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Switching and escalating therapy in long-lasting multiple sclerosis: not always necessary.

Carvalho AT, Sá MJ - ISRN Neurol (2012)

Bottom Line: From the cohort of 51 patients followed in our MS clinic with relapse-remitting MS who started an DMD between 1996 and 1999, we found a high percentage (51%) of patients who were efficiently treated with the first DMD.Our results may be related to the open and multidisciplinary model of our MS clinic organization.Identifying characteristics associated with therapy persistence may be useful in developing strategies to improve therapy effectiveness.

View Article: PubMed Central - PubMed

Affiliation: MS Clinic, Department of Neurology, Centro Hospitalar de São João, 4200-319 Porto, Portugal ; Department of Neurology, Centro Hospitalar de Vila Nova Gaia/Espinho, 4434-502 Vila Nova de Gaia, Portugal.

ABSTRACT
Although therapy switch is common among patients with multiple sclerosis (MS), sometimes the initial prescribed treatment is maintained for a long period with clinical stability, low disability, and nonsignificant side effects. We aim to describe demographic and clinical characteristics of patients treated in our MS clinic with the same disease-modifying drug (DMD) lasting for >12 years. From the cohort of 51 patients followed in our MS clinic with relapse-remitting MS who started an DMD between 1996 and 1999, we found a high percentage (51%) of patients who were efficiently treated with the first DMD. These patients were mainly females, with low annualized relapse rate and Multiple Sclerosis Severity Score (MSSS). Our results may be related to the open and multidisciplinary model of our MS clinic organization. Identifying characteristics associated with therapy persistence may be useful in developing strategies to improve therapy effectiveness.

No MeSH data available.


Related in: MedlinePlus

Initial prescribed DMD in patients who never needed to switch/escalate therapy.
© Copyright Policy - open-access
Related In: Results  -  Collection


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fig1: Initial prescribed DMD in patients who never needed to switch/escalate therapy.

Mentions: From the cohort of RRMS patients who started IFNβ from 1996 to 1999 (only IFNβ formulations were available in that time span), we identified 26 cases (51%) treated with the same drug lasting for >12 years (mean = 14 years, range 13–16) (Table 1). Fourteen patients (54%) were treated with Betaferon, 8 (31%) with Avonex and 4 (15%) with Rebif (Figure 1). No serious adverse effects were reported. Concerning gender distribution, 18 patients (69%) were females and 8 males (ratio 2.3 : 1). First symptoms began in the mean age of 31 years (range 16–48), with a mean disease duration of 18.6 years (range 13–32) until March 2012. Regarding clinical presentation, motor symptoms were the most common, occurring in 11 patients (42%); brainstem occurred in 8 (31%), sensory in 4 patients (15%), optic neuritis in 2 (8%), and cerebellar in 1 (4%) (Figure 2). Mean ARR before and after initiating treatment was 0.5 and 0.1, respectively. Median EDSS when starting treatment and currently was 1.5 (range 0–6) and 4 (range 0–6), respectively; present mean MSSS is 2.56 (range 0.10–5.15). Regarding pregnancy, only two women get pregnant during DMD treatment, both under Avonex. Pregnancies developed without complications, deliveries were both normal and newborns were healthy. The remaining women, except one, already had children at the time of starting DMD.


Switching and escalating therapy in long-lasting multiple sclerosis: not always necessary.

Carvalho AT, Sá MJ - ISRN Neurol (2012)

Initial prescribed DMD in patients who never needed to switch/escalate therapy.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3539327&req=5

fig1: Initial prescribed DMD in patients who never needed to switch/escalate therapy.
Mentions: From the cohort of RRMS patients who started IFNβ from 1996 to 1999 (only IFNβ formulations were available in that time span), we identified 26 cases (51%) treated with the same drug lasting for >12 years (mean = 14 years, range 13–16) (Table 1). Fourteen patients (54%) were treated with Betaferon, 8 (31%) with Avonex and 4 (15%) with Rebif (Figure 1). No serious adverse effects were reported. Concerning gender distribution, 18 patients (69%) were females and 8 males (ratio 2.3 : 1). First symptoms began in the mean age of 31 years (range 16–48), with a mean disease duration of 18.6 years (range 13–32) until March 2012. Regarding clinical presentation, motor symptoms were the most common, occurring in 11 patients (42%); brainstem occurred in 8 (31%), sensory in 4 patients (15%), optic neuritis in 2 (8%), and cerebellar in 1 (4%) (Figure 2). Mean ARR before and after initiating treatment was 0.5 and 0.1, respectively. Median EDSS when starting treatment and currently was 1.5 (range 0–6) and 4 (range 0–6), respectively; present mean MSSS is 2.56 (range 0.10–5.15). Regarding pregnancy, only two women get pregnant during DMD treatment, both under Avonex. Pregnancies developed without complications, deliveries were both normal and newborns were healthy. The remaining women, except one, already had children at the time of starting DMD.

Bottom Line: From the cohort of 51 patients followed in our MS clinic with relapse-remitting MS who started an DMD between 1996 and 1999, we found a high percentage (51%) of patients who were efficiently treated with the first DMD.Our results may be related to the open and multidisciplinary model of our MS clinic organization.Identifying characteristics associated with therapy persistence may be useful in developing strategies to improve therapy effectiveness.

View Article: PubMed Central - PubMed

Affiliation: MS Clinic, Department of Neurology, Centro Hospitalar de São João, 4200-319 Porto, Portugal ; Department of Neurology, Centro Hospitalar de Vila Nova Gaia/Espinho, 4434-502 Vila Nova de Gaia, Portugal.

ABSTRACT
Although therapy switch is common among patients with multiple sclerosis (MS), sometimes the initial prescribed treatment is maintained for a long period with clinical stability, low disability, and nonsignificant side effects. We aim to describe demographic and clinical characteristics of patients treated in our MS clinic with the same disease-modifying drug (DMD) lasting for >12 years. From the cohort of 51 patients followed in our MS clinic with relapse-remitting MS who started an DMD between 1996 and 1999, we found a high percentage (51%) of patients who were efficiently treated with the first DMD. These patients were mainly females, with low annualized relapse rate and Multiple Sclerosis Severity Score (MSSS). Our results may be related to the open and multidisciplinary model of our MS clinic organization. Identifying characteristics associated with therapy persistence may be useful in developing strategies to improve therapy effectiveness.

No MeSH data available.


Related in: MedlinePlus