A multicentRE observational analysiS of PErsistenCe to Treatment in the new multiple sclerosis era: the RESPECT study.

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 (n = 163; 43.6%), disease activity (n = 95; 25.4%), adverse events (n = 64; 17.1%), convenience (i.e. availability of new drug formulations) and pregnancy planning (n = 21; 1.1%). Although the proportion of discontinuers was higher with self-injectable (n = 107; 22.9%) than with oral DMT (n = 215; 16.4%), the Cox regression model revealed no significant between-group difference (p = 0.12). Female sex [hazard ratio (HR) = 1.39, p = 0.01] and previous exposure to ≥ 3 DMTs (HR = 1.71, p = 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.

• Authors: Roberta Lanzillo, Luca Prosperini, Claudio Gasperini, Marcello Moccia, Roberta Fantozzi, Carla Tortorella, Viviana Nociti, Pietro Annovazzi, Paola Cavalla, Marta Radaelli, Simona Malucchi, Valentina Torri Clerici, Laura Boffa, Fabio Buttari, Paolo Ragonese, Giorgia Teresa Maniscalco, Massimiliano Di Filippo, Maria Chiara Buscarinu, Federica Pinardi, Antonio Gallo, Giancarlo Coghe, Ilaria Pesci, Alice Laroni, Alberto Gajofatto, Massimiliano Calabrese, Valentina Tomassini, Eleonora Cocco, Claudio Solaro, R.I.Re.MS study group
• Journal: Journal of neurology (J Neurol) Vol. 265 Issue 5 Pg. 1174-1183 (May 2018) ISSN: 1432-1459 [Electronic] Germany
• PMID: 29549468 (Publication Type: Journal Article, Multicenter Study, Observational Study)

Chemical References

• Immunologic Factors

Topics

• Administration, Oral
• Adult
• Female
• Follow-Up Studies
• Humans
• Immunologic Factors (administration & dosage, adverse effects)
• Injections
• Kaplan-Meier Estimate
• Male
• Multiple Sclerosis, Relapsing-Remitting (diagnosis, drug therapy)
• Patient Dropouts
• Prognosis
• Proportional Hazards Models
• Retrospective Studies
• Risk Factors
• Self Administration
• Sex Factors
• Time Factors