Background Until the arrival of new oral drugs to our hospital (dimethyl fumarate and teriflunomide), the drugs prescribed for the treatment of mild forms of relapsing remitting multiple sclerosis (RRMS) were for parenteral administration. Nowadays, there is no clear therapeutic positioning for these therapies.
Purpose The primary endpoint was to analyse the prescription of disease modifying therapies over 1 year and the influence of new oral drugs.
Material and methods This was an observational retrospective study conducted in 2015 in patients with RRMS who had started a treatment or had changed treatment. Patient and treatment data were collected from the electronic clinical history and the outpatient unit of the hospital pharmacy: age, gender, EDSS, treatment, previous treatment and reason for change. Data obtained were analysed on an Excel spreadsheet.
Results 33 patients were included, 66% women, with a mean age of 44±12 years. Mean EDSS was 2. 21 patients had no received previous treatment (63%), and of these 10 (47%) received dimethyl fumarate, 1 teriflunomide (4%), 4 intramuscular interferon beta-1A (19%), 3 subcutaneous interferon beta-1A (14%), 1 glatiramer acetate (5%), 1 natalizumab (5%) and 1 fingolimod (5%). Of the other 12 patients whose treatment was modified, 5 changed from fingolimod to alemtuzumab (41%), 2 from glatiramer acetate to dimethyl fumarate (16%), 1 from subcutaneous interferon beta-1A to natalizumab (8%), 1 from intramuscular interferon beta-1A to fingolimod (8%), 1 from intramuscular interferon beta-1A to dimethyl fumarate (8%), 1 from natalizumab to fingolimod (8%) and 1 from fingolimod to natalizumab (8%). Reasons for change were adverse reactions in 8 patients, insufficient control of the disease in 3 and a more convenient oral treatment in 1. To sum up, oral treatments were prescribed in 52% of new patients and 25% of patients who changed their treatment.
Conclusion Since the arrival of the new oral treatments, most of the new patients have received them, but only a quarter of those patients who have changed their treatment. Our study shows that oral therapies are mainly prescribed to new patients with mild forms of RRMS. It is therefore urgent to unify criteria for the correct positioning of disease modifying therapies.
References and/or acknowledgements European MS Platform.
No conflict of interest
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