Examining Disease Modifying Therapy Utilization Rates in Patients With MS

Previous data shows that early initiation of disease modifying therapy (DMT) is recommended for patients with relapsing-remitting multiple sclerosis to achieve the most optimal outcome, however several challenges exist that hinder treatment timeliness.

Researchers presented results of a study examining rates of DMT utilization and descriptive and demographic correlates of DMT use in individuals newly diagnosed with multiple sclerosis (MS) at the MS Virtual 2020: 8th Joint ACTRIMS-ECTRIMS Meeting.

“A better understanding of patient-intrinsic factors may help physicians to guide patients during this critical phase of newly diagnosed chronic neurological disease,” explained Gloria von Geldern, MD, neurology, MS Center, University of Washington, and colleagues, in their virtual poster.

Their study observed 230 individuals at two metropolitan MS centers, longitudinally assessing different psychological domains at 1-, 2-, 6-, 9-, and 12-months following diagnosis and their use of DMT throughout the first year following diagnosis. Included patients were 70.9% female, 88.2% white, average 39-years-old, with a mean EDSS (Expanded Disability Status Scale) of 3.9. The majority of patients had relapsing-remitting MS (n=204), others were clinically isolated or not specified. Participants had 15.3 years of education (10-21) and 176 (76.5%) were working (others unemployed, retired, sick leave, disabled or student).

“During their first year after MS diagnosis, 133 of 210 (63%) were not on a DMT at 1-month, 46 of 210 (22%) at 6-months and 47 of 201 (22%) patients were not on a disease modifying therapy at 12 months,” found the researchers. “Not being on a DMT at month 1 was not correlated with employment (r=0.019), years of education (r=-0.042), gender (-0.006), age (0.052) or EDSS (-0.043).”

The researchers observed that of the patients who had initiated a DMT at 12 months, 52.4% individuals were treated with first-line injectable DMTs (glatiramer acetate or beta interferon), 35.7% with oral DMT and 11.9% with an infusion DMT (natalizumab or ocrelizumab).

“In this prospective observational longitudinal study,” said researchers, “initiation of DMT following diagnosis of MS was done in less than half of patients within the first month of the study (which was up to the first 4 months after diagnosis of MS).” Further, 22% of patients did not initiate DMT at 1-year.

“No definite demographic factors associated with time to DMT initiation could be identified in our cohort. Since early initiation of DMT has been associated with improved outcome, this phenomenon deserves further investigation,” concluded researchers. “When treating patients with MS, special attention should be paid to facilitate an early start of DMT.”

—Edan Stanley

Reference:
von Geldern G, Wundes A, Mehta D, et al. Disease modifying therapies in people newly diagnosed with multiple sclerosis. Posted presented at MS Virtual 2020: 8th Joint ACTRIMS-ECTRIMS Meeting; September 11-13, 2020; virtual.