Younger MS Patients Who Are Hospitalized May Be at Higher Risk of Quitting Treatment, Study Reports – Multiple Sclerosis News Today

MS patients who start treatment at a younger age, and whose condition requires hospitalization, are more likely to stop treatment, a Canadian study reports.

The research, published in the journal Dovepress,dealt with the main reasons Canadian patients quit first-line injected disease-modifying therapies, or DMTs. Itwas titledPersistence to disease-modifying therapies for multiple sclerosis in a Canadian cohort.

DMTs can reduce MS activity, but patients must stick with them in order for them to be effective.

There is currently a paucity of clinical trial data on what happens to individuals when they discontinue DMT, the researchers wrote. However, recent preliminary evidence from observational studies suggest increased relapses and disability in those who discontinue DMT.

Researchers sought to identify MS patients at higher risk of discontinuing treatment. They looked at Manitoba Provinces medical database to identify the types of drugs MS patients were taking, and for how long.

The analysis covered 721 patientswho received injected beta-interferons or Copaxonebetween 1996 and 2011, and whom doctors followed for at least a year. Tevamanufactures Copaxone, whose generic name isglatiramer acetate.

The mean age of the patients in the study was37.6 years, and 74.2 percent were women.

Researchers defined a discontinuation of a DMT as a 90-day or longer gap in treatment.

A third of thepatients were treated with beta-interferon-1b, either Bayer HealthCaresBetaferon/Betaseron orNovartisExtavia. It wasthe first such therapy available in Manitoba.

Twenty-three percent of patients received beta-interferon-1a, either BiogensAvonex orMercksRebif. And21 percent received Copaxone.

The median time before a patient discontinued a DMTwas 4.2 years.

Although 62.6 percent of patients discontinued treatment at some point, 57.4 percent either reinitiatedit or switched to a different DMT. Patients who were on DMT at least a year were more likely to stay with it than those who stopped in the first year.

Importantly, patients who started a DMT at a younger age were more likely to stop taking it than older patients.

Our results are also consistent with previous work examining persistence for other chronic medication classes, including statins, antihypertensives, bisphosphonates, and oral antidiabetic agents, where the risk for discontinuing drugs declined in a linear fashion with age, the researchers wrote.

The team also found that 16 percent of patients had to be hospitalized overnight, with 3 percent of the cases due to MS-related complications. And these hospitalized patients were more likely to stop their DMT treatment earlier, the researchers said.

Summing up, the team said: Subjects who were younger when starting a DMT, had prior MS-related hospitalizations, were more recently diagnosed with MS, or had a greater lag time between their MS diagnosis and DMT initiation were more likely to discontinue therapy.

Although not all of the factors identified with discontinuing DMT can be modified, they may help practitioners enhance MS care by identifying individuals who may be at particular risk for DMT discontinuation, the researchers concluded.

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Younger MS Patients Who Are Hospitalized May Be at Higher Risk of Quitting Treatment, Study Reports - Multiple Sclerosis News Today