Citations 4
The Association Between Neighborhood Disadvantage and Exposure to Plasma Exchange During Attacks in AQP4-IgG+ NMOSD (P4-1.007)
Palmer, Kaitlyn, Conway, Devon, Du, Mengke, Swetlik, Carol , Widmar, Julie, Miller, Deborah, O’Mahony, Julia , Abbatemarco, Justin, Conway, Devon , Du, Mengke, Aboseif, Albert , Kunchok, Amy , Miller, D M , Abbatemarco, Justin
Neurology | June 10, 2026 | Volume: 106 | Issue: 11_Supplement_1 | Pages: No page available
Disease-modifying treatment preferences and decision-making in a multiple sclerosis randomized and observational clinical trial (DELIVER-MS)
Tallantyre, Emma C , Planchon, Sarah M. , Howard, Harriet, Mays, John, Frowd, Nadia, Cohen, Jeffrey A. , Hersh, Carrie M. , Miller, Deborah , Dever, Meredith , Gray, Emma H., LaRocca, Nicholas G., Bale, Clare , Covey-Crump, Gwen, Alvarez, Enrique, Craner, Matt, Freeman, L, Frost, N, Hobart, JC, Hutton, George J, Hyland, Megan , Kalra, S, Kannan, Meena, Kantarci, OH , Lashley, Daniel, Lily, Oliver, Mahad, D, Nicholas, J, Nicholas, R, Paling, David, Pearson, Owen , Rice, Claire M , Samudralwar, Rohini, Schmalstieg, William F., Singh, M, The, E Zune, Zabeti, Aram , Love, Thomas E, Gunzler, Douglas , Liu, Y, GERRY, STEPHEN, Evangelou, N, Hersh, Carrie M , Miller, D M , Nakamura, Kunio , Goldman, Myla D , Harding, Katharine E , Hobart, Jeremy , Kalra, Seema , Nicholas, Richard , Pearson, Owen R , Rice, Claire M , Weinstock‐Guttman, Bianca , Evangelou, Nikos , Ontaneda, Daniel , Cohen, Jeffrey Allen , Tallantyre, Emma Clare , Coles, Alasdair J. , Covey-Crump, Gwen L , Arun, Tarunya , Brownlee, Wallace J , Craner, Matthew J., Freeman, Leorah A. , Goldman, Myla , Gupta, Rajesh , Hutton, George J., Kantarci, Orhun H. , Mahad, Don , Paling, David , The, Ei Zune , Love, Thomas E.
Multiple Sclerosis Journal | May 31, 2026 | Volume: 32 | Issue: 7 | Pages: 722-736
Background: There is growing support for high-efficacy disease-modifying therapy (DMT) in multiple sclerosis (MS), but escalation (ESC) approaches remain common. Objective: To describe decision-making in a pragmatic trial of early high-efficacy treatment (EHT) versus ESC. Methods: DELIVER-MS is a multi-center, pragmatic, randomized controlled trial (RCT) with a parallel observational study (OBS), which enrolled treatment-naïve people with RRMS in 31 UK/US sites. Primary outcome was as follows: 36-month brain volume loss according to initial treatment approach (EHT vs. ESC). Stepwise multivariable logistic regression was used to predict participation in RCT versus OBS and choice of EHT versus ESC within the OBS cohort. Results: In total, 816 people with MS were enrolled. Participants declined randomization due to preference for a particular DMT (85%), efficacy concerns (20%), and safety concerns (9%). RCT versus OBS participation was associated with lower relapse rate ( p = 0.043) and greater brain parenchymal fraction ( p = 0.002). Among 374 in the OBS cohort, 125 (33%) chose ESC and 249 (67%) chose EHT. People commencing EHT had higher education attainment ( p < 0.001) and relapse rate ( p = 0.025). Conclusion: Baseline DELIVER-MS data demonstrate that participants with milder disease are more likely to participate in RCT. The choice of EHT versus ESC was associated with demographic factors and disease activity. Clinical trial registration: NCT03535298
Neighborhood Disadvantage is Not Associated with Exposure to NMOSD Treatment (P11-8.009)
Palmer, Kaitlyn, Conway, Devon , Du, Mengke, Swetlik, Carol , Widmar, Julie, O’Mahony, Julia , Abbatemarco, Justin , Aboseif, Albert , Kunchok, Amy , Miller, D M
Neurology | April 7, 2025 | Volume: 104 | Issue: 7_Supplement_1 | Pages: No page available
Neighborhood disadvantage, race, and clinical outcomes in neuromyelitis optica spectrum disorder
Abbatemarco, JR, Aboseif, Albert , Swetlik, Carol , Widmar, Julie, Harvey, Teresa, Kunchok, Amy , O’Mahony, Julia , Miller, DM, Conway, DS, Miller, Deborah , Miller, D M , Conway, D S , Pittock, Sean J , Aboseif, Albert , Abbatemarco, JR, Harvey, T, Conway, Devon
Multiple Sclerosis Journal | August 6, 2024 | Volume: 30 | Issue: 10 | Pages: 1322-1330
Background: Little is known about the relationship between neighborhood disadvantage and neuromyelitis optica spectrum disorder (NMOSD) outcomes. Objective: The objective is to determine the impact of neighborhood disadvantage on time from symptom onset to diagnosis and annualized relapse rate (ARR). Methods: Neighborhood disadvantage were captured with the Area Deprivation Index (ADI), a validated measure of neighborhood-level disadvantage. Negative binomial regression models assessed the impact of ADI on diagnostic delay (⩾3 months between symptom onset and diagnosis) and ARR. Results: A total of 158 NMOSD patients were identified, a majority of whom were White (56.3%) and female (89.9%) with a mean age of 46 years at diagnosis. The ADI did not significantly affect odds of diagnostic delay (odds ratio (OR) = 0.99, p = 0.26). In univariable models, the ADI was not significantly associated with ARR (OR = 1.004, p = 0.29), but non-White race (OR = 1.541, p = 0.02) and time on immunosuppressive therapies (ISTs; OR = 0.994, p = 0.03) were. White patients used IST for an average of 81% of the follow-up period, compared to an average of 65% for non-White patients ( p < 0.01). Conclusion: No significant relationship between neighborhood-level disadvantage and diagnostic delay or ARR in NMOSD patients was observed. Non-White patients had a higher ARR, which may be related to less IST use.