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Title: Country, sex, EDSS change and therapy choice independently predict treatment discontinuation in multiple sclerosis and clinically isolated syndrome
Authors: Meyniel, Claire
Spelman, Timothy
Jokubaitis, Vilija G.
Trojano, Maria
Izquierdo, Guillermo
Grand’Maison, Francois
Oreja-Guevara, Celia
Boz, Cavit
Lugaresi, Alessandra
Girard, Marc
Grammond, Pierre
Iuliano, Gerardo
Fiol, Marcela
Cabrera-Gomez, Jose Antonio
Fernandez-Bolanos, Ricardo
Giuliani, Giorgio
Lechner-Scott, Jeannette
Cristiano, Edgardo
Herbert, Joseph
Petkovska-Boskova, Tatjana
Bergamaschi, Roberto
Pesch, Vincent van
Moore, Fraser
Vella, Norbert
Slee, Mark
Santiago, Vetere
Barnett, Michael
Havrdova, Eva
Young, Carolyn
Sirbu, Carmen-Adella
Tanner, Mary
Rutherford, Michelle
Butzkueven, Helmut
Authors: MSBasis Study Group
Keywords: Multiple sclerosis -- Research
Multiple sclerosis, Relapsing-remitting
Nervous system -- Diseases -- Research
Issue Date: 2012
Publisher: PLOS
Citation: Meyniel, C., Spelman, T., Jokubaitis, V. G., Trojano, M., Izquierdo, G., Grand’Maison, F.,....Butzkueven, H. (2012). Country, sex, EDSS change and therapy choice independently predict treatment discontinuation in multiple sclerosis and clinically isolated syndrome. PloS one, 7(6), e38661.
Abstract: 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.
Appears in Collections:Scholarly Works - FacM&SMed

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