Disease activity after discontinuation of disease-modifying therapies in patients with multiple sclerosis in Argentina: data from the nationwide registry RelevarEM

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.

KEYWORDS:

• Discontinuation
• Disease-modifying therapies
• multiple sclerosis
• Argentina
• registry

Acknowledgments

We would like to thank all our neurologist colleagues who participate in the RelevarEM registry.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Authors’ contributions

Gisela Zanga and Marcos Sorbara contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Gisela Zanga, Marcos Sorbara, Carla Portinari, Josefina Barber, Tomas Ibañez and Lucia Brolese. The first draft of the manuscript was written by Gisela Zanga and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Additional information

Funding

The author(s) reported that there is no funding associated with the work featured in this article.