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- Title
A multicentRE observational analysiS of PErsistenCe to Treatment in the new multiple sclerosis era: the RESPECT study.
- Authors
Lanzillo, Roberta; Prosperini, Luca; Gasperini, Claudio; Moccia, Marcello; Fantozzi, Roberta; Tortorella, Carla; Nociti, Viviana; Annovazzi, Pietro; Cavalla, Paola; Radaelli, Marta; Malucchi, Simona; Clerici, Valentina Torri; Boffa, Laura; Buttari, Fabio; Ragonese, Paolo; Maniscalco, Giorgia Teresa; Di Filippo, Massimiliano; Buscarinu, Maria Chiara; Pinardi, Federica; Gallo, Antonio
- Abstract
In this independent, multicenter, retrospective study, we investigated the short-term persistence to treatment with first-line self-injectable or oral disease-modifying treatments (DMTs) in patients with relapsing-remitting multiple sclerosis. Data of patients regularly attending 21 Italian MS Centres who started a self-injectable or an oral DMT in 2015 were collected to: (1) estimate the proportion of patients discontinuing the treatment; (3) explore reasons for discontinuation; (3) identify baseline predictors of treatment discontinuation over a follow-up period of 12 months. We analyzed data of 1832 consecutive patients (1289 women, 543 men); 374 (20.4%) of them discontinued the prescribed DMT after a median time of 6 months (range 3 days to 11.5 months) due to poor tolerability (<italic>n</italic> = 163; 43.6%), disease activity (<italic>n</italic> = 95; 25.4%), adverse events (<italic>n</italic> = 64; 17.1%), convenience (i.e. availability of new drug formulations) and pregnancy planning (<italic>n</italic> = 21; 1.1%). Although the proportion of discontinuers was higher with self-injectable (<italic>n</italic> = 107; 22.9%) than with oral DMT (<italic>n</italic> = 215; 16.4%), the Cox regression model revealed no significant between-group difference (<italic>p</italic> = 0.12). Female sex [hazard ratio (HR) = 1.39, <italic>p</italic> = 0.01] and previous exposure to ≥ 3 DMTs (HR = 1.71, <italic>p</italic> = 0.009) were two independent risk factors for treatment discontinuation, regardless of prescribed DMTs. Our study confirms that persistence to treatment represents a clinical challenge, irrespective of the route of administration.
- Subjects
MULTIPLE sclerosis treatment; DISEASE relapse; HEALTH outcome assessment; QUALITY of life; DRUG formularies
- Publication
Journal of Neurology, 2018, Vol 265, Issue 5, p1174
- ISSN
0340-5354
- Publication type
Article
- DOI
10.1007/s00415-018-8831-x