nicolino M, Thomas C, Altman JJ, Amsallem D, Aras N, Boukari L, Dubrel M, Fain O, Letellier E, Lucidarme N, Mekinian A, Morin AS, Stirnemann J, Atlan C, Audry D, Augustin J, Bakir R, Bartolucci P, Chevalier X, Godeau B, Guillaud C, Khellaf M, Limal N, Lousteau V, Mahevas M, Méliksetyan G, Michel M, Roumier M, Bayart S, Bonnet F, Decaux O, Bekherraz A, Brihaye B, Dachez R, Daugas E, Hayem G, Meyer O, Papo T, Pasqualoni E, Sacre K, Travert F, Bellon H, Beltrand J, Lefrere F, Simon A, Benhamou PY, Benveniste O, Bolgert F, Costedoat-Chalumeau N, De Paz R, Demeret S, Fautrel B, Jacqueminet S, Louapre C, Maillart E, Morel N, Papeix C, Rigabert J, Bensaid P, Berger C, Berquin P, Le Moing AG, Berroir S, Besson G, Boutte C, Casez O, Bonnotte B, Audia S, Bossu-Estour C, Bourgarit A, Dupuy A, Keshmandt H, Bourre B, Brac A, Perrin A, Pondarré C, Villar-Fimbel S, Bruckert I, Cosson A, Magy-Bertrand N, Tisserand G, Camu W, Carlander B, Morales RJ, Cances C, Pasquet M, Castilla Lievre MA, Chabroux S, Charif M, Chatelus E, Sibilia J, Chevrant-Breton J, Clavel S, Bille-Turc F, Cohen J, Courcoux MF, Leverger G, Machet L, Cuisset JM, Cony-Makhoul P, Darsy P, Favre S, Giraud P, Leitenschenck L, Monteiro I, Morati C, DeSeze J, Dinulescu M, Dhaoui T, Dommange-Romero F, Drevard E, Dupuis C, Dumuis ML, Durand JM, Farad S, Lecomte P, Pierre P, Fouyssac F, Gaudin P, Gautier A, Gellen-Dautremer J, Jarrin I, Richette P, Georget E, Gras P, Moreau T, Giraud E, Hacini M, Mayer A, Guillaumat C, Guillaume S, Guitton C, Kone-Paut I, Marsaud C, Rossi L, Guyot MH, Hassler P, Heimfert C, Heinzlef O, Hillion B, Hocquelet C, Husson H, Ichai P, Jeziorski E, Deslandre CJ, Le Guern V, Kamenov K, Kerlan V, Lemoine P, Misery L, Pan-Petesch B, Krivitzky A, Labauge P, Rodier M, Lacade C, Razafimahefa B, Lachgar K, Larmarau MP, Leblanc T, Lebrun-Frenay C, Lefèbvre P, Lejoyeux P, Leske C, Ly K, Magy L, Mansuy S, Marechaud R, Martin Negrier ML, Sole G, Maupetit J, Mazingue F, Mochon S, Moktar B, Morcamp D, Morlet-Barla N, Nicolas G, Pautot V, Pellier I, Verret JL, Outteryck O, Vermersch P, Pallot-Prades B, Paquet JM, Puechal X, Sortais A, Pelletier J, Rico A, Pez D, Stankoff B, Quittet P, Rémy C, Roba E, Rosario H, Roudaut N, Sonnet E, Ruel M, Sebban S, Schaepelynck P, Simonin MJ, Vial C, Viallard JF, Ladedan I, Zenone T. Risk of autoimmune diseases and human papilloma virus (HPV) vaccines: Six years of case-referent surveillance. J Autoimmun 2017; 79:84-90. [DOI: 10.1016/j.jaut.2017.01.005] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Revised: 12/08/2016] [Accepted: 01/26/2017] [Indexed: 10/20/2022]
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Gay MC, Bungener C, Thomas S, Vrignaud P, Thomas PW, Baker R, Montel S, Heinzlef O, Papeix C, Assouad R, Montreuil M. Anxiety, emotional processing and depression in people with multiple sclerosis. BMC Neurol 2017; 17:43. [PMID: 28231828 PMCID: PMC5324294 DOI: 10.1186/s12883-017-0803-8] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2016] [Accepted: 01/20/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Despite the high comorbidity of anxiety and depression in people with multiple sclerosis (MS), little is known about their inter-relationships. Both involve emotional perturbations and the way in which emotions are processed is likely central to both. The aim of the current study was to explore relationships between the domains of mood, emotional processing and coping and to analyse how anxiety affects coping, emotional processing, emotional balance and depression in people with MS. METHODS A cross-sectional questionnaire study involving 189 people with MS with a confirmed diagnosis of MS recruited from three French hospitals. Study participants completed a battery of questionnaires encompassing the following domains: i. anxiety and depression (Hospital Anxiety and Depression Scale (HADS)); ii. emotional processing (Emotional Processing Scale (EPS-25)); iii. positive and negative emotions (Positive and Negative Emotionality Scale (EPN-31)); iv. alexithymia (Bermond-Vorst Alexithymia Questionnaire) and v. coping (Coping with Health Injuries and Problems-Neuro (CHIP-Neuro) questionnaire. Relationships