Contributions
Abstract: EP1354
Type: Poster Sessions
Abstract Category: Clinical aspects of MS - Epidemiology
Introduction: Delay in multiple sclerosis (MS) diagnosis and delayed time to start disease-modifying therapy (DMT) are risk factors associated with burden of disease that could be prevented.
Objectives: Time between symptom onset and MS diagnosis was evaluated in incident MS cases and pattern of use of DMT was analysed.
Methods: Data were obtained from the MS incidence study in the Highlands, a prospective hospital-register based study that was carried out over a 12-month period, from 1st January 2016 to 31st December 2016. The 2010 McDonald criteria for diagnosis of MS were used for those incident patients diagnosed during that period.
Results: 36 incident new MS cases were registered in the NHS Highlands in 2016. They included 32 females (88.8%) and 4 males (11.1%). Mean age was 40.47±12.14 years [range: 15-67 years].
Initial symptoms/syndrome were: poor balance and gait ataxia, 1 case (2.7%); fatigue and poor balance, 1 case (2.7%); hemisensory syndrome, 2 cases (5.5%); lower limb weakness, 9 cases (25%); optic neuritis, 7 cases (19.4%); and sensory symptoms, 16 cases (44.4%).
Mean period of time between first assessment at Neurology clinic and diagnosis was 10.5±13.7 months [median: 4 months]. The mean period of time from symptoms onset to diagnosis of MS was 38.8±43.2 months [median: 22 months].
A significant correlation (Spearman´s coefficient 0.34; p=0.04) between age and time to diagnosis was observed. No significant differences were observed in time “initial symptoms-to-diagnosis” by gender.
19 patients (52.8%) started a DMT: first line therapy (17 cases; 47%) and second line therapy (2 cases; 5.8%). Most commonly used DMTs were injectables (8 cases; 22%) and oral ones (9 cases; 25%). Three patients stopped medication due to tolerability issues during the follow up.
The 47.2% of new MS patients (17/36) were not taking any DMT. Reasons for not taking DMTs were: not keen to use traditional pharmacological therapy, 4 cases (23.5%); progressive MS in absence of identified relapses, 4 cases (17.6%); planning or thinking in pregnancy, 3 cases (17.6%); mild MS symptoms, 3 cases (17.6%); cancer, 1 cases (5.8%); interested only in treating sensory symptoms, 1 case (5.8%); waiting list/locum assessments, 1 case (5.8%).
Conclusions: Although the gap period between symptom onset and diagnosis is moderate, a significant proportion of recently diagnosed MS patients are not keen to start with a DMT.
Disclosure: Dr Carod-Artal have participated in advisory boards with Merck, Biogen, Teva, and Novartis, and have received travel grants from Biogen, Sanofi, Merck, Roche, and Novartis.
Abstract: EP1354
Type: Poster Sessions
Abstract Category: Clinical aspects of MS - Epidemiology
Introduction: Delay in multiple sclerosis (MS) diagnosis and delayed time to start disease-modifying therapy (DMT) are risk factors associated with burden of disease that could be prevented.
Objectives: Time between symptom onset and MS diagnosis was evaluated in incident MS cases and pattern of use of DMT was analysed.
Methods: Data were obtained from the MS incidence study in the Highlands, a prospective hospital-register based study that was carried out over a 12-month period, from 1st January 2016 to 31st December 2016. The 2010 McDonald criteria for diagnosis of MS were used for those incident patients diagnosed during that period.
Results: 36 incident new MS cases were registered in the NHS Highlands in 2016. They included 32 females (88.8%) and 4 males (11.1%). Mean age was 40.47±12.14 years [range: 15-67 years].
Initial symptoms/syndrome were: poor balance and gait ataxia, 1 case (2.7%); fatigue and poor balance, 1 case (2.7%); hemisensory syndrome, 2 cases (5.5%); lower limb weakness, 9 cases (25%); optic neuritis, 7 cases (19.4%); and sensory symptoms, 16 cases (44.4%).
Mean period of time between first assessment at Neurology clinic and diagnosis was 10.5±13.7 months [median: 4 months]. The mean period of time from symptoms onset to diagnosis of MS was 38.8±43.2 months [median: 22 months].
A significant correlation (Spearman´s coefficient 0.34; p=0.04) between age and time to diagnosis was observed. No significant differences were observed in time “initial symptoms-to-diagnosis” by gender.
19 patients (52.8%) started a DMT: first line therapy (17 cases; 47%) and second line therapy (2 cases; 5.8%). Most commonly used DMTs were injectables (8 cases; 22%) and oral ones (9 cases; 25%). Three patients stopped medication due to tolerability issues during the follow up.
The 47.2% of new MS patients (17/36) were not taking any DMT. Reasons for not taking DMTs were: not keen to use traditional pharmacological therapy, 4 cases (23.5%); progressive MS in absence of identified relapses, 4 cases (17.6%); planning or thinking in pregnancy, 3 cases (17.6%); mild MS symptoms, 3 cases (17.6%); cancer, 1 cases (5.8%); interested only in treating sensory symptoms, 1 case (5.8%); waiting list/locum assessments, 1 case (5.8%).
Conclusions: Although the gap period between symptom onset and diagnosis is moderate, a significant proportion of recently diagnosed MS patients are not keen to start with a DMT.
Disclosure: Dr Carod-Artal have participated in advisory boards with Merck, Biogen, Teva, and Novartis, and have received travel grants from Biogen, Sanofi, Merck, Roche, and Novartis.