TY - JOUR
T1 - A multicentRE observational analysiS of PErsistenCe to Treatment in the new multiple sclerosis era: the RESPECT study
AU - Lanzillo, R
AU - Prosperini, L
AU - Gasperini, C
AU - Moccia, M
AU - Fantozzi, R
AU - Tortorella, C
AU - Nociti, V
AU - Annovazzi, P
AU - Cavalla, P
AU - Radaelli, M
AU - Malucchi, S
AU - Clerici, VT
AU - Boffa, L
AU - Buttari, F
AU - Ragonese, P
AU - Maniscalco, GT
AU - Di Filippo, M
AU - Buscarinu, MC
AU - Pinardi, F
AU - Gallo, A
AU - Coghe, G
AU - Pesci, I
AU - Laroni, A
AU - Gajofatto, A
AU - Calabrese, M
AU - Tomassini, V
AU - Cocco, E
AU - Solaro, C
AU - group, R.I.Re.MS study
PY - 2018
Y1 - 2018
N2 - 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.
AB - 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.
U2 - 10.1007/s00415-018-8831-x
DO - 10.1007/s00415-018-8831-x
M3 - Article
VL - 265
SP - 1174
EP - 1183
JO - Journal of Neurology
JF - Journal of Neurology
SN - 0340-5354
IS - 5
ER -