de Sá J, Ferreira J, Macedo A M
Hospital de Santa Maria. Centro hospitalario Lisboa Norte, Lisboa, Portugal.
Universidade do Algarve, Algarve, Portugal.
Rev Neurol. 2023 Jan 31;76(s01):S1-S6. doi: 10.33588/rn.76s01.2022296.
Multiple sclerosis is a chronic neurological disease with numerous disease-modifying treatments available, including dimethyl fumarate (DMF), a first-line therapy for relapsing-remitting multiple sclerosis. Although rates of discontinuation of DMF are generally low in clinical trials, non-adherence to treatment is associated with poorer clinical outcomes. Assessing real-world adherence and predictive factors is critical to be able to improve clinical outcomes for patients. This study evaluated adherence to DMF over 24 months in a cohort of patients treated in a Portuguese healthcare centre.
A prospective, non-interventional, single-centre study with 24 months' follow-up was conducted. The study included adult patients with relapsing-remitting multiple sclerosis treated with DMF in routine clinical practice. Adherence to DMF was calculated and patients were considered to have adhered if the value was above 80%. Clinical and socio-demographic variables were compared between groups.
Of the 80 patients included, 74% were women, with a mean age of 39 years and a mean age of 32 years at diagnosis. Twenty-six patients had not received any previous treatment. Adherence varied between 93, 82 and 87.5% at 6, 12 and 24 months, respectively. No differences were found between patients who had not received any prior treatment and those who had been treated.
This real-world analysis showed significant adherence to DMF treatment by Portuguese patients over a period of two years. However, these results must be interpreted in the light of the substantial changes in outpatient consultations and the various periodic restrictions due to the COVID-19 pandemic, which had an important effect on patient follow-up and data collection.
多发性硬化症是一种慢性神经疾病,有多种疾病修正治疗方法可供选择,包括富马酸二甲酯(DMF),它是复发缓解型多发性硬化症的一线治疗药物。尽管在临床试验中DMF的停药率通常较低,但不坚持治疗与较差的临床结果相关。评估实际治疗依从性和预测因素对于改善患者的临床结果至关重要。本研究评估了在葡萄牙一家医疗中心接受治疗的一组患者在24个月内对DMF的依从性。
进行了一项前瞻性、非干预性、单中心研究,随访24个月。该研究纳入了在常规临床实践中接受DMF治疗的复发缓解型多发性硬化症成年患者。计算DMF的依从性,如果值高于80%,则认为患者坚持治疗。对两组之间的临床和社会人口统计学变量进行了比较。
纳入的80例患者中,74%为女性,平均年龄39岁,诊断时平均年龄32岁。26例患者之前未接受过任何治疗。在6个月、12个月和24个月时,依从性分别为93%、82%和87.5%。未接受过任何先前治疗的患者与接受过治疗的患者之间未发现差异。
这项真实世界分析显示,葡萄牙患者在两年时间里对DMF治疗的依从性较高。然而,由于门诊咨询的大幅变化以及COVID-19大流行导致的各种周期性限制,这些结果必须结合这些因素来解释,这些因素对患者随访和数据收集产生了重要影响。