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

R Lanzillo, L Prosperini, C Gasperini, M Moccia, R Fantozzi, C Tortorella, V Nociti, P Annovazzi, P Cavalla, M Radaelli, S Malucchi, VT Clerici, L Boffa, F Buttari, P Ragonese, GT Maniscalco, M Di Filippo, MC Buscarinu, F Pinardi, A GalloG Coghe, I Pesci, A Laroni, A Gajofatto, M Calabrese, V Tomassini, E Cocco, C Solaro, R.I.Re.MS study group

Research output: Contribution to journalArticlepeer-review

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. © 2018, Springer-Verlag GmbH Germany, part of Springer Nature.
Original languageEnglish
Pages (from-to)1174-1183
Number of pages10
JournalJournal of Neurology
Volume265
Issue number5
DOIs
Publication statusPublished - 2018

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