A multicentRE observational analysiS of PErsistenCe to Treatment in the new multiple sclerosis era: the RESPECT study.

Autor: Lanzillo R; Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University, Naples, Italy. robertalanzillo@libero.it., Prosperini L; Department of Neurosciences, S. Camillo-Forlanini Hospital, C.ne Gianicolense 87, 00152, Rome, Italy. luca.prosperini@gmail.com.; Department of Neurology and Psychiatry, Sapienza University, Rome, Italy. luca.prosperini@gmail.com., Gasperini C; Department of Neurosciences, S. Camillo-Forlanini Hospital, C.ne Gianicolense 87, 00152, Rome, Italy., Moccia M; Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University, Naples, Italy., Fantozzi R; Department of Neurology, IRCCS NEUROMED, Pozzilli, IS, Italy., Tortorella C; Department of Neurosciences, S. Camillo-Forlanini Hospital, C.ne Gianicolense 87, 00152, Rome, Italy., Nociti V; Department of Geriatrics, Neurosciences and Orthopedics, Institute of Neurology, Catholic University, Rome, Italy., Annovazzi P; MS Study Center, ASST Valle Olona, Gallarate Hospital, Gallarate, VA, Italy., Cavalla P; MS Center, Neurology 1 Unit, City of Health and Science University Hospital, Turin, Italy., Radaelli M; Division of Neuroscience, Institute of Experimental Neuroscience (INSpe), S. Raffaele Scientific Institute, Milan, Italy., Malucchi S; SCDO Neurologia 2-Regional Multiple Sclerosis Center, University Hospital San Luigi Gonzaga, Orbassano, TO, Italy., Clerici VT; Department of Neuroimmunology and Neuromuscular Diseases, Neurological Institute C. Besta IRCCS Foundation, Milan, Italy., Boffa L; MS Clinical and Research Unit, Department of Systems Medicine, Tor Vergata University, Rome, Italy., Buttari F; Department of Neurology, IRCCS NEUROMED, Pozzilli, IS, Italy.; MS Clinical and Research Unit, Department of Systems Medicine, Tor Vergata University, Rome, Italy., Ragonese P; Department of Experimental Biomedicine and Clinical Neurosciences, University of Palermo, Palermo, Italy., Maniscalco GT; MS Centre, Neurology Unit, Cardarelli Hospital, Naples, Italy., Di Filippo M; Neurology Unit, Medicine Department, University of Perugia, Perugia, Italy., Buscarinu MC; Department of Neurosciences, Center for Experimental Neurological Therapies, S. Andrea Hospital, Mental Health and Sensory Organs (NESMOS), Sapienza University, Rome, Italy., Pinardi F; MS Centre, Bellaria Hospital, UOSI-SM Rehabilitation, Bellaria, BO, Italy., Gallo A; I Clinic of Neurology, University of Campania, Naples, Italy., Coghe G; Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy., Pesci I; MS Centre, Neurology Unit, S. Secondo Hospital, Fidenza, PA, Italy., Laroni A; Department of Neurology, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy., Gajofatto A; Department of Neuroscience, Biomedicine and Movement Sciences, University Hospital of Verona, Verona, Italy., Calabrese M; Department of Neuroscience, Biomedicine and Movement Sciences, University Hospital of Verona, Verona, Italy., Tomassini V; Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, University Hospital of Wales, Cardiff, UK., Cocco E; Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy., Solaro C; Neurology Unit, Centro di Recupero e Rieducazione Funzionale, Moncrivello, VC, Italy.
Jazyk: angličtina
Zdroj: Journal of neurology [J Neurol] 2018 May; Vol. 265 (5), pp. 1174-1183. Date of Electronic Publication: 2018 Mar 16.
DOI: 10.1007/s00415-018-8831-x
Abstrakt: In this independent, multicenter, retrospective study, we investigated the short-term persistence to treatment with first-line self-injectable or oral disease-modifying treatments (DMTs) in patients with relapsing-remitting multiple sclerosis. Data of patients regularly attending 21 Italian MS Centres who started a self-injectable or an oral DMT in 2015 were collected to: (1) estimate the proportion of patients discontinuing the treatment; (3) explore reasons for discontinuation; (3) identify baseline predictors of treatment discontinuation over a follow-up period of 12 months. We analyzed data of 1832 consecutive patients (1289 women, 543 men); 374 (20.4%) of them discontinued the prescribed DMT after a median time of 6 months (range 3 days to 11.5 months) due to poor tolerability (n = 163; 43.6%), disease activity (n = 95; 25.4%), adverse events (n = 64; 17.1%), convenience (i.e. availability of new drug formulations) and pregnancy planning (n = 21; 1.1%). Although the proportion of discontinuers was higher with self-injectable (n = 107; 22.9%) than with oral DMT (n = 215; 16.4%), the Cox regression model revealed no significant between-group difference (p = 0.12). Female sex [hazard ratio (HR) = 1.39, p = 0.01] and previous exposure to ≥ 3 DMTs (HR = 1.71, p = 0.009) were two independent risk factors for treatment discontinuation, regardless of prescribed DMTs. Our study confirms that persistence to treatment represents a clinical challenge, irrespective of the route of administration.
Databáze: MEDLINE
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