Matthew Warrender-Sparkes1, Tim Spelman2, Guillermo Izquierdo3, Maria Trojano4, Alessandra Lugaresi5, François Grand'Maison6, Eva Havrdova7, Dana Horakova7, Cavit Boz8, Celia Oreja-Guevara9, Raed Alroughani10, Gerardo Iuliano11, Pierre Duquette12, Marc Girard12, Murat Terzi13, Raymond Hupperts14, Pierre Grammond15, Thor Petersen16, Ricardo Fernandez-Bolaños17, Marcela Fiol18, Eugenio Pucci19, Jeannette Lechner-Scott20, Freek Verheul21, Edgardo Cristiano22, Vincent Van Pesch23, Tatjana Petkovska-Boskova24, Fraser Moore25, Ilya Kister26, Roberto Bergamaschi27, Maria Laura Saladino28, Mark Slee29, Michael Barnett30, Maria Pia Amato31, Cameron Shaw32, Neil Shuey33, Carolyn Young34, Orla Gray35, Ludwig Kappos36, Helmut Butzkueven37, Tomas Kalincik38, Vilija Jokubaitis39. 1. Department of Medicine, University of Melbourne, Melbourne, Australia. 2. Department of Neurology, Royal Melbourne Hospital, Melbourne, Australia. 3. Hospital Universitario Virgen Macarena, Sevilla, Spain. 4. Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari, Italy. 5. MS Center, Department of Neuroscience, Imaging and Clinical Sciences, University 'G. d'Annunzio', Chieti, Italy. 6. Neuro Rive-Sud, Hôpital Charles LeMoyne, Quebec, Canada. 7. Department of Neurology and Center of Clinical Neuroscience, 1st Faculty of Medicine, General University Hospital and Charles University in Prague, Czech Republic. 8. Karadeniz Technical University, Trabzon, Turkey. 9. University Hospital San Carlos, IdISSC, Madrid, Spain. 10. Amiri Hospital, Kuwait City, Kuwait. 11. Ospedali Riuniti di Salerno, Salerno, Italy. 12. Hôpital Notre-Dame, Montreal, Canada. 13. Ondokuz Mayis Üniversitesi, Samsun, Turkey. 14. Orbis Medicle Center, Sittard, The Netherlands. 15. Hotel-Dieu de Levis, Quebec, Canada. 16. Aarhus University Hospital, Aarhus C, Denmark. 17. Hospital Universitario Virgen de Valme, Seville, Spain. 18. FLENI, Buenos Aires, Argentina. 19. Ospedale di Macerata, Macerata, Italy. 20. John Hunter Hospital, Newcastle, Australia. 21. Groen Hart Ziekenhuis, Gouda, The Netherlands. 22. Hospital Italiano, Buenos Aires, Argentina. 23. Cliniques Universitaires Saint-Luc, Brussels, Belgium. 24. Neurology Clinical Center, Skopje, Macedonia. 25. Jewish General Hospital, Montreal, Canada. 26. New York University Langone Medical Center, New York, USA. 27. National Neurological Institute C. Mondino, Pavia, Italy. 28. INEBA, Buenos Aires, Argentina. 29. Flinders University and Medical Centre, Adelaide, Australia. 30. Brain and Mind Research Institute, Sydney, Australia. 31. Department NEUROFARBA, Section of Neurosciences, University of Florence, Florence, Italy. 32. Geelong Hospital, Geelong, Australia. 33. St Vincent's Hospital, Melbourne, Australia. 34. The Walton Centre for Neurology and Neurosurgery, Liverpool, United Kingdom. 35. Craigavon Area Hospital, Portadown, United Kingdom. 36. University Hospital Basel, Neurology, Departments of Medicine, Clinical Research and Biomedicine, Basel, Switzerland. 37. Department of Medicine, University of Melbourne, Melbourne, Australia/ Department of Neurology, Box Hill Hospital, Monash University, Box Hill, Australia. 38. Department of Medicine, University of Melbourne, Melbourne, Australia/Department of Neurology, Royal Melbourne Hospital, Melbourne, Australia. 39. Department of Medicine, University of Melbourne, Melbourne, Australia vilija.jokubaitis@unimelb.edu.au.
Abstract
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.
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.
Authors: Oscar Fernández; Guillermo Izquierdo; Eduardo Aguera; Cristina Ramo; Miguel Hernandez; Diego Silva; Rob Walker; Helmut Butzkueven; Chenyu Wang; Michael Barnett Journal: Mult Scler J Exp Transl Clin Date: 2020-09-13
Authors: Robert Zivadinov; Nasreen Khan; Jennie Medin; Pia Christoffersen; Jennifer Price; Jonathan R Korn; Ian Bonzani; Michael G Dwyer; Niels Bergsland; Ellen Carl; Diego Silva; Bianca Weinstock-Guttman Journal: J Neuroimaging Date: 2016-12-05 Impact factor: 2.486
Authors: Bruce A C Cree; Douglas L Arnold; Mark Cascione; Edward J Fox; Ian M Williams; Xiangyi Meng; Lesley Schofield; Nadia Tenenbaum Journal: Ther Adv Neurol Disord Date: 2018-05-20 Impact factor: 6.570
Authors: Francisco Barrero; Javier Mallada-Frechin; María Luisa Martínez-Ginés; María Eugenia Marzo; Virginia Meca-Lallana; Guillermo Izquierdo; José Ramón Ara; Celia Oreja-Guevara; José Meca-Lallana; Lucía Forero; Irene Sánchez-Vera; María José Moreno Journal: PLoS One Date: 2020-04-02 Impact factor: 3.240