Treatment outcomes of high-efficacy disease-modifying therapies in patients with relapsing-remitting multiple sclerosis: A longitudinal observational study - PubMed
6 days ago
- #Real-World Evidence
- #Multiple Sclerosis
- #Disease-Modifying Therapies
- Study assesses real-world effectiveness of high-efficacy disease-modifying therapies (HE-DMTs) in relapsing-remitting multiple sclerosis (RRMS).
- 1,408 RRMS patients from Kuwaiti national MS registry were included in this retrospective, observational, longitudinal, multicenter study.
- Primary objective: proportion of patients with relapse-free status at 12 months; secondary objectives included disability progression/improvement, EDSS changes, NEDA-3, and discontinuation patterns.
- First-line HE-DMTs showed high relapse-free (≥80%) and NEDA-3 (≥75%) rates, especially with ocrelizumab and natalizumab.
- Significant EDSS reductions observed with natalizumab (-0.80), ocrelizumab (-0.46), and rituximab (-0.66) in first-line HE-DMTs.
- Highest confirmed disability improvement (CDI) rates: alemtuzumab (40.6%) and rituximab (22.1%) in first-line setting.
- Discontinuation rates varied: highest for alemtuzumab (scheduled stopping), fingolimod (adverse events), and natalizumab (JC virus sero-positivity). Ocrelizumab had lowest discontinuation rate (5.4%).
- Early initiation of HE-DMTs significantly impacts disease activity and disability; effectiveness decreases with later therapy lines.
- Findings highlight importance of early therapeutic intervention and individualized treatment decisions due to varying tolerability among DMTs.