Stick with treatment – but ask about switching if it’s not working for you

A major international study has shown that consistently taking a disease-modifying therapy (DMT) and having a lower relapse rate are independently associated with slower long-term disability progression in people with relapsing multiple sclerosis (MS).1

The researchers examined real-world evidencea covering nearly 2500 people with MS from six countries who had started treatment with an established DMTb between 1989 and 2006. They wanted to know which factors might have affected how quickly disability progressed in the following 10 years. They found that the following were all associated with slower disability progression.

  • Shorter delay between onset of symptoms and starting a DMT.

  • Longer total time taking a DMT during the study period (some people didn’t take their medication continuously).

  • Lower relapse rate (i.e. fewer relapses during the study period).

  • Younger age at the onset of MS symptoms.

  • Pregnancy at any time during the study period (which builds on other investigators’ as-yet unexplained observations).

The researchers conclude that these results show the long-term benefits of starting and continuing to take a DMT. They also argue strongly that people who experience relapses while taking an established DMT should consider switching to a DMT that acts on the body in a different way.

In other words, it’s good to start taking a DMT and to stick with it – but also to ask your healthcare professionals about switching if it’s not working for you. Your local MS patient organizations may be able to provide resources to help with these conversations.

Footnotes

aReal-world evidence is produced by analysing data from routine clinical practice that has been collected in a registry or database.

b‘An established DMT’ refers to a disease-modifying therapy approved for relapsing forms of MS during the late 1980s and 1990s.

Reference

1. Jokubaitis VG, Spelman T, Kalincik T et al. Predictors of long-term disability accrual in relapse-onset multiple sclerosis. Ann Neurol 2016; doi:10.1002/ana.24682.


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