#MSBlog: Long-term adherence to DMTs does occur. Can we assume these drugs are effective?
Carvalho AT, Sá MJ. Switching and escalating therapy in long-lasting multiple sclerosis: not always necessary. ISRN Neurol. 2012;2012:451457. doi: 10.5402/2012/451457.
Background: Although therapy switch is common among MSers, sometimes the initial prescribed treatment is maintained for a long period with clinical stability, low disability, and non-significant side effects.
“I wonder who defined non-significant as being non-significant? MSers or Neurologist or Nurse or Pharma Company?”
Aim: To describe demographic and clinical characteristics of MSers treated in a MS clinic with the same disease-modifying drug (DMD) lasting for >12 years.
Methods & results: From the cohort of 51 MSers followed with relapse-remitting MS who started an DMD between 1996 and 1999, they found a high percentage (51%) of MSers who were efficiently treated with the first DMD. These MSers were mainly females, with low annualized relapse rate and Multiple Sclerosis Severity Score (MSSS).
Conclusion: These results may be related to the open and multidisciplinary model of this specific MS clinic organization, which encourages adherence. Identifying characteristics associated with therapy persistence may be useful in developing strategies to improve therapy effectiveness.
“Adherence to injectable treatments long-term is complicated and has to do with the drugs being effective and managing side-effects. It is clear that some MSers do well injectables and tolerate them long-term. These are the MSers who are the most likely to derive the long-term benefits of these drugs, i.e. reduced disability and longer survival. The elephant in the room is those who don’t stay on their treatment; what has happened to them and why? Are these the ones with cognitive impairment and depression? The ones in wheelchairs? More data please?”