ArticleNeurology and therapy2022
Persistence, Adherence, and Switching to Higher-Cost Therapy in Patients with Multiple Sclerosis Initiating Oral Disease-Modifying Therapies: A Retrospective Real-World Study.
Article in Neurology and therapy, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it, 16 citations in OpenAlex.
- Safety and effectiveness of diroximel fumarate in relapsing forms of multiple sclerosis: a systematic review and meta-analysis.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2025Pooled it
- Beyond Efficacy: Persistence, NEDA, and Therapeutic Decision-Making in First-Line Multiple Sclerosis Treatment.Neurology and therapy · 2025Article
- Persistence to Ocrelizumab Compared with Other Disease-Modifying Therapies for Multiple Sclerosis: Results from the German NeuroTransData Registry.Neurology and therapy · 2025Article
- Evaluation of Disease Modifying Therapies and Prognostic Factors Affecting Multiple Sclerosis Progression in a Local Centre of Hong Kong.Pragmatic and observational research · 2025Article
- Real-World Experience with Diroximel Fumarate in Patients with Multiple Sclerosis: A Prospective Multicenter Study.Clinical drug investigation · 2024Observational
- Shared Decision-Making in the Treatment of Multiple Sclerosis: Results of a Cross-Sectional, Real-World Survey in Europe and the United States.Patient preference and adherence · 2024Article
- Letter to the Editor Regarding: "Real-World Analysis Affirms the High Persistence and Adherence Observed with Diroximel Fumarate in Patients with Multiple Sclerosis".Neurology and therapy · 2023Article
- Response to Letter to the Editor Regarding "Real-World Analysis Affirms the High Persistence and Adherence Observed with Diroximel Fumarate in Patients with Multiple Sclerosis".Neurology and therapy · 2023Article
- Achievement of No Evidence of Disease Activity-3 with Oral Disease-Modifying Treatment in Patients with Relapsing-Remitting Multiple Sclerosis.Saudi journal of medicine & medical sciencesArticle
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Authors and funding
5 authors at 4 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionTherapeutic efficacy of disease-modifying therapies (DMTs) for multiple sclerosis (MS) is often hindered by poor persistence and adherence, impacted by patient-perceived efficacy concerns, adverse effects, inconvenience, and forgetfulness. This study measured persistence, adherence, and time to switching to higher-cost therapy among patients with MS initiating teriflunomide, dimethyl fumarate, fingolimod, or diroximel fumarate treatment.
methodsThis retrospective study used Symphony Health US claims data from patients with MS newly initiated on one of four oral DMTs between January and June 2020. Persistence was defined as the duration a patient continued their medication. Adherence was measured using medication possession ratio (MPR); patients with MPR ≥ 80% were considered adherent. Switching was measured by comparing proportions of patients switching and mean time to switch to one of three higher-cost therapies (ocrelizumab, natalizumab, or cladribine). Kaplan-Meier curves assessed persistence. Chi-square tests determined proportions of patients on therapy after 12 months.
resultsA total of 6934 patients newly initiated on oral DMTs met study inclusion criteria (teriflunomide, n = 1968; dimethyl fumarate, n = 3409; diroximel fumarate, n = 616; fingolimod, n = 941). Patients newly initiated on teriflunomide and fingolimod had significantly higher persistence rates after 12 months (60% and 66%, respectively vs 44% dimethyl fumarate and 49% diroximel fumarate; p < 0.0001), and the highest proportion of adherent patients at 6 months (71% and 76%, vs 60% dimethyl fumarate and 58% diroximel fumarate) and 12 months (55% and 59%, vs 40% dimethyl fumarate and 44% diroximel fumarate). Mean time to switching to higher-cost therapies ranged from 247 days (diroximel fumarate to natalizumab) to 342 days (teriflunomide to ocrelizumab), with the highest rate of switching in patients on dimethyl fumarate (7%).
conclusionPatients newly initiated on teriflunomide and fingolimod had better real-world persistence and adherence at 6 and 12 months, and longer time to switch to higher-cost therapies, than patients on dimethyl fumarate or diroximel fumarate.
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