Evaluation of the use of high-efficacy treatments (HETs) in patients with relapsing-remitting multiple sclerosis in Argentina.


Journal

Multiple sclerosis and related disorders
ISSN: 2211-0356
Titre abrégé: Mult Scler Relat Disord
Pays: Netherlands
ID NLM: 101580247

Informations de publication

Date de publication:
Nov 2023
Historique:
received: 27 07 2022
revised: 02 08 2023
accepted: 08 08 2023
medline: 10 11 2023
pubmed: 28 8 2023
entrez: 27 8 2023
Statut: ppublish

Résumé

Disease-modifying therapies (DMTs) in multiple sclerosis (MS) can be classified according to the efficacy in which they prevent inflammatory activity. To date, there are limited data regarding the use of high-efficacy treatments (HETs) in Latin America (LATAM). We aimed to analyze the use of HETs in Argentina, focusing on the clinical and sociodemographic characteristics of the patients who use these treatments and the changes in the trend of use over the years. A retrospective cohort study was done using the Argentina MS patient registry, RelevarEM. Patients diagnosed with relapsing-remitting MS (RRMS) according to validated diagnostic criteria and under treatment with natalizumab, alemtuzumab, cladribine, rituximab or ocrelizumab were included. Out of 2450 RRMS patients under a DMT, 462 (19%) were on HETs. One third of those patients (35%) received HETs as the first treatment. The most frequent reason for switching to HETs was treatment failure to previous DMT (77%). The time from MS diagnosis to the first HET in treatment-naive patients was less than one year (IQR: 0-1 year) and in treatment-experienced patients it was 5 years (IQR: 3-9 years). Between 2015 and 2017 (P1), 729 patients included in RelevarEM started a new treatment, of which 85 (11.65%) were HETs. Between 2018 and 2020 (P2), 961 patients included in RelevarEM started a new treatment, of which 284 (29.55%) were HETs. When comparing P2 with P1, a significant increase in the use of HETs was observed (p < 0.01). The most frequently used HETs were alemtuzumab (50.59%) in P1, and cladribine (45.20%) in P2. The demographic and clinical characteristics of patients under HET in Argentina were identified. Based on a real-world setting, we found a significant trend towards and a rapid increase in the use of HETs in clinical practice in patients with RRMS.

Sections du résumé

BACKGROUND BACKGROUND
Disease-modifying therapies (DMTs) in multiple sclerosis (MS) can be classified according to the efficacy in which they prevent inflammatory activity. To date, there are limited data regarding the use of high-efficacy treatments (HETs) in Latin America (LATAM). We aimed to analyze the use of HETs in Argentina, focusing on the clinical and sociodemographic characteristics of the patients who use these treatments and the changes in the trend of use over the years.
METHODS METHODS
A retrospective cohort study was done using the Argentina MS patient registry, RelevarEM. Patients diagnosed with relapsing-remitting MS (RRMS) according to validated diagnostic criteria and under treatment with natalizumab, alemtuzumab, cladribine, rituximab or ocrelizumab were included.
RESULTS RESULTS
Out of 2450 RRMS patients under a DMT, 462 (19%) were on HETs. One third of those patients (35%) received HETs as the first treatment. The most frequent reason for switching to HETs was treatment failure to previous DMT (77%). The time from MS diagnosis to the first HET in treatment-naive patients was less than one year (IQR: 0-1 year) and in treatment-experienced patients it was 5 years (IQR: 3-9 years). Between 2015 and 2017 (P1), 729 patients included in RelevarEM started a new treatment, of which 85 (11.65%) were HETs. Between 2018 and 2020 (P2), 961 patients included in RelevarEM started a new treatment, of which 284 (29.55%) were HETs. When comparing P2 with P1, a significant increase in the use of HETs was observed (p < 0.01). The most frequently used HETs were alemtuzumab (50.59%) in P1, and cladribine (45.20%) in P2.
CONCLUSION CONCLUSIONS
The demographic and clinical characteristics of patients under HET in Argentina were identified. Based on a real-world setting, we found a significant trend towards and a rapid increase in the use of HETs in clinical practice in patients with RRMS.

Identifiants

pubmed: 37634468
pii: S2211-0348(23)00436-4
doi: 10.1016/j.msard.2023.104935
pii:
doi:

Substances chimiques

Cladribine 47M74X9YT5
Alemtuzumab 3A189DH42V
Immunosuppressive Agents 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

104935

Informations de copyright

Copyright © 2023. Published by Elsevier B.V.

Déclaration de conflit d'intérêts

Declaration of Competing Interest Irrestrictive research grants from Biogen Argentina, Genzyme Argentina, Merck Argentina, Novartis Argentina, and Roche Argentina allowed the development and implementation of the RELEVAREM Registry. Those grants did not interfere in the development plan, variables, PI selection, patient information nor other aspects of the Registry. Authors declare no conflict of interest with the research done.

