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. 2021 Jun;28(6):2026-2036.
doi: 10.1111/ene.14790. Epub 2021 Mar 19.

Untreated patients with multiple sclerosis: A study of French expert centers

Xavier Moisset  1 , Audrey-Anne Fouchard  1 , Bruno Pereira  1 , Frédéric Taithe  1 , Guillaume Mathey  2   3 , Gilles Edan  4 , Jonathan Ciron  5 , Bruno Brochet  6   7   8 , Jérôme De Sèze  9 , Caroline Papeix  10 , Patrick Vermersch  11 , Pierre Labauge  12   13 , Gilles Defer  14 , Christine Lebrun-Frenay  15 , Thibault Moreau  16 , David Laplaud  17   18 , Eric Berger  19 , Jean Pelletier  20 , Bruno Stankoff  21 , Olivier Gout  22 , Eric Thouvenot  23   24 , Olivier Heinzlef  25 , Abdullatif Al-Khedr  26 , Bertrand Bourre  27   28 , Olivier Casez  29 , Philippe Cabre  30 , Alexis Montcuquet  31 , Alain Créange  32 , Jean-Philippe Camdessanché  33 , Serge Bakchine  34 , Aude Maurousset  35 , Karolina Hankiewicz  36 , Corinne Pottier  37 , Nicolas Maubeuge  38 , Dalia Dimitri Boulos  39 , Chantal Nifle  40 , Sandra Vukusic  41   42   43 , Pierre Clavelou  1 ; OFSEP investigators
Affiliations
Free article

Untreated patients with multiple sclerosis: A study of French expert centers

Xavier Moisset et al. Eur J Neurol. 2021 Jun.
Free article

Abstract

Background and purpose: Disease-modifying therapies (DMTs) have an impact on relapses and disease progression. Nonetheless, many patients with multiple sclerosis (MS) remain untreated. The objectives of the present study were to determine the proportion of untreated patients with MS followed in expert centers in France and to determine the predictive factors of nontreatment.

Methods: We conducted a retrospective cohort study. Data were extracted from the 38 centers participating in the European Database for Multiple Sclerosis (EDMUS) on December 15, 2018, and patients with MS seen at least once during the study period (from June 15, 2016 to June 14, 2017) were included.

Results: Of the 21,189 patients with MS (age 47.1 ± 13.1 years; Expanded Disability Status Scale (EDSS) score 3.4 ± 2.4), 6,631 (31.3%; 95% confidence interval [CI] 30.7-31.9) were not receiving any DMT. Although patients with a relapsing-remitting course (n = 11,693) were the most likely to receive DMT, 14.8% (95% CI 14.2-15.4) were still untreated (6.8% never treated). After multivariate analysis among patients with relapsing-remitting MS, the main factors explaining never having been treated were: not having ≥9 lesions on brain magnetic resonance imaging (odds ratio [OR] 0.52 [95% CI 0.44-0.61]) and lower EDSS score (OR 0.78 [95% CI 0.74-0.82]). Most patients with progressive MS (50.4% for secondary and 64.2% for primary progressive MS) did not receive any DMT during the study period, while 11.6% of patients with secondary and 34.0% of patients with primary progressive MS had never received any DMT.

Conclusion: A significant proportion of patients with MS did not receive any DMT, even though such treatments are reimbursed by the healthcare system for French patients. This result highlights the unmet need for current DMTs for a large subgroup of patients with MS.

Keywords: multiple sclerosis; progressive; relapsing-remitting; unmet medical needs; untreated.

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References

REFERENCES

    1. Brown JWL, Coles A, Horakova D, et al. Association of initial disease-modifying therapy with later conversion to secondary progressive multiple sclerosis. JAMA. 2019;321(2):175-187. https://doi.org/10.1001/jama.2018.20588
    1. Harding K, Williams O, Willis M, et al. Clinical outcomes of escalation vs early intensive disease-modifying therapy in patients with multiple sclerosis. JAMA Neurol. 2019;76(5):536-541. https://doi.org/10.1001/jamaneurol.2018.4905
    1. Ontaneda D, Tallantyre E, Kalincik T, Planchon SM, Evangelou N. Early highly effective versus escalation treatment approaches in relapsing multiple sclerosis. Lancet Neurol. 2019;18(10):973-980. https://doi.org/10.1016/S1474-4422(19)30151-6
    1. Montalban X, Gold R, Thompson AJ, et al. ECTRIMS/EAN Guideline on the pharmacological treatment of people with multiple sclerosis. Mult Scler Houndmills Basingstoke Engl. 2018;24(2):96-120. https://doi.org/10.1177/1352458517751049
    1. Rae-Grant A, Day GS, Marrie RA, et al. Comprehensive systematic review summary: disease-modifying therapies for adults with multiple sclerosis: report of the guideline development, dissemination, and implementation subcommittee of the American Academy of Neurology. Neurology. 2018;90(17):789-800. https://doi.org/10.1212/WNL.0000000000005345

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