Commencing January 2024 Dr Chao Zhu was awarded a $500,000 5-year Fellowship titled, “Development and implementation of a clinical score for treatment de-escalation and discontinuation from high-efficacy therapy”. Dr Zhu is working with Associate Investigators Professor Helmut Butzkueven and A/Prof Anneke van der Walt.
Prior to the commencement of this important Fellowship, Professor Butzkueven said, “With this Trish Fellowship, Dr Zhu will work with over 93,000 patient records from MSBase and over 250,000 from Denmark, Sweden, Italy and France to develop and test a score-based individualised treatment recommendation, before developing an APP to make the score generally available and continue to refine its accuracy. This research will maximise prevention of progression and disability while improving safety, especially in the many older people with MS.”
The project aims to develop a practical tool to help people with multiple sclerosis (MS) and their doctors decide whether it is safe to reduce or stop strong treatments after long-term use. While these treatments are effective, they may increase the risk of serious side effects such as infections or cancer over time. The goal is to provide a personalised risk estimate to support safer and more informed treatment decisions.
Over the past year, Dr Zhu and his team has successfully developed the DR-MS risk score using data from a large international MS registry. This tool estimates the likelihood of experiencing important health events, such as worsening disability, relapse, or serious infection, within three years after changing treatment. The model has been tested internally and showed reliable performance. Dr Zhu also created a simplified version of the score so that it can be easily used in clinical practice.
Dr Zhu has now moved into the next phase of the project, which is to test the tool using data from other countries. Applications have been submitted to the French and Danish MS registries and are currently under review. While Dr Zhu is waiting for approval, he and his team have completed all preparation work so that analysis can begin immediately once access is granted.
Dr Zhu and his team have also undertaken additional studies to further strengthen the project. He completed a large study comparing the effectiveness of two commonly used MS treatments, ofatumumab and ocrelizumab, using data from MSBase and the French registry. This work has been written up and submitted to the Journal of Neurology, Neurosurgery and Psychiatry and is currently under review. In addition, he has initiated a major safety study focusing on two high-efficacy treatments, ocrelizumab and natalizumab, to better understand the risk of serious infections and cancers. This study has received approval from MSBase and serves as an important complement to the main project, as it provides further evidence to support treatment decision-making.
Dr Zhu and his team have also started preparing for the next stage of the project, which involves developing a digital tool (app) to deliver the risk score in a user-friendly way. This includes planning how clinicians will enter patient information, how results will be displayed, and how the tool can be integrated into the MSBase system for real-world use.
Over the next 12 months, the primary focus will be on completing the external validation of the DR-MS risk scoring system using independent registry data. Pending approval of the submitted data applications, Dr Zhu will conduct validation analyses using the French MS Registry (OFSEP), and potentially additional datasets if access is granted.