Initiation of the first disease-modifying treatment for multiple sclerosis patients in the Czech Republic - data from the national registry ReMuS

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F27661989%3A_____%2F18%3AN0000023" target="_blank" >RIV/27661989:_____/18:N0000023 - isvavai.cz</a>

Result on the web

<a href="https://journals.sagepub.com/doi/epub/10.1177/1352458518798582" target="_blank" >https://journals.sagepub.com/doi/epub/10.1177/1352458518798582</a>

DOI - Digital Object Identifier

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Result language

angličtina

Original language name

Initiation of the first disease-modifying treatment for multiple sclerosis patients in the Czech Republic - data from the national registry ReMuS

Original language description

Background: The Czech national registry ReMuS has been collecting data on more than 13,000 multiple sclerosis (MS) patients since 2013. Among others, the data indicates the influence of reimbursement criteria on the accessibility and utilization of various first disease-modifying drugs (DMD). Objective: To describe the temporal evolution of treatment commencement in the Czech Republic and estimate factors influencing treatment effect. Methods: The study included patients starting with first-line therapy (glatiramer acetate, interferon beta, teriflunomide) or starting directly with more effective but costlier escalation therapy (alemtuzumab, dimethyl fumarate, fingolimod, natalizumab). MS patients initiating DMD between 2013-2016 were identified from the respective DMD start date. We explored the relationship between the type of DMD treatment and the severity of MS before and shortly after DMD start. Probability of having relapse within 1 year after DMD initiation was modelled using logistic regression to access the effect of Expanded Disability Status Scale (EDSS) one year before DMD and the effect of number of previous relapses with regards to other characteristics (age, sex, disease duration). Differences in covariates between patients starting therapy in years 2013-2016 were explored using ANOVA. Results: Out of 3,328 patients, 3,203 started on first-line therapy and 125 started directly on escalation therapy. The proportion of patients starting on escalation therapy increased in time (1.8% in 2013 and 4.7% in 2016). The occurrence of a relapse one year after DMD initiation is significantly connected with the EDSS one year before DMD (p< 0.001, higher EDSS is associated with higher probability of a relapse) and the number of previous relapses (p< 0.001, patients with ≥2 prior relapses were more likely to have further relapse). Both the average EDSS and the number of relapses prior to DMD are significantly lower (p=0.002 and 0.018) in patients starting the first DMD in later years of the explored interval.

Czech name

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Czech description

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Type

J_ost - Miscellaneous article in a specialist periodical

CEP classification

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OECD FORD branch

30210 - Clinical neurology

Project

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Continuities

N - Vyzkumna aktivita podporovana z neverejnych zdroju

Publication year

2018

Confidentiality

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Name of the periodical

Multiple Sclerosis Journal

ISSN

1352-4585

e-ISSN

1477-0970

Volume of the periodical

24

Issue of the periodical within the volume

Supplement 2

Country of publishing house

GB - UNITED KINGDOM

Number of pages

1

Pages from-to

292-293

UT code for WoS article

000446861400453

EID of the result in the Scopus database

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