Auteurs

Ricardo Alonso (R)

Centro Universitario de Esclerosis Múltiple, Hospital Ramos Mejía, Ciudad de Buenos Aires, Argentina; Servicio de Neurología, Sanatorio Güemes, Ciudad de Buenos Aires, Argentina.

Magdalena Casas (M)

Centro Universitario de Esclerosis Múltiple, Hospital Ramos Mejía, Ciudad de Buenos Aires, Argentina.

Luciana Lazaro (L)

Centro Universitario de Esclerosis Múltiple, Hospital Ramos Mejía, Ciudad de Buenos Aires, Argentina.

Nora Fernandez Liguori (NF)

Servicio de Neurología, Sanatorio Güemes, Ciudad de Buenos Aires, Argentina; Servicio de Neurología, Hospital Tornú, Ciudad de Buenos Aires, Argentina.

Cecilia Pita (C)

Centro Universitario de Esclerosis Múltiple, Hospital Ramos Mejía, Ciudad de Buenos Aires, Argentina.

Leila Cohen (L)

Centro Universitario de Esclerosis Múltiple, Hospital Ramos Mejía, Ciudad de Buenos Aires, Argentina.

Juan Ignacio Rojas (JI)

Centro de esclerosis Múltiple Buenos Aires, Ciudad de Buenos Aires, Argentina; Servicio de Neurología, CEMIC, Ciudad de Buenos Aires, Argentina.

Agustín Pappolla (A)

Centro de esclerosis Múltiple Buenos Aires, Ciudad de Buenos Aires, Argentina.

Liliana Patrucco (L)

Centro de esclerosis Múltiple Buenos Aires, Ciudad de Buenos Aires, Argentina.

Edgardo Cristiano (E)

Centro de esclerosis Múltiple Buenos Aires, Ciudad de Buenos Aires, Argentina.

Marcos Burgos (M)

Servicio de Neurología, Hospital San Bernardo, Salta, Argentina.

Carlos Vrech (C)

Servicio de Neurología, Sanatorio Allende, Córdoba, Spain.

Raul Piedrabuena (R)

Servicio de Neurología, Clínica Universitaria Reina Fabiola, Córdoba, Spain.

Lopez Pablo (L)

Sección de Neuroinmunología, Hospital Alemán, Ciudad de Buenos Aires, Argentina.

Norma Deri (N)

DIABAI, Argentina.

Geraldine Luetic (G)

Instituto Neurociencias, Rosario, Argentina.

Jimena Miguez (J)

Servicio de neurología, Hospital Italiano, Argentina.

Mariela Cabrera (M)

Servicio de neurología, Hospital Militar, Campo de Mayo, Argentina.

Alejandra Martinez (A)

Servicio de neurología, Hospital Posadas, Ciudad de Buenos Aires, Argentina.

Gisela Zanga (G)

Servicio de neurología, Hospital Cesar Milstein, Ciudad de Buenos Aires, Argentina.

Verónica Tkachuk (V)

Servicio de neurología, Hospital de Clínica José de San Martín, Ciudad de Buenos Aires, Argentina.

Santiago Tizio (S)

Servicio de neurología, Hospital Español, La Plata, Argentina.

Edgar Carnero Contentti (E)

Sección de Neuroinmunología, Hospital Alemán, Ciudad de Buenos Aires, Argentina.

Eduardo Knorre (E)

Servicio de neurología, Hospital Álvarez, Ciudad de Buenos Aires, Argentina.

Felisa Leguizamon (F)

Servicio de neurología, Hospital Álvarez, Ciudad de Buenos Aires, Argentina.

Carolina Mainella (C)

Servicio de neurología, Hospital Español, Rosario, Argentina.

Pedro Nofal (P)

Servicio de neurología, Hospital Nuestra Señora del Carmen, Tucumán, Argentina.

Susana Liwacki (S)

Servicio de neurología, Hospital Córdoba, Córdoba, Spain.

Javier Hryb (J)

Servicio de neurología, Hospital Durand, Ciudad de Buenos Aires, Argentina.

Maria Menichini (M)

Instituto Neurociencias, Rosario, Argentina.

Claudia Pestchanker (C)

Servicio de neurología, Hospital de San Luis, San Luis, Argentina.

Orlando Garcea (O)

Centro Universitario de Esclerosis Múltiple, Hospital Ramos Mejía, Ciudad de Buenos Aires, Argentina.

Berenice Silva (B)

Centro Universitario de Esclerosis Múltiple, Hospital Ramos Mejía, Ciudad de Buenos Aires, Argentina; Servicio de neurología, Hospital Italiano, Argentina. Electronic address: bsilva@leloir.org.ar.

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Classifications MeSH