by Joshua Baker, Vanderbilt University
Probability of remaining persistent to index DMT was 51% over 3 years (n = 540). Persistence decreased over the study period. The tick marks represent patient censoring (transferred care, lost to follow-up, or deceased). The bottom chart displays the number of patients remaining on index DMT across certain time intervals. For example, at 12 months, 387 patients remained on index DMT and 99 patients had an event (discontinuation/switch). DMT, disease-modifying therapy. Credit: Multiple Sclerosis and Related Disorders (2022). DOI: 10.1016/j.msard.2022.103860
Relapsing multiple sclerosis (RMS) is the most common form of multiple sclerosis. Since there is no cure, patients are maintained on disease-modifying therapy (DMT) to help slow disease progression, reduce disease relapses, and limit new disease activity.
However, long-term persistence to DMTs is low, with many patients switching or discontinuing DMT treatment. Low DMT persistence increases the risk for relapse and relapse-related costs related to emergency department visits and inpatient admissions.
In a retrospective, cross-sectional study, reported in Multiple Sclerosis and Related Disorders, Miranda Kozlicki, PharmD, and colleagues discovered that over three years, only 36% of patients remained on index treatments. Some common reasons for discontinuing or switching DMTs were adverse events/side effects, insurance formulary changes, and lack of disease improvement.
The study found that specialty pharmacists, because of their direct, frequent contact with patients and providers, are in a unique position to identify the need for DMT discontinuation/switch, coordinate care during DMT transitions, and reduce the risk of relapse.
Leave a Reply