Almost two-thirds of people newly diagnosed with multiple sclerosis (MS) in the United States, identified through a national database, were not prescribed disease-modifying therapies (DMTs) over an average of more than two years of follow-up, a real-world study of nearly 5,700 patients found.
Current guidelines “recommend early treatment with DMTs,” its researchers wrote, pointing to a possibly troubling “gap” between those guidelines and real-world use.
They also noted that the data used, while selective to ensure accuracy, did not address disease severity, and that treatment might have begun outside this follow-up period.
The study, “Treatment patterns and comorbid burden of patients newly diagnosed with multiple sclerosis in the United States,” was published in BMC Neurology.
Most MS patients, around 85%, are diagnosed initially with relapsing-remitting MS (RRMS), and a number over time will transition to secondary progressive MS (SPMS). Prior to the availability of disease-modifying therapies, studies estimated that 50% of all RRMS patients would make this shift within 10 years, and 90% within 25 years, the National MS Society reports.
DMTs — treatments that address a disorder’s underlying causes — tend to work better in the RRMS phase, becoming less effective with the move to SPMS because of fewer relapses and lesser disease activity.
In fact, the American Academy of Neurology includes guidelines on starting newly diagnosed patients on DMTs, and both the European Committee of Treatment and Research in Multiple Sclerosis and the European Academy of Neurology recommend early treatment with DMTs for patients with active RRMS.
Although more than a dozen DMTs have been approved to treat RRMS, detailed knowledge of treatment patterns and research that looks beyond treatment switching, adherence, and preference in type (injection or oral therapy) is lacking.
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