Health care situation of patients with relapsing-remitting multiple sclerosis receiving immunomodulatory therapy: a retrospective survey of more than 9000 German patients with MS
| Autor: | R. Dachsel, C. Wernsdörfer, H. Landefeld, G. Reifschneider, P. Knorn, S. Ries, S. Windhagen, P. Schicklmaier, S. Domke, Gabriele Niemczyk, A. Friedrich, M. Mäurer, H. Albrecht, Stefan Schwab |
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| Rok vydání: | 2010 |
| Předmět: |
medicine.medical_specialty
medicine.diagnostic_test business.industry Multiple sclerosis Retrospective cohort study Magnetic resonance imaging medicine.disease Surgery Natalizumab Neurology Internal medicine Monoclonal Cohort medicine Neurology (clinical) Glatiramer acetate business Cohort study medicine.drug |
| Zdroj: | European Journal of Neurology. 18:1036-1045 |
| ISSN: | 1351-5101 |
| DOI: | 10.1111/j.1468-1331.2010.03313.x |
| Popis: | Background and purpose: First-line immunomodulatory treatment with interferon-beta or glatiramer acetate is accepted as effective basic therapy in patients with relapsing–remitting multiple sclerosis (RRMS). However, a considerable portion of patients does not benefit from treatment. Method: To test basic immunomodulatory treatment under real-life conditions, we retrospectively analyzed clinical and subclinical disease activity within the last 12 months in a cohort of 9916 patients with RRMS, of which 7896 patients were receiving immunomodulatory treatment. In addition, factors associated with treating physicians’ consideration of a switch of current treatment were assessed. Results: The majority of treated patients (approximately 66%) experienced no relapse during the last 12 months. However, in line with common clinical study findings, about one-third (approximately 34%) of patients had relapses. When MRI data were taken into account, approximately one-quarter (24%) of patients would qualify for therapy escalation to monoclonal antibody natalizumab. Relapse rate in the preceding year (the year directly prior to the start of retrospective data collection) was strongly associated with considering a switch of current treatment. In addition, therapy switch was more often considered in younger patients. The relationship between MRI findings in the absence of clinical symptoms and consideration of a treatment switch was not as clear. Conclusions: This analysis confirms that disease progression occurs in a considerable proportion of patients with RRMS. These patients should be considered for therapy escalation. |
| Databáze: | OpenAIRE |
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