Related Experiment Video
Updated: May 25, 2026
10:46
A Method of Trigonometric Modelling of Seasonal Variation Demonstrated with Multiple Sclerosis Relapse Data
Published on: December 9, 2015
Long-term persistence with the immunomodulatory drugs for multiple sclerosis: a retrospective database study
Charity Evans1, Jennifer Tam, Elaine Kingwell
1Faculty of Medicine Neurology, University of British Columbia, Vancouver, British Columbia, Canada.
Clinical Therapeutics
|February 3, 2012
Summary
Long-term persistence to immunomodulatory drugs (IMDs) for multiple sclerosis (MS) is limited, with about half of patients discontinuing within six years. Factors like disease duration and disability impact discontinuation rates for these MS treatments.
Area of Science:
- Neurology
- Pharmacology
- Public Health
Background:
- Immunomodulatory drugs (IMDs) are the primary treatment for multiple sclerosis (MS) in Canada.
- Limited data exists on the long-term adherence and persistence patterns of these widely used MS therapies.
Purpose of the Study:
- To investigate the patterns and influencing factors of long-term persistence to first-line IMDs in a British Columbia MS patient cohort.
- To analyze discontinuation rates and identify patient characteristics associated with stopping IMD therapy.
Main Methods:
- Retrospective analysis of the British Columbia MS database for adult patients prescribed first-line IMDs between 1995 and 2008.
- Kaplan-Meier survival analysis and Cox regression were used to assess time to discontinuation of all IMDs and the initially prescribed IMD.
Main Results:
- 1896 MS patients were included; median persistence to any first-line IMD was 6.3 years.
- Longer disease duration and higher disability levels increased the risk of IMD discontinuation.
- Persistence to the initially prescribed IMD was shorter, with a median of 2.9 years; no association with age, sex, or specific IMD type.
Conclusions:
- Around 50% of multiple sclerosis patients discontinue IMD therapy within six years, raising questions about treatment adequacy.
- Further research is required to understand the reasons for discontinuation and the lack of improvement in MS IMD persistence over time compared to other chronic diseases.
Related Concept Videos
01:19Multiple Sclerosis l: Introduction
Multiple sclerosis is a chronic autoimmune disease of the central nervous system (CNS) that affects the brain, spinal cord, and optic nerves. It is an inflammatory demyelinating disorder and a leading cause of neurological disability in young adults.EpidemiologyMS commonly begins between 20 and 40 years of age and is twice as common in women. Its exact cause remains unclear, but genetic susceptibility contributes, with higher risk in first-degree relatives and identical twins. A greater...
01:23Immunological Memory
Immunological memory, a pivotal pillar of the adaptive immune system, is responsible for the body's ability to remember and respond more swiftly and effectively to previously encountered pathogens. This remarkable feature is what makes vaccines so effective in preventing diseases.
What is Immunological Memory?
Immunological memory is an integral function of the immune system that allows it to recognize and react more rapidly and effectively to pathogens previously encountered. This feature is...
What is Immunological Memory?
Immunological memory is an integral function of the immune system that allows it to recognize and react more rapidly and effectively to pathogens previously encountered. This feature is...
01:24Drug Accumulation During Multiple Dosing: Intermittent IV Infusions
Intermittent intravenous (IV) infusion is a method of drug administration where medications are delivered over short infusion periods followed by intervals of no drug delivery. This approach helps to prevent sustained high drug concentrations in the bloodstream, reducing the risk of adverse effects associated with prolonged exposure. Unlike continuous infusion, steady-state concentrations may not be achieved during a single dosing cycle but can be reached through repeated...
01:21Drug Accumulation During Multiple Dosing: Repetitive IV Injections
Calculating drug dosage and accumulation in multiple-dose regimens is crucial for achieving therapeutic efficacy while avoiding toxicity. This involves determining the plasma drug concentrations over time to optimize dosing schedules. The principle of superposition is fundamental in this process, allowing for the prediction of drug concentration in plasma following multiple doses based on single-dose data.The principle of superposition asserts that the plasma concentration-time curves from...
01:29Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents
Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel Disease...
01:21Vaccines
Vaccines are among the most effective tools in preventive medicine, designed to prepare the immune system to recognize and combat infectious agents. By introducing antigens—substances that the immune system identifies as foreign—vaccines stimulate an adaptive immune response that leads to immunological memory. This immunological memory enables the body to mount a faster and more effective response upon future exposures to the actual pathogen.Vaccines can be categorized based on the type of...