Effectiveness of first-line treatment for relapsing-remitting multiple sclerosis in Brazil: A 16-year non-concurrent cohort study

Autor: Augusto Afonso Guerra Junior, Isabela Maia Diniz, Francisco de Assis Acurcio, Juliana Alvares Teodoro, Kathiaja Miranda Souza, Isabella de Figueiredo Zuppo, Nelio Gomes Ribeiro Junior, Lívia Lovato Pires de Lemos, Álvaro Nagib Atallah
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Male
Epidemiology
Cost-Benefit Analysis
Kaplan-Meier Estimate
Biochemistry
Geographical locations
Cohort Studies
0302 clinical medicine
Medical Conditions
Medicine and Health Sciences
Medicine
Public and Occupational Health
030212 general & internal medicine
Multidisciplinary
Pharmaceutics
Neurodegenerative Diseases
Treatment Outcome
Neurology
Population study
Female
Brazil
Cohort study
Research Article
Adult
medicine.medical_specialty
Multiple Sclerosis
Science
Inflammatory Diseases
Immunology
Lower risk
Autoimmune Diseases
03 medical and health sciences
Pharmacotherapy
Multiple Sclerosis
Relapsing-Remitting
Drug Therapy
Adjuvants
Immunologic
Internal medicine
Humans
Proportional Hazards Models
Retrospective Studies
Treatment Guidelines
Health Care Policy
Proportional hazards model
business.industry
Multiple sclerosis
Biology and Life Sciences
Proteins
Retrospective cohort study
Guideline
Glatiramer Acetate
Interferon-beta
South America
medicine.disease
Demyelinating Disorders
Health Care
Medical Risk Factors
Clinical Immunology
Interferons
People and places
Clinical Medicine
business
030217 neurology & neurosurgery
Zdroj: PLoS ONE
PLoS ONE, Vol 15, Iss 9, p e0238476 (2020)
ISSN: 1932-6203
Popis: BackgroundRelapsing-remitting multiple sclerosis (RRMM) is a chronic, progressive, inflammatory and immune-mediated disease that affects the central nervous system and is characterized by episodes of neurological dysfunction followed by a period of remission. The pharmacological strategy aims to delay the progression of the disease and prevent relapse. Interferon beta and glatiramer are commonly used in the Brazilian public health system and are available to patients who meet the guideline criteria. The scenario of multiple treatments available and in development brings the need for discussion and evaluation of the technologies already available before the incorporation of new drugs. This study analyses the effectiveness of first-line treatment of RRMS measured by real-world evidence data, from the Brazilian National Health System (SUS).Methods and findingsWe conducted a non-concurrent national cohort between 2000 and 2015. The study population consisted of 22,722 patients with RRMS using one of the following first-line drugs of interest: glatiramer or one of three presentations of interferon beta. Kaplan-Meier analysis was used to estimate the time to treatment failure. A univariate and multivariate Cox proportional hazard model was used to evaluate factors associated with treatment failure. In addition, patients were propensity score-matched (1:1) in six groups of comparative first-line treatments to evaluate the effectiveness among them. The analysis indicated a higher risk of treatment failure in female patients (HR = 1.08; P = 0,01), those with comorbidities at baseline (HR = 1.20; PConclusionsThis retrospective cohort suggests that glatiramer is associated with greater effectiveness compared to the three presentations of interferon beta. When evaluating beta interferons, the results suggest that the intramuscular presentation is not effective in the treatment of multiple sclerosis.
Databáze: OpenAIRE
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