Disease modifying therapies (DMT)

MS patients who start treatment at a younger age, and whose condition requires hospitalization, are more likely to stop treatment, a Canadian study reports. The research, published in the journal Dovepress, dealt with the main reasons Canadian patients quit first-line injected disease-modifying therapies, or DMTs. It was titled “Persistence to disease-modifying therapies for multiple sclerosis in a Canadian cohort.” DMTs can reduce MS activity, but patients must stick with them in order for them to be effective. “There is currently a paucity of clinical trial data on what happens to individuals when they discontinue DMT," the researchers wrote. "However, recent preliminary evidence from observational studies suggest increased relapses and disability in those who discontinue DMT." Researchers sought to identify MS patients at higher risk of discontinuing treatment. They looked at Manitoba Province's medical database to identify the types of drugs MS patients were taking, and for how long. The analysis covered 721 patients who received injected beta-interferons or Copaxone between 1996 and 2011, and whom doctors followed for at least a year. Teva manufactures Copaxone, whose generic name is glatiramer acetate. The mean age of the patients in the study was 37.6 years, and 74.2 percent were women. Researchers defined a discontinuation of a DMT as a 90-day or longer gap in treatment. A third of the patients were treated with beta-interferon-1b, either Bayer HealthCare's Betaferon/Betaseron or Novartis' Extavia. It was the first such therapy available in Manitoba. Twenty-three percent of patients received beta-interferon-1a, either Biogen's Avonex or Merck's Rebif. And 21 percent received Copaxone. The median time before a patient discontinued a DMT was 4.2 years. Although 62.6 percent of patients discontinued treatment at some point, 57.4 percent either reinitiated it or switched to a different DMT. Patients who were on DMT at least a year were more likely to stay with it than those who stopped in the first year. Importantly, patients who started a DMT at a younger age were more likely to stop taking it than older patients. “Our results are also consistent with previous work examining persistence for other chronic medication classes, including statins, antihypertensives, bisphosphonates, and oral antidiabetic agents, where the risk for discontinuing drugs declined in a linear fashion with age,” the researchers wrote. The team also found that 16 percent of patients had to be hospitalized overnight, with 3 percent of the cases due to MS-related complications. And these hospitalized patients were more likely to stop their DMT treatment earlier, the researchers said. Summing up, the team said: "Subjects who were younger when starting a DMT, had prior MS-related hospitalizations, were more recently diagnosed with MS, or had a greater lag time between their MS diagnosis and DMT initiation were more likely to discontinue therapy." Although "not all of the factors identified with discontinuing DMT" can be modified, "they may help practitioners enhance MS care by identifying individuals who may be at particular risk for DMT discontinuation," the researchers concluded.

It’s been a little over six months since I completed Round 1 of my Lemtrada infusions, so it’s time again to ask myself, “How am I doing?” The answer: I’m not sure. For many years, my brain MRI has remained unchanged. I can’t remember the last time…

Lemtrada (alemtuzumab) may be an effective option for relapsing-remitting multiple sclerosis (RRMS) patients withdrawing from prior treatment with Tysabri (natalizumab), an Italian study shows. The study, “High-Risk PML Patients Switching from Natalizumab to Alemtuzumab: an Observational Study,” appeared in the journal Neurology and Therapy. Tysabri, an antibody with…

Multiple sclerosis patients taking Tecfidera, or dimethyl fumarate, were more productive at work than those on Copaxone or beta-interferon therapies, according to a study. Tecfidera also increased patients’ quality of life, researchers said. The study covered patients with relapsing-remitting multiple sclerosis, or RRMS. The four beta-interferon treatments were Avonex, Betaseron, Rebif,…

I was in Boston last week at the headquarters of Sanofi Genzyme. Yes, the big drug company. They brought together several people they consider to be “digital influencers” to pick their brains about what’s on the minds of people like you, who read what we write. Sanofi…

Have you ever hit a brick wall trying to self-inject? I have. It was with Avonex, the first DMD that I used. To make a long story short, after a couple of years of poking myself in the thigh muscle, I just couldn’t do it anymore. That’s…

Already an approved treatment for relapsing and primary progressive multiple sclerosis (MS), Ocrevus (ocrelizumab) is still undergoing scrutiny in several clinical trials. Most focus on the drug’s effects in specific patient groups, but one study aims to advance understanding of how Ocrevus works to harness disease. To do so, the open-label Phase 3…

In case you missed them, here are some news stories that appeared in MS News Today that caught my eye over the past week. Acne Therapy Reduces Rate of Multiple Sclerosis Progression, Canadian Study Reports At first glance, the headlines about this drug announced what seemed to be…

The U.S. Food and Drug Administration has approved a supplemental biologics license application for two Bayer products that help multiple sclerosis patients keep track of their injections of Betaseron (interferon beta-1b). The products are the myBETAapp and the Betaconnect Navigator software. A biologics license application is a request for permission to market…

Older patients with secondary progressive multiple sclerosis (SPMS) as well as older relapsing patients whose MS has been inactive after five years may safely discontinue their treatments, Canadian researchers at Vancouver’s University of British Columbia argue. Their Sanofi Genzyme-sponsored study, “When Should Disease-Modifying Treatments Be Discontinued in Patients with Multiple Sclerosis: An…

