SynthesisBMC neurology2020
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.
Synthesis in BMC neurology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05112484 (Importance of Therapeutic Monitoring of Orally Administered Disease-modifying Drugs Used in the Treatment of Multiple Sclerosis), which is not on this map. Cited by 32 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Importance of Therapeutic Monitoring of Orally Administered Disease-modifying Drugs Used in the Treatment of Multiple Sclerosis
Who cites it
32 citing papers in PubMed, 5 syntheses or guidelines pooled it, 56 citations in OpenAlex.
- Rituximab for people with multiple sclerosis.The Cochrane database of systematic reviews · 2025Pooled it
- A systematic review to explore patients' MS knowledge and MS risk knowledge.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2024Pooled it
- Factors affecting adherence to disease-modifying therapies in multiple sclerosis: systematic review.Journal of neurology · 2022Pooled it
- Rituximab for people with multiple sclerosis.The Cochrane database of systematic reviews · 2021Pooled it
- Objective medication adherence and persistence in people with multiple sclerosis: a systematic review, meta-analysis, and meta-regression.Journal of managed care & specialty pharmacy · 2021Pooled it
- Association of medication adherence with treatment preferences: incentivizing truthful self-reporting.The European journal of health economics : HEPAC : health economics in prevention and care · 2025Trial
- Recognition and management of acute relapse of multiple sclerosis, neuromyelitis optica spectrum disorder and myelin oligodendrocyte glycoprotein antibody-associated disease.Cell death and differentiation · 2026Review
- Clinical, demographic, and pharmacological predictors of medication adherence to disease-modifying therapies in multiple sclerosis: a multidimensional analysis of merged survey and claims data.Naunyn-Schmiedeberg's archives of pharmacology · 2026Article
- Clinical Practice Evidence of Treatment Satisfaction with Moderate and High-Efficacy Drugs in Multiple Sclerosis.Patient preference and adherence · 2025Article
- Adherence, Persistence, Switching and Costs of Injectable and Oral Therapies for Multiple Sclerosis. Real Life Analysis Over 6 Years of Treatment.Hospital pharmacy · 2024Article
- REBISTART: Adherence of Patients with Multiple Sclerosis to Treatment with Subcutaneous Interferon Beta in the Context of a Patient Support Program.Neurology and therapy · 2024Article
- Personalized Intervention to Improve Medication Adherence for Persons with Multiple Sclerosis.Patient preference and adherence · 2024Article
- Real-world effectiveness of cladribine as an escalation strategy for MS: Insights from the Czech nationwide ReMuS registry.Journal of central nervous system disease · 2024Article
- Beliefs about Medicines and the Level of Intentional Non-Adherence to Treatment among Patients with Multiple Sclerosis Treated with First-Line Drugs.Journal of clinical medicine · 2023Article
- Medication self-management toolkits for adults with multiple sclerosis: A scoping review.Exploratory research in clinical and social pharmacy · 2023Article
- Real-World Analysis Affirms the High Persistence and Adherence Observed with Diroximel Fumarate in Patients with Multiple Sclerosis.Neurology and therapy · 2023Article
- [Actual adherence to dimethyl fumarate in patients with relapsing-remitting multiple sclerosis].Revista de neurologia · 2023Article
- Adherence to subcutaneous interferon beta-1a treatment among patients with relapsing multiple sclerosis: the MAIN-MS study.Frontiers in neurology · 2023Article
- The Quality of Life and Medication Adherence in Patients with Multiple Sclerosis-Cross-Sectional Study.International journal of environmental research and public health · 2022Article
- Relationship between Patient Preferences, Attitudes to Treatment, Adherence, and Quality of Life in New Users of Teriflunomide.Pharmaceuticals (Basel, Switzerland) · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundNonadherence to disease-modifying drugs (DMDs) for multiple sclerosis (MS) is associated with poorer clinical outcomes, including higher rates of relapse and disease progression, and higher medical resource use. A systematic review and quantification of adherence and persistence with oral DMDs would help clarify the extent of nonadherence and nonpersistence in patients with MS to help prescribers make informed treatment plans and optimize patient care. The objectives were to: 1) conduct a systematic literature review to assess the availability and variability of oral DMD adherence and/or persistence rates across 'real-world' data sources; and 2) conduct meta-analyses of the rates of adherence and persistence for once- and twice-daily oral DMDs in patients with MS using real-world data.
methodsA systematic review of studies published between January 2010 and April 2018 in the PubMed database was performed. Only studies assessing once- and twice-daily oral DMDs were available for inclusion in the analysis. Study quality was evaluated using a modified version of the Newcastle-Ottawa Scale, a tool for assessing quality of observational studies. The random effects model evaluated pooled summary estimates of nonadherence.
resultsFrom 510 abstracts, 31 studies comprising 16,398 patients with MS treated with daily oral DMDs were included. Overall 1-year mean medication possession ratio (MPR; n = 4 studies) was 83.3% (95% confidence interval [CI] 74.5-92.1%) and proportion of days covered (PDC; n = 4 studies) was 76.5% (95% CI 72.0-81.1%). Pooled 1-year MPR ≥80% adherence (n = 6) was 78.5% (95% CI 63.5-88.5%) and PDC ≥80% (n = 5 studies) was 71.8% (95% CI 59.1-81.9%). Pooled 1-year discontinuation (n = 20) was 25.4% (95% CI 21.6-29.7%).
conclusionsApproximately one in five patients with MS do not adhere to, and one in four discontinue, daily oral DMDs before 1 year. Opportunities to improve adherence and ultimately patient outcomes, such as patient education, medication support/reminders, simplified dosing regimens, and reducing administration or monitoring requirements, remain. Implementation of efforts to improve adherence are essential to improving care of patients with MS.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.