Author Of 1 Presentation
P0870 - Effectiveness of Disease-Modifying Therapies in Relapsing Multiple Sclerosis in South China. (ID 1324)
Abstract
Background
The increasing availability of disease modifying therapies (DMTs) and updated diagnostic criteria could impact on diagnostic rates and patient outcomes of multiple sclerosis (MS).
Objectives
We aimed to evaluate the use of DMTs in MS patients in Hong Kong, and the effectiveness and outcomes based on onset year and timing of DMT initiation.
Methods
In this cohort study, we identified 159 relapsing-remitting MS (RRMS) patients from a prospective registry and evaluated their medical records. Patients who were treated with DMT for at least one year were analysed (N=139, 87%). We evaluated the number and reasons of switching DMTs, and disease control. Among patients who had MRI performed within 3 months before DMT initiation (N=95), we evaluated predicting factors of disability progression and DMT switch, and compared differences among patients with different year of disease onset, and duration from onset to DMT initiation.
Results
Of 139 patients, the median disease duration, onset to DMT initiation, and treatment duration were 9 years, 2 years and 5 years, respectively. 67% patients had switched DMT, near half was due to disease progression; 35% of all patients were stable on their second DMT, while 13% had switched >3 times. 74% patients remained relapse-free on their latest DMT. A longer disease duration was significantly associated with disability progression [odds ratio(OR) 1.22 per year, p<0.01]. Shorter duration from disease onset to DMT initiation [OR=0.887, p=0.044] and failure to achieve no evidence of disease activity-3 (NEDA3) at 1 year after DMT initiation [OR=0.36, p=0.024] were significantly associated with DMT switch. Of note, patients with disease onset in 2012-2018 (when DMT could be fully reimbursed), as compared to those in 2001-2011, had significantly shorter duration from onset to DMT initiation (0.69±1.15 vs 4.65±4.07 years, p<0.01), and less patients having disability progression at last visit (9.6% vs 30%, p=0.02). Patients who started DMT within 1 year from disease onset, compared to those who started between 1-5 years, had significantly shorter disease duration (5.68±3.60 vs 8.52±4.23 years, p<0.01), higher pre-treatment annualized relapse rate (ARR) (2.44±3.68 vs 0.87±0.73, p=0.014), and lower latest ARR (0.09±0.20 vs 0.29±0.60, p=0.047).
Conclusions
Our study shows current DMTs are effective in reducing relapse rate of MS patients in South China, and earlier commencement of DMTs may improve disease control.