About 20%, or 1 in 5, multiple sclerosis (MS) patients fail to adhere to oral disease-modifying therapies (DMTs) taken each day, and about 1 in 4 stop using a prescribed daily oral treatment within one year, a study based on reported real-world use found.
The study “Real-world adherence to, and persistence with, once- and twice-daily oral disease-modifying drugs in patients with multiple sclerosis: a systematic review and meta-analysis” was published in the journal BMC Neurology.
Current guidelines recommend DMDs for people diagnosed with relapsing forms of MS, including relapsing-remitting MS and active secondary progressive disease. These medications have been shown to lower relapses rate, slow MS progression, and improve outcomes in the long term. Monitoring of adherence to these prescribed medications, adverse events, and tolerability is recommended.
Poor adherence to DMTs and their discontinuation are linked to worse clinical outcomes, higher rates of relapse and disease progression, and greater use of medical resources.
Oral DMTs are thought to improve adherence to treatment, because they are thought to be easier for patients to use than injectable treatments. However, several recent real-world studies suggest that adherence and persistence to once or twice daily oral DMTs — such as Gilenya (fingolimod, by Novartis), Tecfidera (dimethyl fumarate, by Biogen), and Aubagio (teriflunomide, by Sanofi Genzyme) — is actually similar to self-injectable therapies.
Researchers conducted a systematic review of real-world studies to assess the extent of non-adherence to oral DMTs by MS patients, searching for oral DMTs approved between January 2010 and April 2018.
Of note, two of its six researchers are employees of EMD Serono (known as Merck KGaA outside North America), which markets the MS injectable therapy Rebif (interferon beta-1a), and the oral short-course treatment Mavenclad (cladribine tablets; approved in early 2019).
From an initial 510 selected studies, 31 studies were analyzed, covering 16,398 MS patients treated daily with oral DMTs.
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