Adherence to Multiple Sclerosis Disease-Modifying Therapies in Ontario is Low

Background/Objective:Differences in patient adherence to various disease-modifying drugs (DMDs) in the treatment of multiple sclerosis (MS) are not well understood. The goal of this study was to evaluate adherence of adult MS patients in Ontario with public drug plan coverage to various DMDs: intramuscular interferon beta-1a (i.m. IFNβ-1a, Avonex), subcutaneous interferon beta-1a (s.c. IFNβ-1a, Rebif), subcutaneous interferon beta-1b (IFNβ-1b, Betaseron) or glatiramer acetate (Copaxone).Methods:In this retrospective cohort study, Ontario Public Drug Plan beneficiaries aged 15 or older who were newly treated with i.m. IFNβ-1a, s.c. IFNβ-1a, IFNβ-1b or glatiramer acetate between April 2006 and March 2008 were followed forward until treatment discontinuation, switch to another DMD or a maximum two year follow-up period. Cumulative persistence rates were analyzed by the Kaplan-Meier method. The proportion of patients reaching the study endpoints after the two year follow-up period was also calculated.Results:Cumulative persistence rates for all four DMDs were similar over time (p=0.80), ranging from 73.6-79.1% at six months, 59.1-63.1% at one year and 41.5-47.4% at two years. After two years, the proportion of patients who had discontinued treatment, switched to another DMD or died was similar among DMDs (p=0.79, Fisher's exact test). Switching between DMD types was low and occurred in 3.4-6.5% of new DMD users.Conclusions:Adherence to DMDs in adult MS patients in Ontario is poor, which is consistent with previously reported adherence rates to MS DMDs in other regions. No significant differences in adherence exist between the DMDs evaluated in this study.

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Clinical trials in relapsing-remitting multiple sclerosis (a new proposal for dealing with basic problems and restrictions)

Journal of Medical Science ◽

10.20883/medical.e24 ◽

2015 ◽

Vol 84 (2) ◽

pp. 104-106

Author(s):

Mieczyslaw Wender ◽

Grazyna Michalowska-Wender

Keyword(s):

Multiple Sclerosis ◽

Glatiramer Acetate ◽

Relapse Rate ◽

Interferon Beta ◽

Therapy Group ◽

Current Standard ◽

Reference Drug ◽

Disease Modifying Drugs ◽

Double Blinded ◽

Relapsing Remitting Multiple Sclerosis

The natural course of multiple sclerosis is characterized by a high variability of pattern, relapse rate and different progression indices. They also present a dramatic impact on the interpretation of treatment trials. Older reports, based on uncontrolled observations are therefore of little value. Currently it is generally accepted that a proper treatment trial should be double blinded and, although probably controversial, that it should be compared with a group of MS patients treated with placebo. Such an approach would be easily acceptable to prove the effectiveness of recently discovered disease modifying drugs. We know that current standard methods of therapy with interferon beta or glatiramer acetate are able to decrease the relapse rate at least by one third, to elongate the intervals between the relapses and to decrease the progression indices. Currently MS is considered a generalized degenerative disease. The lesions are persistent, therefore immunomodulatory treatment has to be started as early as possible. An alternative approach, somewhat suggestive for the use of placebo trials, seems to be a comparison of proposed new drug therapy group with a group of patients treated with a generally accepted reference drug, such as interferon beta or glatiramer acetate, including all clinical and MRI measures.

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Pregnancy in multiple sclerosis: from scientific aspects to practical

The Moldovan Medical Journal ◽

10.52418/moldovan-med-j.64-3.21.14 ◽

2021 ◽

Vol 64 (3) ◽

pp. 78-84

Author(s):

Anna Belenciuc ◽

◽

Ana-Maria Bubuioc ◽

Olesea Odainic ◽

Marina Sangheli ◽

...

