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Switching and escalating therapy in long-lasting multiple sclerosis: not always necessary
Ana Teresa Carvalho1, Maria José Sá
1MS Clinic, Department of Neurology, Centro Hospitalar de São João, 4200-319 Porto, Portugal ; Department of Neurology, Centro Hospitalar de Vila Nova Gaia/Espinho, 4434-502 Vila Nova de Gaia, Portugal.
ISRN Neurology
|January 15, 2013
Summary
Many multiple sclerosis (MS) patients achieve long-term stability on their first disease-modifying drug (DMD). This persistence is linked to female sex, low relapse rates, and mild MS, potentially influenced by clinic organization.
Area of Science:
- Neurology
- Immunology
- Pharmacology
Background:
- Therapy switch is frequent in multiple sclerosis (MS) management.
- Long-term treatment persistence with initial disease-modifying drugs (DMDs) is observed in some patients.
- Understanding factors influencing sustained DMD use is crucial for optimizing MS care.
Purpose of the Study:
- To characterize demographic and clinical features of MS patients maintaining the same DMD for over 12 years.
- To identify predictors of long-term treatment persistence in a real-world MS clinic setting.
Main Methods:
- Retrospective analysis of 51 patients with relapse-remitting MS (RRMS).
- Patients initiated their first DMD between 1996 and 1999 and were followed for >12 years.
- Data collected included demographics, annualized relapse rate, and Multiple Sclerosis Severity Score (MSSS).
Main Results:
- 51% of patients remained on their initial DMD for over 12 years.
- Patients with sustained therapy were predominantly female, with low annualized relapse rates and low MSSS.
- Clinical stability and minimal side effects were noted in this cohort.
Conclusions:
- A significant proportion of MS patients can maintain long-term efficacy and stability with their first DMD.
- Female sex, low disease activity (relapse rate), and lower disease severity (MSSS) are associated with therapy persistence.
- The findings may reflect the positive impact of an open, multidisciplinary MS clinic model on treatment adherence and effectiveness.
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