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| Content Provider | frontiers |
|---|---|
| Author | Simonsen, Cecilia Smith Flemmen, Heidi Øyen Broch, Line Brunborg, Cathrine Berg-Hansen, Pål Moen, Stine Marit Celius, Elisabeth Gulowsen |
| Description | Background: Moderate and high efficacy disease modifying therapies (DMTs) have a profound effect on disease activity. The current treatment guidelines only recommend high efficacy DMTs for patients with highly active MS. The objective was to examine the impact of initial treatment choice in achieving no evidence of disease activity (NEDA) at year 1 and 2.Methods: Using a real-world population-based registry with limited selection bias from the southeast of Norway, we determined how many patients achieved NEDA on moderate and high efficacy DMTs.Results: 68.0% of patients who started a high efficacy DMT as the first drug achieved NEDA at year 1 and 52.4% at year 2 as compared to 36.0 and 19.4% of patients who started a moderate efficacy DMT as a first drug. The odds ratio (OR) of achieving NEDA on high efficacy drugs compared to moderate efficacy drugs as a first drug at year 1 was 3.9 (95% CI 2.4–6.1, p < 0.001). The OR for high efficacy DMT as the second drug was 2.5 (95% CI 1.7–3.9, p < 0.001), and was not significant for the third drug. Patients with a medium or high risk of disease activity were significantly more likely to achieve NEDA on a high efficacy therapy as a first drug compared to moderate efficacy therapy as a first drug.Conclusions: Achieving NEDA at year 1 and 2 is significantly more likely in patients on high-efficacy disease modifying therapies than on moderate efficacy therapies, and the first choice of treatment is the most important. The immunomodulato... |
| Abstract | BACKGROUND: Moderate and high efficacy disease modifying therapies (DMTs) have a profound effect on disease activity. The current treatment guidelines only recommend high efficacy DMTs for patients with highly active MS. The objective was to examine the impact of initial treatment choice in achieving no evidence of disease activity (NEDA) at year one and year two. METHODS: Using a real-world population-based registry with limited selection bias from the southeast of Norway, we determined how many patients achieved NEDA on moderate and high efficacy DMTs. RESULTS: 68.0% of patients who started a high efficacy DMT as the first drug achieved NEDA at year one and 52.4% at year two as compared to 36.0% and 19.4% of patients who started a moderate efficacy DMT as a first drug. The odds ratio (OR) of achieving NEDA on high efficacy drugs compared to moderate efficacy drugs as a first drug at year one was 3.9 (95% CI 2.4-6.1, p<0.001). The OR for high efficacy DMT as the second drug was 2.5 (95%CI 1.7-3.9, p<0.001), and was not significant for the third drug. Patients with a medium or high risk of disease activity were significantly more likely to achieve NEDA on a high efficacy therapy as a first drug compared to moderate efficacy therapy as a first drug. CONCLUSION: Achieving NEDA at year one and two is significantly more likely in patients on high-efficacy disease modifying therapies than on moderate efficacy therapies, and the first choice of treatment is the most important. The immunomodulatory treatment guidelines should be updated to ensure early, high efficacy therapy for the majority of patients diagnosed with MS. |
| ISSN | 16642295 |
| DOI | 10.3389/fneur.2021.693017 |
| Volume Number | 12 |
| Journal | Frontiers in Neurology |
| Language | English |
| Publisher Date | 2021-06-17 |
| Access Restriction | Open |
| Subject Keyword | Multiple sclerosis No evidence of disease activity (NEDA) Disease activity Treatment decision Disease modifying therapies |
| Content Type | Text |
| Resource Type | Article |
| Subject | Neurology Neurology (clinical) |
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