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Gisela Z, Carla P, Josefina B, Tomas I, Lucia B, Pappolla A, Miguez J, Patrucco L, Cristiano E, Norma D, Verónica T, Carlos V, Leila C, Alonso R, Garcea O, Silva B, Celica Y, Marrodan M, Gaitán MI, Correale J, Marcos B, Luciana L, Anibal C, Emanuel S, Eduardo K, Judith S, Dario T, Javier H, Pedro N, Felisa L, Pablo LA, Susana L, Patricio B, Raul P, Adriana C, Alejandra M, María Eugenia B, Contentti Edgar C, Amelia AP, Carolina M, Mariano C, Luciano R, Matias K, Eduardo K, María Celeste C, Maria Laura M, Santiago T, Mariela C, Fatima PC, Andres B, Geraldine L, Alonso Serena M, Juan Ignacio R, Marcos S. Disease activity after discontinuation of disease-modifying therapies in patients with multiple sclerosis in Argentina: data from the nationwide registry RelevarEM. Neurol Res 2023; 45:112-117. [PMID: 36184106 DOI: 10.1080/01616412.2022.2124792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
INTRODUCTION The discontinuation of disease-modifying therapies (DMTs) in multiple sclerosis (MS) is commonly seen in real-world settings due to several factors. AREA COVER The aim of this study is to describe the frequency of disease activity after discontinuation of DMTs in MS patients included in the Argentinean MS and NMOSD registry. DISCUSION Patients with relapsing remitting MS (RRMS) and active secondary progressive MS (SPMS) were included based on the following criteria: they discontinued treatment for more than 6 months, they had been treated with a DMT for ≥2 years, and they had at least 6 months of follow-up in the registry after discontinuation. Demographic and clinical data were collected. Disease activity during follow-up was defined as the presence of a clinical relapse or a new magnetic resonance (MRI) lesion (either new lesions on T2-weighted sequence and/or contrast enhancement). Bivariate analysis was applied to identify clinical and demographic factors related to disease activity. CONCLUSION We included 377 patients (75.5% RRMS, 22.5% SPMS) who had discontinued DMTs. The mean (SD) follow-up after discontinuation was 15.7 (7.9) months. After discontinuation, the presence of relapse was detected in 18.8% and 3.5% in RRMS and SPMS, respectively; and new MRI activity in 22% and 3.5%, respectively. We found that higher risk of relapse and MRI activity was associated with younger age (p < 0.001), shorter disease duration (p < 0.001), and RRMS phenotype (p = 0.006). Males showed higher MRI activity (p 0.011). This study provides real-world data that can guide physicians when considering discontinuation of DMTs.
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Affiliation(s)
- Zanga Gisela
- Departamento de Neurologia. Hospital Cesar Milstein, Buenos Aires, Argentina
| | - Portinari Carla
- Departamento de Neurologia. Hospital Cesar Milstein, Buenos Aires, Argentina
| | - Barber Josefina
- Departamento de Neurologia. Hospital Cesar Milstein, Buenos Aires, Argentina
| | - Ibañez Tomas
- Departamento de Neurologia. Hospital Cesar Milstein, Buenos Aires, Argentina
| | - Brolese Lucia
- Departamento de Neurologia. Hospital Cesar Milstein, Buenos Aires, Argentina
| | - Agustín Pappolla
- Servicio de Neurología, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Jimena Miguez
- Servicio de Neurología, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Liliana Patrucco
- Servicio de Neurología, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Edgardo Cristiano
- Centro de esclerosis múltiple de Buenos Aires, CABA, Buenos Aires, Argentina
| | | | - Tkachuk Verónica
- Sección de Neuroinmunología y Enfermedades Desmielinizantes, Servicio de Neurología, Hospital de Clínicas José de San Martín, CABA
| | - Vrech Carlos
- Departamento de Enfermedades desmielinizantes - Sanatorio Allende, Córdoba
| | - Cohen Leila
- Centro Universitario de Esclerosis Múltiple. Hospital Ramos Mejía, CABA
| | - Ricardo Alonso
- Centro Universitario de Esclerosis Múltiple. Hospital Ramos Mejía, CABA
| | - Orlando Garcea
- Centro Universitario de Esclerosis Múltiple. Hospital Ramos Mejía, CABA
| | - Berenice Silva
- Centro Universitario de Esclerosis Múltiple. Hospital Ramos Mejía, CABA
| | | | | | | | | | - Burgos Marcos
- Servicio de Neurología - Hospital San Bernardo, Salta
| | | | - Chertcoff Anibal
- Sección de Enfermedades Desmielinizantes - Hospital Británico, CABA
| | | | | | - Steinberg Judith
- Sección de Enfermedades Desmielinizantes - Hospital Británico, CABA
| | | | - Hryb Javier
- Servicio de Neurología, Hospital Carlos G Durand, Buenos Aires, Argentina
| | - Nofal Pedro
- Hospital de Clínicas Nuestra Señora del Carmen, Tucuman, Argentina
| | | | - Lopez A Pablo
- Neuroimmunology Unit, Department of Neurosciences, Hospital Alemán, Buenos Aires, Argentina
| | - Liwacki Susana
- Clínica Universitaria Reina Fabiola, Córdoba.,Servicio de Neurología - Hospital Córdoba, Córdoba
| | - Blaya Patricio
- Hospital Presidente Perón de Avellaneda, Avellaneda, Argentina.,Neurocomp, Buenos Aires, Argentina
| | - Piedrabuena Raul
- Clínica Universitaria Reina Fabiola, Córdoba.,Instituto Lennox, Córdoba
| | - Carra Adriana
- Sección de Enfermedades Desmielinizantes - Hospital Británico, CABA
| | - Martinez Alejandra
- Sección de Enfermedades Desmielinizantes - Hospital Británico, CABA.,Servicio de Neurología, Hospital Posadas, Buenos Aires, Argentina
| | - Balbuena María Eugenia
- Sección de Neuroinmunología y Enfermedades Desmielinizantes, Servicio de Neurología, Hospital de Clínicas José de San Martín, CABA
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Rojas Juan Ignacio
- Centro de esclerosis múltiple de Buenos Aires, CABA, Buenos Aires, Argentina.,Servicio de Neurología, Hospital Universitario de CEMIC, CABA
| | - Sorbara Marcos
- Departamento de Neurologia. Hospital Cesar Milstein, Buenos Aires, Argentina
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