Time-to-treatment In the management of relapsing/remitting multiple sclerosis

Lisa G. Pont, Minass Semerdijan, Therese Burke, Linda Mekhael, Stephen Vucic, Vanessa Hughes

Research output: Contribution to journalMeeting abstract


Background: Despite drug therapy for multiple sclerosis (MS) having a critical role in in slowing disease progression and alleviating symptoms, many patients
appear to delay onset of treatment.

Objectives: The aim of this study was to explore the time-to-treatment in a longitudinal cohort of MS patients and identify factors associated with delay in
treatment initiation.

Methods: Data from a longitudinal patient cohort of all patients treated at a specialist MS clinic in Sydney, Australia was used. All patients with relapsing remitting disease, treated at the clinic between June 2008 and September 2015 were included in the study. Time to treatment initiation was calculated as the number of days between the first date of documented definitive diagnosis,
and the date that the drug therapy treatment was first prescribed. Cox regression survival analysis was used to identify factors associated with time to initiation.

Results: The cohort comprised 109 patients of whom 84.4% initiated treatment in the study period. Interferons (1alpha, 1beta and pegylated, 62.0%, n=57/
92) were most commonly the first agent commenced. The median time-to-initiation was 62 days (IQR 7-142 days). Almost one fifth (19.5%) commenced treatment on the day of diagnosis and 34.8% commenced within a month. Only commencement of interferon 1 alpha was associated with significant delays in time to treatment (OR=5.089, 95%CI 1.044-24.791). No clinical factors including age, gender, level of disability, quality of life, lesion load at diagnosis, and fatigue, were significant in predicting delays treatment initiation.

Conclusions: While many patients are treated within weeks of receiving a diagnosis of MS, many patients experience significant delays in the commencement of therapy. Some differences in time to treatment were
observed for the different drug classes used but further work to better understand these delays are needed to ensure patients receive optimal care.
Original languageEnglish
Article number354
Pages (from-to)207-208
Number of pages2
JournalPharmacoepidemiology and Drug Safety
Issue numberSupplement s3
Publication statusPublished - Aug 2016
Event32nd International Conference on Pharmacoepidemiology & Therapeutic Risk Management - Dublin, Ireland
Duration: 25 Aug 201628 Aug 2016

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