The effect of oral immunomodulatory therapy on treatment uptake and persistence in multiple sclerosis
Language English Country England, Great Britain Media print-electronic
Document type Journal Article, Multicenter Study, Observational Study, Research Support, Non-U.S. Gov't
PubMed
26199347
DOI
10.1177/1352458515594041
PII: 1352458515594041
Knihovny.cz E-resources
- Keywords
- MSBase, Multiple sclerosis, disease-modifying therapy, fingolimod, medication persistence,
- MeSH
- Medication Adherence * MeSH
- Administration, Oral MeSH
- Time Factors MeSH
- Demyelinating Diseases diagnosis drug therapy immunology MeSH
- Adult MeSH
- Fingolimod Hydrochloride administration & dosage adverse effects MeSH
- Immunosuppressive Agents administration & dosage adverse effects MeSH
- Kaplan-Meier Estimate MeSH
- Middle Aged MeSH
- Humans MeSH
- Multivariate Analysis MeSH
- Drug Substitution * MeSH
- Proportional Hazards Models MeSH
- Prospective Studies MeSH
- Registries MeSH
- Multiple Sclerosis, Relapsing-Remitting diagnosis drug therapy immunology MeSH
- Risk Factors MeSH
- Aged MeSH
- Treatment Outcome MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Multicenter Study MeSH
- Observational Study MeSH
- Research Support, Non-U.S. Gov't MeSH
- Names of Substances
- Fingolimod Hydrochloride MeSH
- Immunosuppressive Agents MeSH
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 Neurology Royal Melbourne Hospital Melbourne Australia
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
Jewish General Hospital Montreal Canada
John Hunter Hospital Newcastle Australia
Karadeniz Technical University Trabzon Turkey
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
References provided by Crossref.org
Predictors of treatment switching in the Big Multiple Sclerosis Data Network