Keyword(s):

Multiple Sclerosis ◽

Family Planning ◽

Immune Reconstitution ◽

Interferon Beta ◽

Reproductive Age ◽

Childbearing Age ◽

Disease Modifying Drugs ◽

Choice Of Treatment ◽

Key Issues ◽

Disease Modifying

Background: Multiple sclerosis (MS) is a disease that affects young people of reproductive age (20-40 years old), predominantly women. Therefore, almost every patient has questions about pregnancy and breastfeeding. Family planning is one of the key issues in the choice of treatment tactics. Despite the growing number of therapeutic options for individualized treatment, it is still a question how to manage women with MS who become pregnant while taking disease-modifying drugs or want to become pregnant after starting this treatment. Conclusions: Women with MS should not be discouraged from pregnancy due to their illness. It is necessary to proactively discuss pregnancy planning with all women with MS of childbearing age. Based on available data, interferon beta and glatiramer acetate appear to be most suitable for use up until the time of confirmed pregnancy. A large amount of data (more than 1000 cases) obtained from registries shows that use of interferon beta before conception and during pregnancy suggests no evidence of increase in the rate of congenital anomalies or spontaneous abortions. For women with persistent high disease activity, pulsed immune reconstitution therapy gives additional opportunity for family planning after the last dose. The choice between available options for pulsed immune reconstitution therapy should be based on efficacy balanced against the risks.

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Increasing Use of Disease Modifying Drugs for MS in Canada

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques ◽

10.1017/s0317167100010295 ◽

2010 ◽

Vol 37 (3) ◽

pp. 383-388 ◽

Cited By ~ 14

Author(s):

Dalia L. Rotstein ◽

Muhammad Mamdani ◽

Paul W. O'Connor

Keyword(s):

Glatiramer Acetate ◽

Interferon Beta ◽

Cohort Analysis ◽

Population Data ◽

Annual Number ◽

Total Annual Cost ◽

Disease Modifying Drugs ◽

Prescription Rates ◽

Disease Modifying ◽

Canadian Provinces

Background/Objectives:The course of multiple sclerosis may be slowed by use of the disease modifying drugs (DMDs): subcutaneous or intramuscular interferon beta-1a, interferon beta-1b, glatiramer acetate, and natalizumab. We set out to compare utilization of these drugs in the Canadian provinces from 2002-2007.Methods:Using a retrospective cohort analysis, we reviewed population data from International Medical Statistics (IMS) Health between November 2001 and October 2007.Results:The total annual number of DMD prescriptions increased from 3.9, in 2002, to 5.1, in 2007, per 1,000 Canadians. The total annual cost of prescriptions rose from $187 million to $287 million. Of the four provinces responsible for the majority of prescriptions - Alberta, BC, Ontario, and Quebec - Quebec had the highest average annual prescription rate (7 per 1,000 population) and BC had the lowest rate (3.3 per 1,000 population). Subcutaneous interferon beta-1a was the most commonly used drug whereas glatiramer acetate showed the greatest growth in use from 2002 to 2007.Conclusions:Disease modifying drugs prescription rates and costs increased by more than 30% between 2002 and 2007. There was wide variation in DMD prescription rates and relative drug preferences across the provinces.

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When to Initiate Disease-Modifying Drugs for Relapsing Remitting Multiple Sclerosis in Adults?

Multiple Sclerosis International ◽

10.1155/2011/724871 ◽

2011 ◽

Vol 2011 ◽

pp. 1-11 ◽

Cited By ~ 3

Author(s):

Mona Alkhawajah ◽

Joel Oger

Keyword(s):

Multiple Sclerosis ◽

Decision Making ◽

Glatiramer Acetate ◽

Major Question ◽

Disease Modifying Drugs ◽

Relapsing Remitting ◽

Disease Modifying ◽

Remitting Multiple Sclerosis ◽

Relapsing Remitting Multiple Sclerosis

For patients with Relapsing Remitting Multiple Scierosis Beta Interfaerons and Glatiramer Acetate were the first to be licensed for treatment. This review deals with one major question: when to initiate therapy? Through exploring the unique characteristics of the disease and treatement we suggest an approach that should be helpful in the process of decision-making.

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Long-term follow-up for multiple sclerosis patients initially treated with interferon-beta and glatiramer acetate

Journal of the Neurological Sciences ◽

10.1016/j.jns.2018.09.020 ◽

2018 ◽

Vol 394 ◽

pp. 127-131 ◽

Cited By ~ 5

Author(s):

Brian C. Healy ◽

Bonnie I. Glanz ◽

Jonathan D. Zurawski ◽

Maria Mazzola ◽

Tanuja Chitnis ◽

...

