First-line disease-modifying drugs in relapsing-remitting multiple sclerosis: an Italian real-life multicenter study on persistence

Diana Ferraro, Valentina Camera, Eleonora Baldi, Veria Vacchiano, Erica Curti, Angelica Guareschi, Susanna Malagù, Sara Montepietra, Silvia Strumia, Mario Santangelo, Luisa Caniatti, Matteo Foschi, Alessandra Lugaresi, Franco Granella, Ilaria Pesci, Luisa Motti, Walter Neri, Paolo Immovilli, Enrico Montanari, Francesca VitettaAnna Maria Simone, Patrizia Sola

Research output: Contribution to journalArticle

Abstract

OBJECTIVE: The introduction of oral disease-modifying drugs (DMDs) in addition to the available, injectable, ones for relapsing-remitting multiple sclerosis (RRMS) could be expected to improve medication persistence due to a greater acceptability of the route of administration. The aim of the study was to compare the proportion of patients discontinuing injectable DMDs (interferon beta 1a/1b, pegylated interferon, glatiramer acetate) with those discontinuing oral DMDs (dimethylfumarate and teriflunomide) during an observation period of at least 12 months. Secondary aims were to compare the time to discontinuation and the reasons for discontinuation between the two groups and to explore the demographic and clinical factors associated with DMD discontinuation.

METHODS: In this prospective, multi-center, real-life observational study, patients commencing any first-line DMD between 1 January 2015 and 31 July 2016 were enrolled and followed up for at least 12 months or until the drug was discontinued.

RESULTS: Of the 520 included patients, 262 (49.6%) started an injectable and 258 (50.4%) an oral DMD. There was no difference in the proportion of patients on oral (n = 62, 24%) or on injectable (n = 60, 23%) DMDs discontinuing treatment, the most frequent reason being adverse events/side-effects. Higher baseline Expanded Disability Status Scale (EDSS) scores and younger age increased the odds of treatment withdrawal. Time to treatment discontinuation was not different between the two groups and was not influenced by the initiated DMD (oral versus injectable), even after adjustment for baseline differences.

CONCLUSION: The route of administration alone (i.e. oral versus injectable) was not a significant predictor of persistence with first-line DMDs in RRMS.

Original languageEnglish
Pages (from-to)1803-1807
Number of pages5
JournalCurrent Medical Research and Opinion
Volume34
Issue number10
DOIs
Publication statusPublished - Oct 2018

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Relapsing-Remitting Multiple Sclerosis
Multicenter Studies
Mouth Diseases
Pharmaceutical Preparations
Injections
Medication Adherence
Interferons
Observational Studies
Therapeutics
Observation
Demography

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First-line disease-modifying drugs in relapsing-remitting multiple sclerosis : an Italian real-life multicenter study on persistence. / Ferraro, Diana; Camera, Valentina; Baldi, Eleonora; Vacchiano, Veria; Curti, Erica; Guareschi, Angelica; Malagù, Susanna; Montepietra, Sara; Strumia, Silvia; Santangelo, Mario; Caniatti, Luisa; Foschi, Matteo; Lugaresi, Alessandra; Granella, Franco; Pesci, Ilaria; Motti, Luisa; Neri, Walter; Immovilli, Paolo; Montanari, Enrico; Vitetta, Francesca; Simone, Anna Maria; Sola, Patrizia.

In: Current Medical Research and Opinion, Vol. 34, No. 10, 10.2018, p. 1803-1807.

