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The effect of oral immunomodulatory therapy on treatment uptake and persistence in multiple sclerosis

M. Warrender-Sparkes, T. Spelman, G. Izquierdo, M. Trojano, A. Lugaresi, F. Grand'Maison, E. Havrdova, D. Horakova, C. Boz, C. Oreja-Guevara, R. Alroughani, G. Iuliano, P. Duquette, M. Girard, M. Terzi, R. Hupperts, P. Grammond, T. Petersen, R....

. 2016 ; 22 (4) : 520-32. [pub] 20150721

Jazyk angličtina Země Anglie, Velká Británie

Typ dokumentu časopisecké články, multicentrická studie, pozorovací studie, práce podpořená grantem

Perzistentní odkaz   https://www.medvik.cz/link/bmc17001086

OBJECTIVE: We aimed to analyse the effect of the introduction of fingolimod, the first oral disease-modifying therapy, on treatment utilisation and persistence in an international cohort of patients with multiple sclerosis (MS). METHODS: MSBASIS, a prospective, observational sub-study of the MSBase registry, collects demographic, clinical and paraclinical data on patients followed from MS onset (n=4718). We conducted a multivariable conditional risk set survival analysis to identify predictors of treatment discontinuation, and to assess if the introduction of fingolimod has altered treatment persistence. RESULTS: A total of 2640 patients commenced immunomodulatory therapy. Following the introduction of fingolimod, patients were more likely to discontinue all other treatments (hazard ratio 1.64, p<0.001) while more patients switched to fingolimod than any other therapy (42.3% of switches). Patients switched to fingolimod due to convenience. Patients treated with fingolimod were less likely to discontinue treatment compared with other therapies (p<0.001). Female sex, country of residence, younger age, a high Expanded Disability Status Scale score and relapse activity were all independently associated with higher rates of treatment discontinuation. CONCLUSION: Following the availability of fingolimod, patients were more likely to discontinue injectable treatments. Those who switched to fingolimod were more likely to do so for convenience. Persistence was improved on fingolimod compared to other medications.

Aarhus University Hospital Aarhus C Denmark

Amiri Hospital Kuwait City Kuwait

Brain and Mind Research Institute Sydney Australia

Cliniques Universitaires Saint Luc Brussels Belgium

Craigavon Area Hospital Portadown United Kingdom

Department NEUROFARBA Section of Neurosciences University of Florence Florence Italy

Department of Basic Medical Sciences Neuroscience and Sense Organs University of Bari Italy

Department of Medicine University of Melbourne Melbourne Australia

Department of Medicine University of Melbourne Melbourne Australia Department of Neurology Box Hill Hospital Monash University Box Hill Australia

Department of Medicine University of Melbourne Melbourne Australia Department of Neurology Royal Melbourne Hospital Melbourne Australia

Department of Neurology and Center of Clinical Neuroscience 1st Faculty of Medicine General University Hospital and Charles University Prague Czech Republic

Department of Neurology Royal Melbourne Hospital Melbourne Australia

FLENI Buenos Aires Argentina

Flinders University and Medical Centre Adelaide Australia

Geelong Hospital Geelong Australia

Groen Hart Ziekenhuis Gouda The Netherlands

Hôpital Notre Dame Montreal Canada

Hospital Italiano Buenos Aires Argentina

Hospital Universitario Virgen de Valme Seville Spain

Hospital Universitario Virgen Macarena Sevilla Spain

Hotel Dieu de Levis Quebec Canada

INEBA Buenos Aires Argentina

Jewish General Hospital Montreal Canada

John Hunter Hospital Newcastle Australia

Karadeniz Technical University Trabzon Turkey

MS Center Department of Neuroscience Imaging and Clinical Sciences University 'G d'Annunzio' Chieti Italy

National Neurological Institute C Mondino Pavia Italy

Neuro Rive Sud Hôpital Charles LeMoyne Quebec Canada

Neurology Clinical Center Skopje Macedonia

New York University Langone Medical Center New York USA

Ondokuz Mayis Üniversitesi Samsun Turkey

Orbis Medicle Center Sittard The Netherlands

Ospedale di Macerata Macerata Italy

Ospedali Riuniti di Salerno Salerno Italy

St Vincent's Hospital Melbourne Australia

The Walton Centre for Neurology and Neurosurgery Liverpool United Kingdom

University Hospital Basel Neurology Departments of Medicine Clinical Research and Biomedicine Basel Switzerland

University Hospital San Carlos IdISSC Madrid Spain

Citace poskytuje Crossref.org

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