TY - JOUR
T1 - First-line disease-modifying drugs in relapsing-remitting multiple sclerosis
T2 - an Italian real-life multicenter study on persistence
AU - Ferraro, Diana
AU - Camera, Valentina
AU - Baldi, Eleonora
AU - Vacchiano, Veria
AU - Curti, Erica
AU - Guareschi, Angelica
AU - Malagù, Susanna
AU - Montepietra, Sara
AU - Strumia, Silvia
AU - Santangelo, Mario
AU - Caniatti, Luisa
AU - Foschi, Matteo
AU - Lugaresi, Alessandra
AU - Granella, Franco
AU - Pesci, Ilaria
AU - Motti, Luisa
AU - Neri, Walter
AU - Immovilli, Paolo
AU - Montanari, Enrico
AU - Vitetta, Francesca
AU - Simone, Anna Maria
AU - Sola, Patrizia
N1 - Ricercatore distaccato presso IRCCS a seguito Convenzione esclusiva con Università di Bologna (Lugaresi Alessandra).
La Prof.ssa A. Lugaresi viene da altro Istituto e lavori con affiliazioni diverse usciranno ancora nei prossimi anni.
PY - 2018/10
Y1 - 2018/10
N2 - OBJECTIVE: The introduction of oral disease-modifying drugs (DMDs) in addition to the available, injectable, ones for relapsing-remitting multiple sclerosis (RRMS) could be expected to improve medication persistence due to a greater acceptability of the route of administration. The aim of the study was to compare the proportion of patients discontinuing injectable DMDs (interferon beta 1a/1b, pegylated interferon, glatiramer acetate) with those discontinuing oral DMDs (dimethylfumarate and teriflunomide) during an observation period of at least 12 months. Secondary aims were to compare the time to discontinuation and the reasons for discontinuation between the two groups and to explore the demographic and clinical factors associated with DMD discontinuation.METHODS: In this prospective, multi-center, real-life observational study, patients commencing any first-line DMD between 1 January 2015 and 31 July 2016 were enrolled and followed up for at least 12 months or until the drug was discontinued.RESULTS: Of the 520 included patients, 262 (49.6%) started an injectable and 258 (50.4%) an oral DMD. There was no difference in the proportion of patients on oral (n = 62, 24%) or on injectable (n = 60, 23%) DMDs discontinuing treatment, the most frequent reason being adverse events/side-effects. Higher baseline Expanded Disability Status Scale (EDSS) scores and younger age increased the odds of treatment withdrawal. Time to treatment discontinuation was not different between the two groups and was not influenced by the initiated DMD (oral versus injectable), even after adjustment for baseline differences.CONCLUSION: The route of administration alone (i.e. oral versus injectable) was not a significant predictor of persistence with first-line DMDs in RRMS.
AB - OBJECTIVE: The introduction of oral disease-modifying drugs (DMDs) in addition to the available, injectable, ones for relapsing-remitting multiple sclerosis (RRMS) could be expected to improve medication persistence due to a greater acceptability of the route of administration. The aim of the study was to compare the proportion of patients discontinuing injectable DMDs (interferon beta 1a/1b, pegylated interferon, glatiramer acetate) with those discontinuing oral DMDs (dimethylfumarate and teriflunomide) during an observation period of at least 12 months. Secondary aims were to compare the time to discontinuation and the reasons for discontinuation between the two groups and to explore the demographic and clinical factors associated with DMD discontinuation.METHODS: In this prospective, multi-center, real-life observational study, patients commencing any first-line DMD between 1 January 2015 and 31 July 2016 were enrolled and followed up for at least 12 months or until the drug was discontinued.RESULTS: Of the 520 included patients, 262 (49.6%) started an injectable and 258 (50.4%) an oral DMD. There was no difference in the proportion of patients on oral (n = 62, 24%) or on injectable (n = 60, 23%) DMDs discontinuing treatment, the most frequent reason being adverse events/side-effects. Higher baseline Expanded Disability Status Scale (EDSS) scores and younger age increased the odds of treatment withdrawal. Time to treatment discontinuation was not different between the two groups and was not influenced by the initiated DMD (oral versus injectable), even after adjustment for baseline differences.CONCLUSION: The route of administration alone (i.e. oral versus injectable) was not a significant predictor of persistence with first-line DMDs in RRMS.
U2 - 10.1080/03007995.2018.1451311
DO - 10.1080/03007995.2018.1451311
M3 - Article
C2 - 29526118
SN - 0300-7995
VL - 34
SP - 1803
EP - 1807
JO - Current Medical Research and Opinion
JF - Current Medical Research and Opinion
IS - 10
ER -