between these domains were explored using path analysis. RESULTS Anxiety was a strong predictor of depression, in both a direct and indirect way, and our model explained 48% of the variance of depression. Gender and functional status (measured by the Expanded Disability Status Scale) played a modest role. Non-depressed people with MS reported high levels of negative emotions and low levels of positive emotions. Anxiety also had an indirect impact on depression via one of the subscales of the Emotional Processing Scale ("Unregulated Emotion") and via negative emotions (EPN-31). CONCLUSIONS This research confirms that anxiety is a vulnerability factor for depression via both direct and indirect pathways. Anxiety symptoms should therefore be assessed systematically and treated in order to lessen the likelihood of depression symptoms.
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Affiliation(s)
- Marie-Claire Gay
- Psychology Department, University of Paris West, Nanterre, France.
| | - Catherine Bungener
- Laboratory of Psychopathology, University of Paris Descartes, Paris, France.,Health Psychology, Université Paris Sorbonne Cité, Paris, France
| | - Sarah Thomas
- Clinical Research Unit, Faculty of Health and Social Sciences, Bournemouth University, Bournemouth, UK
| | - Pierre Vrignaud
- Psychology Department, University of Paris West, Nanterre, France
| | - Peter W Thomas
- Clinical Research Unit, Faculty of Health and Social Sciences, Bournemouth University, Bournemouth, UK
| | - Roger Baker
- Clinical Research Unit, Faculty of Health and Social Sciences, Bournemouth University, Bournemouth, UK
| | | | - Olivier Heinzlef
- Neurology Department, Hospital of Poissy-St-Germain en Laye, Paris, France
| | | | - Rana Assouad
- Neurology Department, GHPS Pitié Salpêtrière, Paris, France
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Moreau T, Bungener C, Heinzlef O, Suchet L, Borgel F, Bourdeix I, Meite M, Rerat K, Chouette I. Anxiety and Coping Strategy Changes in Multiple Sclerosis Patients Initiating Fingolimod: The GRACE Prospective Study. Eur Neurol 2016; 77:47-55. [DOI: 10.1159/000451077] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Accepted: 09/26/2016] [Indexed: 11/19/2022]
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47
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Boukobza S, Gay MC, Heinzlef O. Perception du soutien conjugal chez les femmes atteintes de sclérose en plaques et leur conjoint. Rev Neurol (Paris) 2016. [DOI: 10.1016/j.neurol.2016.01.223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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48
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Peyro Saint Paul L, Creveuil C, Heinzlef O, De Seze J, Vermersch P, Castelnovo G, Cabre P, Debouverie M, Brochet B, Dupuy B, Lebiez P, Sartori É, Clavelou P, Brassat D, Lebrun-Frenay C, Daplaud D, Pelletier J, Coman I, Hautecoeur P, Tourbah A, Defer G. Efficacy and safety profile of memantine in patients with cognitive impairment in multiple sclerosis: A randomized, placebo-controlled study. J Neurol Sci 2016; 363:69-76. [DOI: 10.1016/j.jns.2016.02.012] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Revised: 02/04/2016] [Accepted: 02/05/2016] [Indexed: 01/01/2023]
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49
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Barbin L, Rousseau C, Jousset N, Casey R, Debouverie M, Vukusic S, De Sèze J, Brassat D, Wiertlewski S, Brochet B, Pelletier J, Vermersch P, Edan G, Lebrun-Frenay C, Clavelou P, Thouvenot E, Camdessanché JP, Tourbah A, Stankoff B, Al Khedr A, Cabre P, Papeix C, Berger E, Heinzlef O, Debroucker T, Moreau T, Gout O, Bourre B, Créange A, Labauge P, Magy L, Defer G, Foucher Y, Laplaud DA. Comparative efficacy of fingolimod vs natalizumab: A French multicenter observational study. Neurology 2016; 86:771-8. [PMID: 26826205 PMCID: PMC4763805 DOI: 10.1212/wnl.0000000000002395] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2015] [Accepted: 10/29/2015] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To compare natalizumab and fingolimod on both clinical and MRI outcomes in patients with relapsing-remitting