Evidence map›Paper›PMID 38566012›Full record

Observational studyBMC neurology2024

Treatment patterns and persistence on disease modifying therapies for multiple sclerosis and its associated factors.

Simón Cárdenas-Robledo, Laura Estefanía Arenas-Vargas, Rubén Darío Arenas, Jorge Mario Gaspar-Toro, Ángela María Muñoz-Rosero, Aranza Helena Tafur-Borrero, Daniel Stiven Marín-Medina, Hernan Andrés Acosta-Fajardo, Claudia Guío-Sánchez, Lorena López-Reyes

Open access · goldAbstract readObservational Study
In one paragraph

Observational study in BMC neurology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.4field-weighted citation impact, top 41% of its field
1 · What the graph read from 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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 citations in OpenAlex.

  1. Observational
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 2 institutions in 1 country.

Simón Cárdenas-RobledoCentro de Esclerosis Múltiple (CEMHUN), Departamento de Neurología, Hospital Universitario Nacional de Colombia, Calle 44 # 59-75, Bogotá, Colombia. simon.cardenas@hun.edu.co.
Laura Estefanía Arenas-VargasCentro de Esclerosis Múltiple (CEMHUN), Departamento de Neurología, Hospital Universitario Nacional de Colombia, Calle 44 # 59-75, Bogotá, Colombia.
Rubén Darío ArenasDepartamento de Medicina Interna, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, Colombia.
Jorge Mario Gaspar-ToroDepartamento de Medicina Interna, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, Colombia.
Ángela María Muñoz-RoseroDepartamento de Medicina Interna, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, Colombia.
Aranza Helena Tafur-BorreroDepartamento de Medicina Interna, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, Colombia.
Daniel Stiven Marín-MedinaDepartamento de Medicina Interna, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, Colombia.
Hernan Andrés Acosta-FajardoDepartamento de Medicina Interna, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, Colombia.
Claudia Guío-SánchezCentro de Esclerosis Múltiple (CEMHUN), Departamento de Neurología, Hospital Universitario Nacional de Colombia, Calle 44 # 59-75, Bogotá, Colombia.
Lorena López-ReyesCentro de Esclerosis Múltiple (CEMHUN), Departamento de Neurología, Hospital Universitario Nacional de Colombia, Calle 44 # 59-75, Bogotá, Colombia.
Universidad Nacional de Colombia · COHospital Universitario Nacional de Colombia · CO

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEffective interventions for Multiple Sclerosis require timely treatment optimization which usually involves switching disease modifying therapies. The patterns of prescription and the reasons for changing treatment in people with MS, especially in low prevalence populations, are unknown.

objectivesTo describe the persistence, reasons of DMT switches and prescription patterns in a cohort of Colombian people with MS.

methodsWe conducted a retrospective observational study including patients with confirmed MS with at least one visit at our centre. We estimated the overall incidence rate of medication changes and assessed the persistence on medication with Kaplan-Meier survival estimates for individual medications and according to efficacy and mode of administration. The factors associated with changing medications were assessed using adjusted Cox proportional-hazards models. The reasons for switching medication changes were described, and the prescription patterns were assessed using network analysis, with measures of centrality.

resultsSeven hundred one patients with MS were included. Mean age was 44.3 years, and 67.9% were female. Mean disease duration was 11.3 years and 84.5% had relapsing MS at onset, with median EDSS of 1.0. Treatment was started in 659 (94%) of the patients after a mean of 3 years after MS symptom onset. Among them, 39.5% maintained their initial DMT, 29.9% experienced a single DMT change, while 18.7% went through two, and 11.9% had three or more DMT changes until the final follow-up. The total number of treatment modifications reached 720, resulting in an incidence rate of 1.09 (95% confidence interval: 1.01-1.17) per patient per year The median time to change after the first DMT was 3.75 years, and was not different according to the mode of administration or efficacy classification. The main reasons for changing DMT were MS activity (relapses, 56.7%; MRI activity, 18.6%), followed by non-serious adverse events (15.3%) and disability (11.1%). Younger age at MS onset, care under our centre and insurer status were the main determinants of treatment change. Network analysis showed that interferons and fingolimod were the most influential DMTs.

conclusionsA majority of patients switch medications, mostly due to disease activity, and in association with age and insurer status.

Indexed as

Multiple SclerosisMultiple Sclerosis, Relapsing-RemittingSouth American PeopleAdultFemaleFingolimod HydrochlorideHumansMaleProportional Hazards ModelsRetrospective StudiesFingolimod HydrochlorideDisease modifying therapyMultiple sclerosisNetwork analysisPersistence on treatmentTreatment adherenceTreatment patterns

Identifiers

PMID38566012
PMCPMC10986095
OpenAlexW4393491308

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.