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Epidemiological features and persistence to disease-modifying therapies in a population of multiple sclerosis patients from four provinces of Veneto region
Author(s): ,
A. Marangi
Affiliations:
Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona
,
G. Farina
Affiliations:
Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona
,
S. Forlivesi
Affiliations:
Azienda Ospedaliera Universitaria Integrata
,
A. Gajofatto
Affiliations:
Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona
,
S. Monaco
Affiliations:
Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona
,
V. Vicenzi
Affiliations:
Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona
,
M. Calabrese
Affiliations:
Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona
,
L. Deotto
Affiliations:
Azienda Ospedaliera Universitaria Integrata
,
F. Marchioretto
Affiliations:
Sacro Cuore - Don Calabria, Hospital, Verona
,
A. Forgione
Affiliations:
Pederzoli Hospital, Peschiera del Garda
,
G. Stenta
Affiliations:
St. Bortolo Hospital, Vicenza
,
M. Vianello
Affiliations:
Santa Maria di Cà Foncello Hospital, Treviso, Italy
M.D. Benedetti
Affiliations:
Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona
ECTRIMS Online Library. Marangi A.
Oct 12, 2018; 228847
Antonio Marangi
Antonio Marangi
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Abstract: P1005

Type: Poster Sessions

Abstract Category: Clinical aspects of MS - Epidemiology

Introduction: The therapeutic armamentarium in multiple sclerosis (MS) has grown considerably over the last 15 years, with more than 10 disease-modifying therapies (DMTs) available among first and second line drugs. Studies regarding persistence to treatments in MS are of interest since non-persistence seems to lead to negative clinical and economic outcomes.
Objectives: to collect a large set of demographic, clinical, radiologic and therapeutic informations regarding a large sample of MS patients from four provinces of Veneto region covering a population of 2,675,144 inhabitants
Aims: we aimed to describe the epidemiological characteristics and drug strategies in MS into a retrospective real life study. The outcome was persistence to DMTs at 24 months.
Methods: we collected demographic and clinical data, DMTs history and MRI features of MS patients regularly followed in the period from January 2013 to December 2017 in the MS Centers of Verona, Treviso, Belluno and Vicenza areas. McDonald diagnostic criteria and Lublin disease course classification were used to define clinical aspects, and Expanded Disability Status Scale (EDSS) to score disability. Survival analysis assessing time to DMTs discontinuation was explored using Kaplan-Meier curves.
Results: Data about 3002 MS patients were collected. Mean age of patients was 46.5 years ± 12.4 (range 12 years-87 years), with a median disease duration of 14 years. 69.7 % of patients were diagnosed with the relapsing remitting variant of MS, while 19 % were classified as progressive. At the last follow up, 64.8 % of patients were on treatment (data available for 2667 patients), with the most prescribed drug being dimethylfumarate. In order to evaluate persistence avoiding the immortality bias, a cohort of 1056 cases starting any DMT since 2011 was selected. 57 % discontinued the therapy within 24 months due to side effects, lack of efficacy or other reasons. The highest rate of treatment persistence existed in the dimethylfumarate group, while teriflunomide was associated with the lowest persistence (Log Rank p=0.043). Prevalent reasons to quit were safety protocol for natalizumab, both side effects and inefficacy for fingolimod and azathioprine, early side effects for teriflunomide.
Conclusions: More than half of patients treated since 2011 with a DMT in our study discontinued the DMT within 24 months. There is a need for a better definition of the ideal therapeutic strategies for the different groups of MS cases.
Disclosure: This study was funded by a grant from Veneto Region (RP21400000415 RSF)
Antonio Marangi: nothing to disclose
Gabriele Farina: nothing to disclose
Stefano Forlivesi: nothing to disclose
Alberto Gajofatto received research funding from Merck Serono and Cariverona Foundation
Salvatore Monaco: nothing to disclose
Virginia Vicenzi: nothing to disclose
Massimiliano Calabrese: nothing to disclose
Luciano Deotto: nothing to disclose
Fabio Marchioretto: nothing to disclose
Antonio Forgione: nothing to disclose
Gianola Stenta: nothing to disclose
Marika Vianello: nothing to disclose
Maria Donata Benedetti: nothing to disclose

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