Research output: Contribution to journalArticle

Ferraro, D, Camera, V, Baldi, E, Vacchiano, V, Curti, E, Guareschi, A, Malagù, S, Montepietra, S, Strumia, S, Santangelo, M, Caniatti, L, Foschi, M, Lugaresi, A, Granella, F, Pesci, I, Motti, L, Neri, W, Immovilli, P, Montanari, E, Vitetta, F, Simone, AM & Sola, P 2018, 'First-line disease-modifying drugs in relapsing-remitting multiple sclerosis: an Italian real-life multicenter study on persistence', Current Medical Research and Opinion, vol. 34, no. 10, pp. 1803-1807. https://doi.org/10.1080/03007995.2018.1451311
Ferraro, Diana ; Camera, Valentina ; Baldi, Eleonora ; Vacchiano, Veria ; Curti, Erica ; Guareschi, Angelica ; Malagù, Susanna ; Montepietra, Sara ; Strumia, Silvia ; Santangelo, Mario ; Caniatti, Luisa ; Foschi, Matteo ; Lugaresi, Alessandra ; Granella, Franco ; Pesci, Ilaria ; Motti, Luisa ; Neri, Walter ; Immovilli, Paolo ; Montanari, Enrico ; Vitetta, Francesca ; Simone, Anna Maria ; Sola, Patrizia. / First-line disease-modifying drugs in relapsing-remitting multiple sclerosis : an Italian real-life multicenter study on persistence. In: Current Medical Research and Opinion. 2018 ; Vol. 34, No. 10. pp. 1803-1807.
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abstract = "OBJECTIVE: The introduction of oral disease-modifying drugs (DMDs) in addition to the available, injectable, ones for relapsing-remitting multiple sclerosis (RRMS) could be expected to improve medication persistence due to a greater acceptability of the route of administration. The aim of the study was to compare the proportion of patients discontinuing injectable DMDs (interferon beta 1a/1b, pegylated interferon, glatiramer acetate) with those discontinuing oral DMDs (dimethylfumarate and teriflunomide) during an observation period of at least 12 months. Secondary aims were to compare the time to discontinuation and the reasons for discontinuation between the two groups and to explore the demographic and clinical factors associated with DMD discontinuation.METHODS: In this prospective, multi-center, real-life observational study, patients commencing any first-line DMD between 1 January 2015 and 31 July 2016 were enrolled and followed up for at least 12 months or until the drug was discontinued.RESULTS: Of the 520 included patients, 262 (49.6{\%}) started an injectable and 258 (50.4{\%}) an oral DMD. There was no difference in the proportion of patients on oral (n = 62, 24{\%}) or on injectable (n = 60, 23{\%}) DMDs discontinuing treatment, the most frequent reason being adverse events/side-effects. Higher baseline Expanded Disability Status Scale (EDSS) scores and younger age increased the odds of treatment withdrawal. Time to treatment discontinuation was not different between the two groups and was not influenced by the initiated DMD (oral versus injectable), even after adjustment for baseline differences.CONCLUSION: The route of administration alone (i.e. oral versus injectable) was not a significant predictor of persistence with first-line DMDs in RRMS.",
author = "Diana Ferraro and Valentina Camera and Eleonora Baldi and Veria Vacchiano and Erica Curti and Angelica Guareschi and Susanna Malag{\`u} and Sara Montepietra and Silvia Strumia and Mario Santangelo and Luisa Caniatti and Matteo Foschi and Alessandra Lugaresi and Franco Granella and Ilaria Pesci and Luisa Motti and Walter Neri and Paolo Immovilli and Enrico Montanari and Francesca Vitetta and Simone, {Anna Maria} and Patrizia Sola",
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TY - JOUR

T1 - First-line disease-modifying drugs in relapsing-remitting multiple sclerosis

T2 - an Italian real-life multicenter study on persistence

AU - Ferraro, Diana

AU - Camera, Valentina

AU - Baldi, Eleonora

AU - Vacchiano, Veria

AU - Curti, Erica

AU - Guareschi, Angelica

AU - Malagù, Susanna

AU - Montepietra, Sara

AU - Strumia, Silvia

AU - Santangelo, Mario

AU - Caniatti, Luisa

AU - Foschi, Matteo

AU - Lugaresi, Alessandra

AU - Granella, Franco

AU - Pesci, Ilaria

AU - Motti, Luisa

AU - Neri, Walter

AU - Immovilli, Paolo

AU - Montanari, Enrico

AU - Vitetta, Francesca

AU - Simone, Anna Maria

AU - Sola, Patrizia

N1 - Ricercatore distaccato presso IRCCS a seguito Convenzione esclusiva con Università di Bologna (Lugaresi Alessandra). La Prof.ssa A. Lugaresi viene da altro Istituto e lavori con affiliazioni diverse usciranno ancora nei prossimi anni.

