Exploration of the initial patterns of disease-modifying treatment in patients with multiple sclerosis:a real-world study
10.13406/j.cnki.cyxb.003807
- VernacularTitle:多发性硬化疾病修正治疗初治模式探索的真实世界研究
- Author:
Xiaolin YANG
1
;
Jinzhou FENG
;
Xinyue QIN
Author Information
1. 重庆医科大学附属第一医院神经内科,重庆 400016
- Keywords:
multiple sclerosis;
disease-modifying treatment;
treat-ment outcome
- From:
Journal of Chongqing Medical University
2025;50(6):791-798
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the initiation patterns of disease-modifying treatment(DMT)in patients with multiple sclerosis(MS)in Chongqing,China.Methods:The clinical and imaging data of patients with relapsing-remitting MS(RRMS)who commenced DMT(teriflunomide,dimethyl fumarate,sphingosine-1-phosphate receptor modulators,or ofatumumab)for the first time at the Depart-ment of Neurology,The First Affiliated Hospital of Chongqing Medical University from November 2018 to January 2024 were obtained.The analysis focused on the distribution,persistence rate,and safety of initial DMT prescriptions,post-treatment disease activity,and risk factors affecting disease activity.Results:A total of 138 patients with RRMS were included.The distribution of initial DMT pre-scriptions was as follows:teriflunomide(46.4%),dimethyl fumarate(20.3%),sphingosine-1-phosphate receptor modulators(21.7%),and ofatumumab(11.6%).Throughout the follow-up period,72.5%of patients complied with their initial prescription,whereas 23.2%of patients altered their treatments,predominantly transitioning to ofatumumab.No drug-related death or hospitalization was docu-mented during the use of the four DMT prescriptions.However,sphingosine-1-phosphate receptor modulators exhibited the highest in-cidence of adverse events(43.3%).An analysis of post-treatment disease activity in 115 patients indicated that 47.0%of patients dis-played disease activity.Independent risk factors for disease activity comprised incomplete recovery after the initial onset of MS(odds ratio[OR]=3.645,95%CI=1.321-10.06,P=0.013)and smoking(OR=10.052,95%CI=1.025-98.556,P=0.048).Conclusion:In the last five years,the majority of initial DMT prescriptions for patients with RRMS in Chongqing,China,were low-to moderate-efficacy drugs.A considerable percentage of patients exhibited disease activity despite commencing DMT.Prompt commencement of high-efficacy DMT may be more effective in diminishing disease activity and postponing disability progression in patients with MS.
