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 journalArticle

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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Multiple Sclerosis
Mouth Diseases
Therapeutics
Injections
Drug Compounding
Sex Ratio
Proportional Hazards Models
Multicenter Studies
Germany
Retrospective Studies
Pregnancy

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Lanzillo, R., Prosperini, L., Gasperini, C., Moccia, M., Fantozzi, R., Tortorella, C., ... group, R. I. R. MS. S. (2018). A multicentRE observational analysiS of PErsistenCe to Treatment in the new multiple sclerosis era: the RESPECT study. Journal of Neurology, 265(5), 1174-1183. https://doi.org/10.1007/s00415-018-8831-x

A multicentRE observational analysiS of PErsistenCe to Treatment in the new multiple sclerosis era: the RESPECT study. / Lanzillo, R; Prosperini, L; Gasperini, C; Moccia, M; Fantozzi, R; Tortorella, C; Nociti, V; Annovazzi, P; Cavalla, P; Radaelli, M; Malucchi, S; Clerici, VT; Boffa, L; Buttari, F; Ragonese, P; Maniscalco, GT; Di Filippo, M; Buscarinu, MC; Pinardi, F; Gallo, A; Coghe, G; Pesci, I; Laroni, A; Gajofatto, A; Calabrese, M; Tomassini, V; Cocco, E; Solaro, C; group, R.I.Re.MS study.

In: Journal of Neurology, Vol. 265, No. 5, 2018, p. 1174-1183.

Research output: Contribution to journalArticle

Lanzillo, R, Prosperini, L, Gasperini, C, Moccia, M, Fantozzi, R, Tortorella, C, Nociti, V, Annovazzi, P, Cavalla, P, Radaelli, M, Malucchi, S, Clerici, VT, Boffa, L, Buttari, F, Ragonese, P, Maniscalco, GT, Di Filippo, M, Buscarinu, MC, Pinardi, F, Gallo, A, Coghe, G, Pesci, I, Laroni, A, Gajofatto, A, Calabrese, M, Tomassini, V, Cocco, E, Solaro, C & group, RIRMSS 2018, 'A multicentRE observational analysiS of PErsistenCe to Treatment in the new multiple sclerosis era: the RESPECT study', Journal of Neurology, vol. 265, no. 5, pp. 1174-1183. https://doi.org/10.1007/s00415-018-8831-x
Lanzillo, R ; Prosperini, L ; Gasperini, C ; Moccia, M ; Fantozzi, R ; Tortorella, C ; Nociti, V ; Annovazzi, P ; Cavalla, P ; Radaelli, M ; Malucchi, S ; Clerici, VT ; Boffa, L ; Buttari, F ; Ragonese, P ; Maniscalco, GT ; Di Filippo, M ; Buscarinu, MC ; Pinardi, F ; Gallo, A ; Coghe, G ; Pesci, I ; Laroni, A ; Gajofatto, A ; Calabrese, M ; Tomassini, V ; Cocco, E ; Solaro, C ; group, R.I.Re.MS study. / A multicentRE observational analysiS of PErsistenCe to Treatment in the new multiple sclerosis era: the RESPECT study. In: Journal of Neurology. 2018 ; Vol. 265, No. 5. pp. 1174-1183.
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AU - Moccia, M

AU - Fantozzi, R

AU - Tortorella, C

AU - Nociti, V

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AU - Cavalla, P

AU - Radaelli, M

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AU - Maniscalco, GT

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AU - Pinardi, F

AU - Gallo, A

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AU - Pesci, I

AU - Laroni, A

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AU - Solaro, C

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