Country, sex, EDSS change and therapy choice independently predict treatment discontinuation in multiple sclerosis and clinically isolated syndrome

C Meyniel, T Spelman, V Jokubaitis, M Trojano, G Izquierdo, F Grand'Maison, C Oreja-Guevara, C Boz, A Lugaresi, M Girard, P Grammond, G Iuliano, M Fiol, J Cabrera-Gomez, R Fernandez-Bolanos, G Guiliani, J Lechner-Scott, E Cristiano, Joseph Herbert, T Petkovska-BoskovaR Bergamaschi, V Van Pesch, Fraser Moore, Norbert Vella, Mark Slee, V Santiago, Michael Barnett, E Havrdova, Carolyn Young, Carmen Sirbu, M Tanner, M Rutherford, H Butzkueven

    Research output: Contribution to journalArticlepeer-review

    32 Citations (Scopus)


    Objectives: We conducted a prospective study, MSBASIS, to assess factors leading to first treatment discontinuation in patients with a clinically isolated syndrome (CIS) and early relapsing-remitting multiple sclerosis (RRMS). Methods: The MSBASIS Study, conducted by MSBase Study Group members, enrols patients seen from CIS onset, reporting baseline demographics, cerebral magnetic resonance imaging (MRI) features and Expanded Disability Status Scale (EDSS) scores. Follow-up visits report relapses, EDSS scores, and the start and end dates of MS-specific therapies. We performed a multivariable survival analysis to determine factors within this dataset that predict first treatment discontinuation. Results: A total of 2314 CIS patients from 44 centres were followed for a median of 2.7 years, during which time 1247 commenced immunomodulatory drug (IMD) treatment. Ninety percent initiated IMD after a diagnosis of MS was confirmed, and 10% while still in CIS status. Over 40% of these patients stopped their first IMD during the observation period. Females were more likely to cease medication than males (HR 1.36, p = 0.003). Patients treated in Australia were twice as likely to cease their first IMD than patients treated in Spain (HR 1.98, p = 0.001). Increasing EDSS was associated with higher rate of IMD cessation (HR 1.21 per EDSS unit, p<0.001), and intramuscular interferon-β-1a (HR 1.38, p = 0.028) and subcutaneous interferon-β-1a (HR 1.45, p = 0.012) had higher rates of discontinuation than glatiramer acetate, although this varied widely in different countries. Onset cerebral MRI features, age, time to treatment initiation or relapse on treatment were not associated with IMD cessation. Conclusion: In this multivariable survival analysis, female sex, country of residence, EDSS change and IMD choice independently predicted time to first IMD cessation.

    Original languageEnglish
    Article numbere38661
    Pages (from-to)e38661
    Number of pages8
    JournalPLoS One
    Issue number6
    Publication statusPublished - 29 Jun 2012


    Dive into the research topics of 'Country, sex, EDSS change and therapy choice independently predict treatment discontinuation in multiple sclerosis and clinically isolated syndrome'. Together they form a unique fingerprint.

    Cite this