Contributions
Abstract: P701
Type: Poster
Abstract Category: Therapy - disease modifying - Long-term treatment monitoring
Disease-modifying treatments (DMTs) comprise immunomodulating and immunosuppressant medications aimed at slowing the progression of multiple sclerosis (MS). The working hypothesis is that reducing or preventing new lesions and their sequelae slows the worsening of the disease. Long-term persistence with treatment is important to optimize treatment benefit. In this long-term, cohort study we aimed to examine persistence with the use of injectable DMTs, and to determine which factors impacted persistence. We also aimed to investigate no evidence of disease activity (NEDA) during 10 years. NEDA was defined as a composite that consisted of absence of relapses, no sustained Expanded Disability Status Scale (EDSS) score progression, and no new or enlarging T2 or T1 gadolinium-enhancing lesions on annual magnetic resonance imaging (MRI). All consenting adults with relapsing-remitting (RR) MS who started either glatiramer acetate (GA) or interferon-beta 1a/1b (IFNb) between September 1996 and December 2005 were included in the study. Follow-up continued to December 2015, which means all patients were followed up at least 10 years. A total of 1032 patients included in the study. 289 were initially prescribed GA and 743 were initially prescribed IFN-β. Median time-to-discontinuation of all injectable DMTs was 10.2 years. 613 participants remained on treatment after 10 years. Of 419 participants who discontinued injectable DMT, 201 (48%) started an oral or a second-line DMT. 211 (50.4%) patients started another injectable DMT. Only 7 (1.7%) patients remained untreated. Patients who had greater disability at treatment initiation and those who started treatment before age 35 were more likely to discontinue use of injectable. A total of 321 of 613 patients (52.4%) had NEDA 2 years. 112 of 613 (18.3%) maintained NEDA status after 10 years. No differences were found in NEDA status between patients with initially prescribed GA vs initially prescribed IFN-β. When comparing EDA and NEDA patients, EDA patients were found to use more second line drugs than NEDA patients (p=0.006). On the basis of disability, EDA patients progressed, while NEDA patients improved (p< 0.001). In conclusion, persistence in injectable DMTs was high in our cohort. Most patients who discontinued injectable DMT did not remain untreated. Our findings suggest that the combined NEDA measure allows for better early prediction of freedom from progression at as long as 10 years follow-up.
Disclosure:
Serkan Ozakbas: nothing to disclose
Zaur Mehdiyev: nothing to disclose
Gorkem Kosehasanogullari:nothing to disclose
Bilge Piri Cinar: nothing to disclose
Hatice Limoncu: nothing to disclose
Abstract: P701
Type: Poster
Abstract Category: Therapy - disease modifying - Long-term treatment monitoring
Disease-modifying treatments (DMTs) comprise immunomodulating and immunosuppressant medications aimed at slowing the progression of multiple sclerosis (MS). The working hypothesis is that reducing or preventing new lesions and their sequelae slows the worsening of the disease. Long-term persistence with treatment is important to optimize treatment benefit. In this long-term, cohort study we aimed to examine persistence with the use of injectable DMTs, and to determine which factors impacted persistence. We also aimed to investigate no evidence of disease activity (NEDA) during 10 years. NEDA was defined as a composite that consisted of absence of relapses, no sustained Expanded Disability Status Scale (EDSS) score progression, and no new or enlarging T2 or T1 gadolinium-enhancing lesions on annual magnetic resonance imaging (MRI). All consenting adults with relapsing-remitting (RR) MS who started either glatiramer acetate (GA) or interferon-beta 1a/1b (IFNb) between September 1996 and December 2005 were included in the study. Follow-up continued to December 2015, which means all patients were followed up at least 10 years. A total of 1032 patients included in the study. 289 were initially prescribed GA and 743 were initially prescribed IFN-β. Median time-to-discontinuation of all injectable DMTs was 10.2 years. 613 participants remained on treatment after 10 years. Of 419 participants who discontinued injectable DMT, 201 (48%) started an oral or a second-line DMT. 211 (50.4%) patients started another injectable DMT. Only 7 (1.7%) patients remained untreated. Patients who had greater disability at treatment initiation and those who started treatment before age 35 were more likely to discontinue use of injectable. A total of 321 of 613 patients (52.4%) had NEDA 2 years. 112 of 613 (18.3%) maintained NEDA status after 10 years. No differences were found in NEDA status between patients with initially prescribed GA vs initially prescribed IFN-β. When comparing EDA and NEDA patients, EDA patients were found to use more second line drugs than NEDA patients (p=0.006). On the basis of disability, EDA patients progressed, while NEDA patients improved (p< 0.001). In conclusion, persistence in injectable DMTs was high in our cohort. Most patients who discontinued injectable DMT did not remain untreated. Our findings suggest that the combined NEDA measure allows for better early prediction of freedom from progression at as long as 10 years follow-up.
Disclosure:
Serkan Ozakbas: nothing to disclose
Zaur Mehdiyev: nothing to disclose
Gorkem Kosehasanogullari:nothing to disclose
Bilge Piri Cinar: nothing to disclose
Hatice Limoncu: nothing to disclose