Keyword(s):

Multiple Sclerosis ◽

Glatiramer Acetate ◽

Interferon Beta ◽

Long Term Follow Up ◽

Multiple Sclerosis Patients

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Disease-Modifying Drugs Reduce Cortical Lesion Accumulation and Atrophy Progression in Relapsing-Remitting Multiple Sclerosis: Results from a 48-Month Extension Study

Multiple Sclerosis International ◽

10.1155/2015/369348 ◽

2015 ◽

Vol 2015 ◽

pp. 1-5 ◽

Cited By ~ 1

Author(s):

Francesca Rinaldi ◽

Paola Perini ◽

Matteo Atzori ◽

Alice Favaretto ◽

Dario Seppi ◽

...

Keyword(s):

Multiple Sclerosis ◽

Glatiramer Acetate ◽

Reference Population ◽

Cortical Atrophy ◽

Cortical Lesion ◽

Disease Modifying Drugs ◽

Relapsing Remitting ◽

The Mean ◽

Disease Modifying ◽

Relapsing Remitting Multiple Sclerosis

Cortical lesions (CLs) and atrophy are pivotal in multiple sclerosis (MS) pathology. This study determined the effect of disease modifying drugs (DMDs) on CL development and cortical atrophy progression in patients with relapsing-remitting MS (RRMS) over 48 months. Patients (n=165) were randomized to sc IFNβ-1a 44 μg, im IFNβ-1a 30 μg, or glatiramer acetate 20 mg. The reference population comprised 50 DMD-untreated patients with RRMS. After 24 months, 43 of the untreated patients switched to DMDs. The four groups of patients were followed up for an additional 24 months. At 48 months the mean standard deviation number of new CLs was significantly lower in patients treated with sc IFNβ-1a (1.4 ± 1.0, range 0–5) compared with im IFNβ-1a (2.3 ± 1.3, range 0–6,P=0.004) and glatiramer acetate (2.2 ± 1.5, range 0–7,P=0.03). Significant reductions in CL accumulation and new white matter and gadolinium-enhancing lesions were also observed in the 43 patients who switched to DMDs after 24 months, compared with the 24 months of no treatment. Concluding, this study confirms that DMDs significantly reduce CL development and cortical atrophy progression compared with no treatment.

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Post-marketing of disease modifying drugs in multiple sclerosis: An exploratory analysis of gender effect in interferon beta treatment

Journal of the Neurological Sciences ◽

10.1016/j.jns.2009.06.036 ◽

2009 ◽

Vol 286 (1-2) ◽

pp. 109-113 ◽

Cited By ~ 16

Author(s):

M. Trojano ◽

F. Pellegrini ◽

D. Paolicelli ◽

A. Fuiani ◽

G.B. Zimatore ◽

...

Keyword(s):

Multiple Sclerosis ◽

Interferon Beta ◽

Gender Effect ◽

Exploratory Analysis ◽

Disease Modifying Drugs ◽

Post Marketing ◽

Disease Modifying

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Headache in multiple sclerosis - pharmacological aspects

Current Pharmaceutical Design ◽

10.2174/1381612827666210922114100 ◽

2021 ◽

Vol 27 ◽

Author(s):

Marcel Gebhardt ◽

Peter Kropp ◽

Frank Hoffmann ◽

Uwe K. Zettl

Keyword(s):

Multiple Sclerosis ◽

Interferon Beta ◽

Cerebral Vasculitis ◽

General Will ◽

Specific Therapy ◽

Disease Modifying Drugs ◽

Secondary Headaches ◽

Red Flag ◽

Disease Modifying ◽

The One

: For decades, headache was not considered a typical symptom of multiple sclerosis (MS) and was construed as a "red flag" for important differential diagnoses such as cerebral vasculitis. Meanwhile, several studies have demonstrated an increased prevalence of headache in MS compared to the general population. This is due to the heterogeneity of headache genesis with frequent occurrence of both primary and secondary headaches in MS. On the one hand, MS and migraine are often comorbid. On the other hand, secondary headaches occur frequently, especially in the course of MS relapses. These are often migraine-like headaches caused by inflammation, which can improve as a result of MS-specific therapy. Headaches are particularly common in the early stages of chronic inflammatory CNS disease, where inflammatory activity is greatest. In addition, headache can also occur as a side effect of disease-modifying drugs (DMDs). Headache can occur with most DMDs and is most frequently described with interferon-beta therapy. The aim of this work is to present the prevalence of headache and describe the heterogeneity of possible causes of headache in MS. In addition, important therapeutic aspects in the treatment of MS patients in general will be presented as well as different approaches to the treatment of headache in MS depending on the etiological classification.

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