Multiple sclerosis (MS) is a chronic inflammatory and neurodegenerative disease of the central nervous system. After the first demyelinating event, well-established drugs such as glatiramer acetate (GA), interferon beta-1a (IFNβ-1a), IFN beta-1b (IFNβ-1b), peginterferon beta-1a (peg-IFNβ-1a), and teriflunomide are commonly used for MS patients in the Czech Republic. The aim of this observational study was to compare the effectiveness of these drugs in patients with MS who initiated treatment after the first demyelinating event. The study utilizes data from the national ReMuS registry and includes the follow-up of patients for up to two years in real clinical practice in the Czech Republic. The results of the study provide valuable insights for clinical practice and treatment selection based on individual risks and patient preferences.
Pavelek, Z., Sobíšek, L., Šarláková, J., Potužník, P., Peterka, M., Štětkárová, I., Štourač, P., Mareš, J., Hradílek, P., Ampapa, R., Grünermelová, M., Vachová, M., Recmanová, E., Angelucci, F., Halúsková, S., & Vališ, M. (2021). Comparison of Therapies in MS Patients After the First Demyelinating Event in Real Clinical Practice in the Czech Republic: Data From the National Registry ReMuS. In Frontiers in Neurology (Vol. 11). Frontiers Media SA. https://doi.org/10.3389/fneur.2020.593527 PMID: 33510704
Abstract
Background: Multiple sclerosis (MS) is a chronic inflammatory and neurodegenerative disease of the central nervous system. Well-established drugs used for MS patients after the first demyelinating event in the Czech Republic include glatiramer acetate (GA), interferon beta-1a (IFNβ-1a), IFN beta-1b (IFNβ-1b), peginterferon beta-1a (peg-IFNβ-1a), and teriflunomide.
Objective: The objective of this observational study was to compare the effectiveness of the abovementioned drugs in patients with MS who initiated their therapy after the first demyelinating event. Patients were followed for up to 2 years in real clinical practice in the Czech Republic.
Methods: A total of 1,654 MS patients treated after the first demyelinating event and followed up for 2 years were enrolled. Evaluation parameters (endpoints) included the annualized relapse rate (ARR), time to next relapse, change in the Expanded Disability Status Scale (EDSS) score, and time of confirmed disease progression (CDP). When patients ended the therapy before the observational period, the reason for ending the therapy among different treatments was compared.
Results: No significant difference was found among the groups of patients treated with IFNβ-1a/1b, GA, or teriflunomide for the following parameters: time to the first relapse, change in the EDSS score, and the proportion of patients with CDP. Compared to IFNβ-1a (44 mcg), a significant increase in the percentage of relapse-free patients was found for GA, but this treatment effect was not confirmed by the validation analysis. Compared to the other drugs, there was a significant difference in the reasons for terminating GA therapy.
Conclusion: Small differences were found among GA, IFNβ and teriflunomide therapies, with no significant impact on the final outcome after 2 years. Therefore, in clinical practice, we recommend choosing the drug based on individual potential risk from long-term therapy and on patient preferences and clinical characteristics.
Entire paper is available in English on the website of the Frontiers in Neurology.
