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Therapeutic inertia in relapsing-remitting multiple sclerosis.
Rita Rodrigues1, Raquel Rocha2, Gonçalo Bonifácio3
1Neurology Department, Centro Hospitalar de Entre o Douro e Vouga, Santa Maria da Feira, 4520-211, Portugal.
Multiple Sclerosis and Related Disorders
|August 3, 2021
Summary
Therapeutic inertia (TI) affects nearly one in five patients with Relapsing-Remitting Multiple Sclerosis (RRMS) in Portugal. Factors like mild relapses and no adverse events contribute to this treatment gap.
Area of Science:
- Neurology
- Clinical Research
- Pharmacology
Background:
- Therapeutic inertia (TI) is the failure to escalate treatment despite disease activity.
- Prevalence and factors of TI in Portuguese Relapsing-Remitting Multiple Sclerosis (RRMS) patients were previously unknown.
Purpose of the Study:
- To determine the prevalence of TI in RRMS patients in Portugal.
- To identify factors associated with TI in this population.
Main Methods:
- A multicentre, retrospective observational study of 427 RRMS patients in Portugal.
- TI defined as unmet treatment goals despite evidence of disease activity (clinical, MRI, or disability progression).
Main Results:
- TI was present in 18.7% of patients, representing 54.8% of those with potential for inertia.
- Factors associated with TI included radiologically inactive disease, current disease-modifying therapy (DMT) use, and absence of adverse events.
- Patients in higher-level care centers showed more TI.
Conclusions:
- TI affects approximately 1 in 5 RRMS patients in Portugal, with over half of those eligible experiencing it.
- Key determinants of TI include mild disease activity, existing DMT, no adverse events, and higher care level.
- Optimizing therapy in RRMS is crucial, necessitating further research into TI influencing factors.
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