TY - JOUR
T1 - The effect of oral immunomodulatory therapy on treatment uptake and persistence in multiple sclerosis
AU - Warrender-Sparkes, Matthew
AU - Spelman, Tim
AU - Izquierdo, Guillermo
AU - Trojano, Maria
AU - Lugaresi, Alessandra
AU - Grand'Maison, Francois
AU - Havrdova, Eva
AU - Horakova, Dana
AU - Boz, Cavit
AU - Oreja-Guevara, Celia
AU - Alroughani, Raed
AU - Iuliano, Gerardo
AU - Duquette, Pierre
AU - Girard, Marc
AU - Terzi, Murat
AU - Hupperts, Raymond
AU - Grammond, Pierre
AU - Petersen, Thor
AU - Fernandez-Bolanos, Ricardo
AU - Fiol, Marcela
AU - Pucci, Eugenio
AU - Lechner-Scott, Jeannette
AU - Verheul, Freek
AU - Cristiano, Edgardo
AU - Van Pesch, Vincent
AU - Petkovska-Boskova, Tatjana
AU - Moore, Fraser
AU - Kister, Ilya
AU - Bergamaschi, Roberto
AU - Saladino, Maria
AU - Slee, Mark
AU - Barnett, Michael
AU - Amato, Maria
AU - Shaw, Cameron
AU - Shuey, Neil
AU - Young, Carolyn
AU - Gray, Orla
AU - Kappos, Ludwig
AU - Butzkeuven, Helmut
AU - Kalincik, Tomas
AU - Jokubaitis, Vilija
PY - 2016/4/1
Y1 - 2016/4/1
N2 - Objective: We aimed to analyse the effect of the introduction of fingolimod, the first oral disease-modifying therapy, on treatment utilisation and persistence in an international cohort of patients with multiple sclerosis (MS). Methods: MSBASIS, a prospective, observational sub-study of the MSBase registry, collects demographic, clinical and paraclinical data on patients followed from MS onset (n=4718). We conducted a multivariable conditional risk set survival analysis to identify predictors of treatment discontinuation, and to assess if the introduction of fingolimod has altered treatment persistence. Results: A total of 2640 patients commenced immunomodulatory therapy. Following the introduction of fingolimod, patients were more likely to discontinue all other treatments (hazard ratio 1.64, p<0.001) while more patients switched to fingolimod than any other therapy (42.3% of switches). Patients switched to fingolimod due to convenience. Patients treated with fingolimod were less likely to discontinue treatment compared with other therapies (p<0.001). Female sex, country of residence, younger age, a high Expanded Disability Status Scale score and relapse activity were all independently associated with higher rates of treatment discontinuation. Conclusion: Following the availability of fingolimod, patients were more likely to discontinue injectable treatments. Those who switched to fingolimod were more likely to do so for convenience. Persistence was improved on fingolimod compared to other medications.
AB - Objective: We aimed to analyse the effect of the introduction of fingolimod, the first oral disease-modifying therapy, on treatment utilisation and persistence in an international cohort of patients with multiple sclerosis (MS). Methods: MSBASIS, a prospective, observational sub-study of the MSBase registry, collects demographic, clinical and paraclinical data on patients followed from MS onset (n=4718). We conducted a multivariable conditional risk set survival analysis to identify predictors of treatment discontinuation, and to assess if the introduction of fingolimod has altered treatment persistence. Results: A total of 2640 patients commenced immunomodulatory therapy. Following the introduction of fingolimod, patients were more likely to discontinue all other treatments (hazard ratio 1.64, p<0.001) while more patients switched to fingolimod than any other therapy (42.3% of switches). Patients switched to fingolimod due to convenience. Patients treated with fingolimod were less likely to discontinue treatment compared with other therapies (p<0.001). Female sex, country of residence, younger age, a high Expanded Disability Status Scale score and relapse activity were all independently associated with higher rates of treatment discontinuation. Conclusion: Following the availability of fingolimod, patients were more likely to discontinue injectable treatments. Those who switched to fingolimod were more likely to do so for convenience. Persistence was improved on fingolimod compared to other medications.
KW - disease-modifying therapy
KW - fingolimod
KW - medication persistence
KW - MSBase
KW - Multiple sclerosis
UR - http://www.scopus.com/inward/record.url?scp=84962517754&partnerID=8YFLogxK
U2 - 10.1177/1352458515594041
DO - 10.1177/1352458515594041
M3 - Article
SN - 1352-4585
VL - 22
SP - 520
EP - 532
JO - Multiple Sclerosis
JF - Multiple Sclerosis
IS - 4
ER -