PY - 2018/10

Y1 - 2018/10

N2 - OBJECTIVE: The introduction of oral disease-modifying drugs (DMDs) in addition to the available, injectable, ones for relapsing-remitting multiple sclerosis (RRMS) could be expected to improve medication persistence due to a greater acceptability of the route of administration. The aim of the study was to compare the proportion of patients discontinuing injectable DMDs (interferon beta 1a/1b, pegylated interferon, glatiramer acetate) with those discontinuing oral DMDs (dimethylfumarate and teriflunomide) during an observation period of at least 12 months. Secondary aims were to compare the time to discontinuation and the reasons for discontinuation between the two groups and to explore the demographic and clinical factors associated with DMD discontinuation.METHODS: In this prospective, multi-center, real-life observational study, patients commencing any first-line DMD between 1 January 2015 and 31 July 2016 were enrolled and followed up for at least 12 months or until the drug was discontinued.RESULTS: Of the 520 included patients, 262 (49.6%) started an injectable and 258 (50.4%) an oral DMD. There was no difference in the proportion of patients on oral (n = 62, 24%) or on injectable (n = 60, 23%) DMDs discontinuing treatment, the most frequent reason being adverse events/side-effects. Higher baseline Expanded Disability Status Scale (EDSS) scores and younger age increased the odds of treatment withdrawal. Time to treatment discontinuation was not different between the two groups and was not influenced by the initiated DMD (oral versus injectable), even after adjustment for baseline differences.CONCLUSION: The route of administration alone (i.e. oral versus injectable) was not a significant predictor of persistence with first-line DMDs in RRMS.

AB - OBJECTIVE: The introduction of oral disease-modifying drugs (DMDs) in addition to the available, injectable, ones for relapsing-remitting multiple sclerosis (RRMS) could be expected to improve medication persistence due to a greater acceptability of the route of administration. The aim of the study was to compare the proportion of patients discontinuing injectable DMDs (interferon beta 1a/1b, pegylated interferon, glatiramer acetate) with those discontinuing oral DMDs (dimethylfumarate and teriflunomide) during an observation period of at least 12 months. Secondary aims were to compare the time to discontinuation and the reasons for discontinuation between the two groups and to explore the demographic and clinical factors associated with DMD discontinuation.METHODS: In this prospective, multi-center, real-life observational study, patients commencing any first-line DMD between 1 January 2015 and 31 July 2016 were enrolled and followed up for at least 12 months or until the drug was discontinued.RESULTS: Of the 520 included patients, 262 (49.6%) started an injectable and 258 (50.4%) an oral DMD. There was no difference in the proportion of patients on oral (n = 62, 24%) or on injectable (n = 60, 23%) DMDs discontinuing treatment, the most frequent reason being adverse events/side-effects. Higher baseline Expanded Disability Status Scale (EDSS) scores and younger age increased the odds of treatment withdrawal. Time to treatment discontinuation was not different between the two groups and was not influenced by the initiated DMD (oral versus injectable), even after adjustment for baseline differences.CONCLUSION: The route of administration alone (i.e. oral versus injectable) was not a significant predictor of persistence with first-line DMDs in RRMS.

U2 - 10.1080/03007995.2018.1451311

DO - 10.1080/03007995.2018.1451311

M3 - Article

C2 - 29526118

VL - 34

SP - 1803

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JO - Current Medical Research and Opinion

JF - Current Medical Research and Opinion

SN - 0300-7995

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