Treatment patterns in patients with multiple sclerosis: a single hospital cohort study in Sweden

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Treatment patterns in patients with multiple sclerosis : a single hospital cohort study in Sweden

Castelo-Branco, A. (författare): Real-World Solutions, IQVIA, Solna, Sweden

Bengtsson, C. (författare): Real-World Solutions, IQVIA, Solna, Sweden

Piehl, F. (författare): Karolinska University Hospital, Neurology, Solna, Sweden

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Minton, N. (författare): Bristol Myers Squibb, Princeton, United States

Afsari, S. (författare): Bristol Myers Squibb, Princeton, United States

Dietz, D. (författare): Bristol Myers Squibb, Princeton, United States

Montgomery, Scott, 1961- (författare): Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,Karolinska Institutet, Clinical Epidemiology Division, Stockholm, Sweden; University College London, Department of Epidemiology and Public Health, London, United Kingdom

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Sage Publications, 2021
2021
Engelska.
Ingår i: Multiple Sclerosis Journal. - : Sage Publications. - 1352-4585 .- 1477-0970. ; 27:Suppl. 2, s. 732-732

Relaterad länk:: https://urn.kb.se/re...

Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)

Abstract Ämnesord

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Introduction: An increasing number of disease-modifying therapies (DMT) for multiple sclerosis (MS) has led to switching between treatments.Objectives: In a Swedish MS cohort study, we analysed switching treatment patterns, including prescribed symptomatic medications, before and after an MS diagnosis.Methods: A national incident MS cohort diagnosed in 2008–2016 in the Swedish National Patient Register was linked to the national Prescribed Drug Register. A subcohort in the electronic medical records (EMR) of the Karolinska University Hospital was analysed for medication usage.Results: Patients with an MS diagnosis in the EMR cohort (n=1289) were identified (female, 68.2%; mean age (standard deviation), 38.8 (12.2) years). Prescribed symptomatic medications in the year before cohort entry included analgesics (23.2%), antidepressants (13.9%), opioids (13.4%), systemic corticosteroids (11.2%), and anxiolytics (10.0%). In the 4 years after cohort entry, medications included analgesics (65.2%), systemic antibacterials (55.9%), anti-inflammatory and antirheumatics (50.1%), antidepressants (34.8%), anxiolytics (21.1%), antiepileptics (19.1%) and ophthalmic drugs (16.6%). Of 1289 patients, 1040 were prescribed a DMT (80.7%). Median time (months, interquartile range) to first usage of new DMTs by age group was 1.71, 0.82–4.30 (<40 years); 1.87, 0.95–7.00 (40–59 years); and 3.96, 1.15–12.16 (⩾60 years). The most common DMTs (n=patients) were first-line (n=1054): interferons (55.9%), rituximab (15.7%), dimethyl fumarate (9.1%), natalizumab (7.4%), glatiramer acetate (7.1%), fingolimod (3.5%); second-line (n=551): rituximab (29.4%), natalizumab (19.4%), dimethyl fumarate (17.6%), fingolimod (16.3%), glatiramer acetate (7.8%), interferons (3.1%), teriflunomide (2.2%); third-line (n=184): rituximab (51.1%), natalizumab (13.0%), interferons (9.8%), fingolimod (9.8%), dimethyl fumarate (6.0%).Conclusions: These data indicate high usage of prescribed symp-tomatic medications before and after the MS diagnosis, which may indicate the consequences of prodromal and early sympto-matic MS. Most patients were treated with a DMT within months of diagnosis, with predominant initial use of interferons, and switching to more potent agents in later lines of therapy. Prescribing patterns are changing and expected to evolve further with earlier use of powerful agents.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Neurologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Neurology (hsv//eng)

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Av författaren/redakt...: Castelo-Branco, ...; Bengtsson, C.; Piehl, F.; Minton, N.; Afsari, S.; Dietz, D.; visa fler...; Montgomery, Scot ...; visa färre...

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