Background: Multiple sclerosis (MS) is a chronic inflammatory and neurodegenerative disease of the central nervous system. Well-established drugs used for MS patients after the first demyelinating event in the Czech Republic include glatiramer acetate (GA), interferon beta-1a (IFNβ-1a), IFN beta-1b (IFNβ-1b), peginterferon beta-1a (peg-IFNβ-1a), and teriflunomide. Objective: The objective of this observational study was to compare the effectiveness of the abovementioned drugs in patients with MS who initiated their therapy after the first demyelinating event. Patients were followed for up to 2 years in real clinical practice in the Czech Republic. Methods: A total of 1,654 MS patients treated after the first demyelinating event and followed up for 2 years were enrolled. Evaluation parameters (endpoints) included the annualized relapse rate (ARR), time to next relapse, change in the Expanded Disability Status Scale (EDSS) score, and time of confirmed disease progression (CDP). When patients ended the therapy before the observational period, the reason for ending the therapy among different treatments was compared. Results: No significant difference was found among the groups of patients treated with IFNβ-1a/1b, GA, or teriflunomide for the following parameters: time to the first relapse, change in the EDSS score, and the proportion of patients with CDP. Compared to IFNβ-1a (44 mcg), a significant increase in the percentage of relapse-free patients was found for GA, but this treatment effect was not confirmed by the validation analysis. Compared to the other drugs, there was a significant difference in the reasons for terminating GA therapy. Conclusion: Small differences were found among GA, IFNβ and teriflunomide therapies, with no significant impact on the final outcome after 2 years. Therefore, in clinical practice, we recommend choosing the drug based on individual potential risk from long-term therapy and on patient preferences and clinical characteristics.

3rd Faculty of Medicine Charles University and Hospital Kralovské Vinohrady Charles University Prague Prague Czechia

Clinic of Neurology University Hospital Ostrava Ostrava Czechia

Department of Neurology Faculty of Medicine and University Hospital Hradec Králové Charles University Prague Hradec Králové Czechia

Department of Neurology Faculty of Medicine and University Hospital Plzen Charles University Prague Plzeň Czechia

Department of Neurology Faculty of Medicine Palacky University and University Hospital Olomouc Olomouc Czechia

Department of Neurology Hospital of Jihlava Jihlava Czechia

Department of Neurology KZ a s Hospital Teplice Teplice Czechia

Department of Neurology Thomayer Hospital Prague Czechia

Department of Neurology Tomas Bata Regional Hospital Zlín Czechia

Department of Neurology University Hospital and Masaryk University Brno Czechia

Memory Clinic Department of Neurology 2nd Faculty of Medicine Charles University and Motol University Hospital Prague Czechia

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