Evaluation of Disease Modifying Therapies and Prognostic Factors Affecting Multiple Sclerosis Progression in a Local
Bobby Chun Man Lui1, Jessica Tsz Ching Li1, Wai Ting Lo1
1Department of Neurology, Queen Elizabeth Hospital, Kowloon, Hong Kong.
Introduction:
Multiple sclerosis (MS) is a major demyelinating disease causing disability in young adults. Scarce data exists on the clinical benefits and persistence of disease modifying therapies (DMTs) amongst our local population. The primary aim of this study was to investigate the effectiveness, tolerability and discontinuation pattern of various DMTs amongst Hong Kong patients.
Methods:
This was a retrospective study of adult MS patients treated in a tertiary hospital in Hong Kong from 1st December 2012 to 30th November 2022. Demographic, clinical and radiological characteristics were retrieved.
Results:
A total of 103 patients were analysed. Interferons (annualised relapse rate (ARR) reduction 0.492, p <0.001) and fingolimod (ARR reduction 0.557, p = 0.038) had significant ARR reductions in our cohort. Overall treatment persistence were comparable, but teriflunomide had more discontinuation due to side effects and/or intolerance (hazard ratio (HR) 7.50, p = 0.029). Baseline Expanded Disability Status Score (EDSS) more than or equal to 4.0 (odds ratio (OR) 4.56, p = 0.045), and presence of brainstem lesions on magnetic resonance imaging (OR 3.15, p = 0.039) were associated with greater disability progression, while visual onset symptoms at diagnosis (OR 0.14, p = 0.007) were associated with lower risk.
Discussion:
This study illustrated the complexity of managing MS patients. Patients' clinical characteristics, disease activity, risk appetite and treatment side effects should be taken in consideration to reach an informed decision on the use of DMTs in our local MS patients.
