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    The Australian Multiple Sclerosis (MS) Immunotherapy Study: A Prospective, Multicentre Study of Drug Utilisation Using the MSBase Platform

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    Author
    Jokubaitis, VG; Spelman, T; Lechner-Scott, J; Barnett, M; Shaw, C; Vucic, S; Liew, D; Butzkueven, H; Slee, M
    Date
    2013-03-19
    Source Title
    PLOS ONE
    Publisher
    PUBLIC LIBRARY SCIENCE
    University of Melbourne Author/s
    Liew, Danny; Butzkueven, Helmut; Jokubaitis, Vilija; Spelman, Timothy; Kilpatrick, Trevor
    Affiliation
    Medicine - Royal Melbourne Hospital
    Metadata
    Show full item record
    Document Type
    Journal Article
    Citations
    Jokubaitis, V. G., Spelman, T., Lechner-Scott, J., Barnett, M., Shaw, C., Vucic, S., Liew, D., Butzkueven, H. & Slee, M. (2013). The Australian Multiple Sclerosis (MS) Immunotherapy Study: A Prospective, Multicentre Study of Drug Utilisation Using the MSBase Platform. PLOS ONE, 8 (3), https://doi.org/10.1371/journal.pone.0059694.
    Access Status
    Access this item via the Open Access location
    URI
    http://hdl.handle.net/11343/33174
    DOI
    10.1371/journal.pone.0059694
    Open Access at PMC
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3602083
    Description

    C1 - Journal Articles Refereed

    Abstract
    OBJECTIVE: To prospectively characterise treatment persistence and predictors of treatment discontinuation in an Australian relapsing-remitting multiple sclerosis (RRMS) population. METHODS: Tertiary MS treatment centres participating in the MSBase registry prospectively assessed treatment utilisation, persistence, predictors of treatment discontinuation and switch rates. Multivariable survival analyses were used to compare treatment persistence between drugs and to identify predictors of treatment discontinuation. RESULTS: 1113 RRMS patients were studied. Patients persisted on their first disease-modifying therapy (DMT) for a median of 2.5 years. Treatment persistence on GA was shorter than on all IFNβ products (p<0.03). Younger age at treatment initiation and higher EDSS were predictive of DMT discontinuation. Patients persisted on subsequent DMTs, for 2.3 years. Patients receiving natalizumab (NAT) as a subsequent DMT persisted longer on treatment than those on IFNβ or GA (p<0.000). The primary reason for treatment discontinuation for any drug class was poor tolerability. Annualised switch or cessation rates were 9.5-12.5% for individual IFNβ products, 11.6% for GA and 4.4% for NAT. CONCLUSION: This multicentre MS cohort study is the first to directly compare treatment persistence on IFNβ and GA to NAT. We report that treatment persistence in our Australian RRMS population is short, although patients receiving IFNβ as a first DMT persisted longer on treatment than those on GA. Additionally, patients receiving NAT as a subsequent DMT were more likely to persist on treatment than those switched to IFNβ or GA. EDSS and age at DMT initiation were predictive of DMT discontinuation. Treatment intolerance was the principal reason for treatment cessation.
    Keywords
    Neurology and Neuromuscular Diseases; Nervous System and Disorders

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