| Popis: |
Effective interventions for treating multiple sclerosis (MS) require prompt treatment optimization which usually involves switching disease modifying drugs (DMDs). The patterns of prescription and the reasons treatment changes, especially in low prevalence populations, are unknown. We aimed to describe the persistence, reasons of DMD switches and prescription patterns as well as their associated factors using survival and network analysis. 701 cases were included of which 94% received treatment. 29.9%, 18.7% and 11.9% of patients had one, two and three or more DMD changes, respectively, for an estimated incidence rate (95%CI) of 1.09 (1.01–1.17) per patient. The main reasons for changing DMD were disease activity, followed by non-serious adverse events and disability. Younger age at MS onset and insurer status were the main determinants of treatment change, which was not influenced by the efficacy or mode of administration of individual DMDs. Network analysis showed that interferons and fingolimod were the most central DMDs and that most DMD switches involved them. |
