Exploring polypharmacy phenomenon in newly diagnosed relapsing-remitting multiple sclerosis: a cohort ambispective...

Area of Science:

• Neurology
• Pharmacoepidemiology

Background:

• Polypharmacy, the concurrent use of multiple medications, is a growing concern in managing chronic conditions.
• Understanding polypharmacy patterns in relapsing-remitting multiple sclerosis (RRMS) at diagnosis is crucial for optimizing patient care.
• The impact of polypharmacy on treatment adherence and outcomes in RRMS requires further investigation.

Purpose of the Study:

• To determine the prevalence of polypharmacy among newly diagnosed RRMS patients.
• To investigate the association between polypharmacy and patient characteristics such as age and BMI.
• To evaluate the effect of polypharmacy on the discontinuation of the first disease-modifying treatment (DMT) in RRMS.

Main Methods:

• A cohort of 392 RRMS patients initiating their first DMT between 2013 and 2015 was analyzed.
• Patients were categorized into three groups based on the number of non-DMT medications: no-polypharmacy, minor-polypharmacy (1-3 medications), and major-polypharmacy (>3 medications).
• Survival analysis, including multinomial regression and log-rank tests, was employed to assess associations and discontinuation rates.

Main Results:

• Polypharmacy was identified in 44.2% of the RRMS cohort (15.6% minor, 28.6% major).
• Older age and higher BMI were significantly associated with increased polypharmacy.
• Discontinuation rates of the first DMT were similar across all polypharmacy groups (approx. 50-53%), with no statistically significant differences observed.

Conclusions:

• Polypharmacy is prevalent at the time of RRMS diagnosis, particularly in older patients with higher BMI.
• Despite its prevalence, polypharmacy does not appear to influence the likelihood of discontinuing the initial DMT in RRMS patients.
• Further research should explore the clinical implications of polypharmacy in long-term RRMS management.