B A Cohen1, P K Coyle2, T Leist3, M A Oleen-Burkey4, M Schwartz5, H Zwibel6. 1. Department of Neurology, Northwestern University, 710 North Lake Shore Drive, Abbott Hall 1121, Chicago, IL 60611, USA. Electronic address: bac106@northwestern.edu. 2. Department of Neurology, Stony Brook University, Health Sciences Center, T12-020, Stony Brook, NY 11794, USA. Electronic address: Patricia.Coyle@stonybrookmedicine.edu. 3. Comprehensive MS Center, Thomas Jefferson University, 900 Walnut St. #200, Philadelphia, PA 19107, USA. Electronic address: thomas.leist@jefferson.edu. 4. Health Outcomes Research Consulting and Writing, Outcomes Scribe, LLC, 664 Wynding Oaks, Kalamazoo, MI 49006, USA. Electronic address: OutcomesScribe@gmail.com. 5. Biostatistics, MedNet Solutions, Inc., 110 Cheshire Lane, Ste. 300, Minnetonka, MN 55305, USA. Electronic address: mschwartz@mednetstudy.com. 6. Neuroscience Consultants, Comprehensive Multiple Sclerosis Center, 4601 Ponce de Leon Blvd, Ste. 100, Coral Gables, FL 33146, USA. Electronic address: zwibelmdms@aol.com.
Abstract
OBJECTIVES: The objective of the Therapy Optimization in MS (TOP MS) Study was to prospectively assess the relationship between MS disease-modifying therapy (DMT) adherence and MS relapse risk over 2 years. METHODS: Potential participants were recruited for TOP MS by specialty pharmacies who dispensed glatiramer acetate and beta interferons for MS nationwide. Signed IRB-approved informed consents were returned to the pharmacies. TOP MS used electronic data capture with monthly patient entries. Adherence, measured by medication possession ratio (MPR), was derived from pharmacy shipment records. Logistic regression examined the association between protocol-defined relapses and DMT MPR (<0.5; >0.5-<0.9; >0.9). RESULTS: TOP MS enrolled 3151 persons with MS, and 2410 completed the full 2 years. Across all therapies, the mean MPR for the 2-year completer cohort of 2049 who maintained the same DMT was 0.9+0.2 (range: 0.1-1.0), with 63.8% reaching a 2-year MPR >0.9. Evaluated by categories of MPR, the proportion of participants remaining relapse-free for 24 months increased with increasing MPR, and the proportion with >1 relapses declined with increasing levels of MPR (p<0.0008). Regression analysis revealed the odds of relapse for a patient in the MPR >0.9 MPR group was 64% that of a patient in the MPR <0.5 category (p=0.02). Use of >1 DMT prior to the current one was an independent predictor of relapse. CONCLUSIONS: The study provides class III evidence that improvement in adherence to DMT for MS is associated with improved clinical outcomes as measured by relapse reduction.
OBJECTIVES: The objective of the Therapy Optimization in MS (TOP MS) Study was to prospectively assess the relationship between MS disease-modifying therapy (DMT) adherence and MS relapse risk over 2 years. METHODS: Potential participants were recruited for TOP MS by specialty pharmacies who dispensed glatiramer acetate and beta interferons for MS nationwide. Signed IRB-approved informed consents were returned to the pharmacies. TOP MS used electronic data capture with monthly patient entries. Adherence, measured by medication possession ratio (MPR), was derived from pharmacy shipment records. Logistic regression examined the association between protocol-defined relapses and DMT MPR (<0.5; >0.5-<0.9; >0.9). RESULTS: TOP MS enrolled 3151 persons with MS, and 2410 completed the full 2 years. Across all therapies, the mean MPR for the 2-year completer cohort of 2049 who maintained the same DMT was 0.9+0.2 (range: 0.1-1.0), with 63.8% reaching a 2-year MPR >0.9. Evaluated by categories of MPR, the proportion of participants remaining relapse-free for 24 months increased with increasing MPR, and the proportion with >1 relapses declined with increasing levels of MPR (p<0.0008). Regression analysis revealed the odds of relapse for a patient in the MPR >0.9 MPR group was 64% that of a patient in the MPR <0.5 category (p=0.02). Use of >1 DMT prior to the current one was an independent predictor of relapse. CONCLUSIONS: The study provides class III evidence that improvement in adherence to DMT for MS is associated with improved clinical outcomes as measured by relapse reduction.
Authors: Aliza Ben-Zacharia; Meagan Adamson; Allison Boyd; Paula Hardeman; Jennifer Smrtka; Bryan Walker; Tracy Walker Journal: Int J MS Care Date: 2018 Nov-Dec
Authors: Diego Centonze; Roberta Fantozzi; Fabio Buttari; Luigi Maria Edoardo Grimaldi; Rocco Totaro; Francesco Corea; Maria Giovanna Marrosu; Paolo Confalonieri; Salvatore Cottone; Maria Trojano; Valentina Zipoli Journal: Front Neurol Date: 2021-04-22 Impact factor: 4.003