Emma C. Tallantyre
Real‐world persistence of multiple sclerosis disease‐modifying therapies
Tallantyre, Emma C.; Dobson, Ruth; Froud, Joseph L. J.; St John, Frederika A.; Anderson, Valerie M.; Arun, Tarunya; Buckley, Lauren; Evangelou, Nikos; Ford, Helen L.; Galea, Ian; George, Sumi; Gray, Orla M.; Hibbert, Aimee M.; Hu, Mo; Hughes, Stella E.; Ingram, Gillian; Kalra, Seema; Lim, Chia‐Hui E.; Mathews, Joela T. M.; McDonnell, Gavin V.; Mescall, Naomi; Norris, Sam; Ramsay, Stephen J.; Rice, Claire M.; Russell, Melanie J.; Shawe‐Taylor, Marianne J.; Williams, Thomas E.; Harding, Katharine E.; Robertson, Neil P.
Authors
Ruth Dobson
Joseph L. J. Froud
Frederika A. St John
Valerie M. Anderson
Tarunya Arun
Lauren Buckley
Nikos Evangelou
Helen L. Ford
Ian Galea
Sumi George
Orla M. Gray
Aimee M. Hibbert
Mo Hu
Stella E. Hughes
Gillian Ingram
Seema Kalra
Chia‐Hui E. Lim
Joela T. M. Mathews
Gavin V. McDonnell
Naomi Mescall
Sam Norris
Stephen J. Ramsay
Claire M. Rice
Melanie J. Russell
Marianne J. Shawe‐Taylor
Thomas E. Williams
Katharine E. Harding
Neil P. Robertson
Abstract
Background and purpose: Treatment persistence is the continuation of therapy over time. It reflects a combination of treatment efficacy and tolerability. We aimed to describe real‐world rates of persistence on disease‐modifying therapies (DMTs) for people with multiple sclerosis (pwMS) and reasons for DMT discontinuation. Methods: Treatment data on 4366 consecutive people with relapse‐onset multiple sclerosis (MS) were pooled from 13 UK specialist centres during 2021. Inclusion criteria were exposure to at least one MS DMT and a complete history of DMT prescribing. PwMS in blinded clinical trials were excluded. Data collected included sex, age at MS onset, age at DMT initiation, DMT treatment dates, and reasons for stopping or switching DMT. For pwMS who had received immune reconstituting therapies (cladribine/alemtuzumab), discontinuation date was defined as starting an alternative DMT. Kaplan–Meier survival analyses were used to express DMT persistence. Results: In 6997 treatment events (1.6 per person with MS), median time spent on any single maintenance DMT was 4.3 years (95% confidence interval = 4.1–4.5 years). The commonest overall reasons for DMT discontinuation were adverse events (35.0%) and lack of efficacy (30.3%). After 10 years, 20% of people treated with alemtuzumab had received another subsequent DMT, compared to 82% of people treated with interferon or glatiramer acetate. Conclusions: Immune reconstituting DMTs may have the highest potential to offer a single treatment for relapsing MS. Comparative data on DMT persistence and reasons for discontinuation are valuable to inform treatment decisions and in personalizing treatment in MS.
Citation
Tallantyre, E. C., Dobson, R., Froud, J. L. J., St John, F. A., Anderson, V. M., Arun, T., …Robertson, N. P. (in press). Real‐world persistence of multiple sclerosis disease‐modifying therapies. European Journal of Neurology, Article e16289. https://doi.org/10.1111/ene.16289
Journal Article Type | Article |
---|---|
Acceptance Date | Mar 14, 2024 |
Online Publication Date | Apr 3, 2024 |
Deposit Date | Apr 8, 2024 |
Journal | European Journal of Neurology |
Print ISSN | 1351-5101 |
Publisher | Wiley |
Peer Reviewed | Peer Reviewed |
Article Number | e16289 |
DOI | https://doi.org/10.1111/ene.16289 |
Keywords | multiple sclerosis, treatment, persistence, disease‐modifying therapy |
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