A real-world medical-facilities setting has confirmed clinical trial findings that Gilenya (fingolimod) can reduce multiple sclerosis relapses, according to a Spanish study published in Plos One. Gilenya, developed by Novartis Pharmaceuticals, was the first oral disease-modifying therapy to obtain U.S. and European approval. The Food and Drug Administration and European Medicines Agency authorized…

Multiple sclerosis (MS) patients are largely moving away from injectable drugs and towards oral treatments when they switch from first to second-line MS therapies. But that might change with the introduction of Ocrevus (ocrelizumab), which has become the drug of choice for many neurologists advising patients on drug switches. The real-world analysis by…

Two studies that recently appeared in the Multiple Sclerosis Journal shed light on how contraceptive use may affect women with MS, as well as how the disease might affect the safety and effectiveness of birth-control medications. Relapsing MS patients treated with older drugs such as interferons and Copaxone (glatiramer acetate) have a…

A multiple sclerosis (MS) trial now underway in Colorado is assessing the safety and tolerability of switching from Rituxan (rituximab) to Ocrevus (ocrelizumab), and its lead investigator, Dr. Timothy L. Vollmer, largely expects no problems. The neurologist believes the two Genentech therapies — both antibody-based drugs that target the CD20 molecule on B-cells —…

I knew it was only a matter of time before my MS neurologist would have MS PATHS available to collect clinical data from people who have agreed to participate. MS PATHS is an information- and biological sample-gathering clinical study from Biogen, the leading manufacturer of multiple sclerosis disease-modifying…

Many life-affecting decisions are made at the time of an MS diagnosis. Top of the list? The moment you decide your course of treatment. In my case, the decision was entirely up to me. This isn’t typical, I’ve discovered. Many people with MS aren’t…

Real-world data of treatment with Tecfidera (dimethyl fumarate) and Tysabri (natalizumab) in relapsing multiple sclerosis (MS) patients suggest that treatment at early disease stages improves outcomes and prevents disability development. The studies, presented by Biogen at the American Academy of Neurology 2017 Annual Meeting in Boston, might challenge the…

The American Academy of Neurology‘s (AAN) 2017 annual meeting will bring together physicians who practice in all areas of neurology, including our own multiple sclerosis (MS) specialists. In a recent interview with Anthony Traboulsee, MD, associate professor and research chair of the MS Society of…

The latest results on Tecfidera (dimethyl fumarate) and Tysabri (natalizumab) use in a clinical practice setting suggest that early treatment can improve outcomes in multiple sclerosis (MS) patients. This and other recent data on Tecfidera and Tysabri for the treatment of MS will be presented by Biogen at the…

It’s been less than a month since Ocrevus was approved by the FDA, and the buzz hasn’t died down. Though there is some trepidation, the MS community is incredibly excited about what the new “game-changing” medication can do for patients all across the country. Here are just a few…

Multiple sclerosis (MS) patients who used the RebiSmart (Merck Serono) device to inject themselves with interferon beta-1a (INF β-1a) did an excellent job of sticking to their treatment timetable without skipping treatments, according to a study. They also had a lower annual disease relapse rate and more relapse-free periods,…

With last month’s approval of the multiple sclerosis drug Ocrevus, I’ve again heard the plea “But how can I afford it?” Ocrevus carries a price tag of about $65,000 a year. That’s not high compared to some other MS drugs, but it still can mean a higher…

Ampyra (dalfampridine) shows long-term efficacy in improving walking ability in people with multiple sclerosis, according to a study evaluating the treatment’s use in progressive and relapsing MS patients over two years. The study, “Monitoring long-term efficacy of fampridine in gait-impaired patients with multiple sclerosis,” was published in the…

There was much fanfare when the multiple sclerosis drug Ocrevus (ocrelizumab) finally was approved by the U.S. Food and Drug Administration last week. Perhaps a little too much fanfare? For example, a story broadcast on the NBC Nightly News focused on a woman, apparently a participant in an…

A prominent neurologist, who was involved in early research into B-cell therapy, tells Multiple Sclerosis News Today about his positive experience of using ocrelizumab, now branded Ocrevus, with patients. Michael Racke, MD, Department of Neurology at The Ohio State University Wexner Medical Center took time to talk with me about…

Ocrevus is a “fabulous” drug that does wonders for those who respond to it. That’s the view of an MS nurse practitioner in Florida, with whom I spoke this week. Tricia Pagnotta works at the Multiple Sclerosis…

Ocrevus (ocrelizumab), now approved for both relapsing and primary progressive multiple sclerosis (MS), is expected to become available in the coming week. While patients and neurologists are waiting, Multiple Sclerosis News Today spoke to Genentech about the treatment’s approval, future research plans, and what patients can expect in terms…

“Is the MS drug news good for u?” my friend’s text asked. It was Wednesday morning, March 29. Genentech had just announced  that Ocrevus, the “First and only approved disease-modifying therapy for primary progressive form of multiple sclerosis (PPMS) – one of the most disabling forms of…

Here is a transcript of the Multiple Sclerosis News Today interview about Ocrevus (ocrelizumab) with Dr. Robert Lisak of the Consortium of Multiple Sclerosis Centers (CMSC). Lisak, a professor of neurology and of immunology and microbiology at Wayne State University School of Medicine, is a former…

Interest in  Ocrevus (ocrelizumab), the first FDA-approved treatment for both relapsing and primary progressive multiple sclerosis, is running high among patients and the organization representing them — as, arguably, are expectations of its use. But how do physicians involved in MS care view the newcomer? Dr. Robert Lisak (Photo courtesy…