multiple sclerosis (RRMS) from 27 multiple sclerosis centers participating in the French follow-up cohort Observatoire of Multiple Sclerosis. METHODS Patients with RRMS included in the study were aged from 18 to 65 years with an Expanded Disability Status Scale score of 0-5.5 and an available brain MRI performed within the year before treatment initiation. The data were collected for 326 patients treated with natalizumab and 303 with fingolimod. The statistical analysis was performed using 2 different methods: logistic regression and propensity scores (inverse probability treatment weighting). RESULTS The confounder-adjusted proportion of patients with at least one relapse within the first and second year of treatment was lower in natalizumab-treated patients compared to the fingolimod group (21.1% vs 30.4% at first year, p = 0.0092; and 30.9% vs 41.7% at second year, p = 0.0059) and supported the trend observed in nonadjusted analysis (21.2% vs 27.1% at 1 year, p = 0.0775). Such statistically significant associations were also observed for gadolinium (Gd)-enhancing lesions and new T2 lesions at both 1 year (Gd-enhancing lesions: 9.3% vs 29.8%, p < 0.0001; new T2 lesions: 10.6% vs 29.6%, p < 0.0001) and 2 years (Gd-enhancing lesions: 9.1% vs 22.1%, p = 0.0025; new T2 lesions: 16.9% vs 34.1%, p = 0.0010) post treatment initiation. CONCLUSION Taken together, these results suggest the superiority of natalizumab over fingolimod to prevent relapses and new T2 and Gd-enhancing lesions at 1 and 2 years. CLASSIFICATION OF EVIDENCE This study provides Class IV evidence that for patients with RRMS, natalizumab decreases the proportion of patients with at least one relapse within the first year of treatment compared to fingolimod.
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Affiliation(s)
| | - Chloe Rousseau
- Authors' affiliations are listed at the end of the article
| | | | - Romain Casey
- Authors' affiliations are listed at the end of the article
| | | | - Sandra Vukusic
- Authors' affiliations are listed at the end of the article
| | - Jerome De Sèze
- Authors' affiliations are listed at the end of the article
| | - David Brassat
- Authors' affiliations are listed at the end of the article
| | | | - Bruno Brochet
- Authors' affiliations are listed at the end of the article
| | - Jean Pelletier
- Authors' affiliations are listed at the end of the article
| | | | - Gilles Edan
- Authors' affiliations are listed at the end of the article
| | | | | | - Eric Thouvenot
- Authors' affiliations are listed at the end of the article
| | | | - Ayman Tourbah
- Authors' affiliations are listed at the end of the article
| | - Bruno Stankoff
- Authors' affiliations are listed at the end of the article
| | | | - Philippe Cabre
- Authors' affiliations are listed at the end of the article
| | | | - Eric Berger
- Authors' affiliations are listed at the end of the article
| | | | | | | | - Olivier Gout
- Authors' affiliations are listed at the end of the article
| | | | - Alain Créange
- Authors' affiliations are listed at the end of the article
| | - Pierre Labauge
- Authors' affiliations are listed at the end of the article
| | - Laurent Magy
- Authors' affiliations are listed at the end of the article
| | - Gilles Defer
- Authors' affiliations are listed at the end of the article
| | - Yohann Foucher
- Authors' affiliations are listed at the end of the article
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50
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Perreira Paulo L, Rébillon M, Furic B, Heinzlef O. [Expert patients living with multiple sclerosis: description of a training device]. Rev Prat 2015; 65:1222-1224. [PMID: 30512519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
| | - Maryline Rébillon
- Comment Dire, maître de conférences ; Sciences de l'éducation, UPMC - Sorbonne Universités, Paris, France
| | - Brigitte Furic
- Ligue française contre la sclérose en plaques, Paris, France
| | - Olivier Heinzlef
- Ligue française contre la sclérose en plaques, Paris, France
- Service de neurologie, CHI Poissy-Saint-Germainen- Laye, Saint- Germain-en-Laye, France
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