Long-Term Persistence with Injectable Therapy in Relapsing-Remitting XXXX : An 18-Year Observational Cohort Study.

@entity1 @entity15093 @entity1638 @entity2391 @entity15
UNASSIGNED: Disease modifying therapies (DMTs) reduce the frequency of relapses and accumulation of disability in @entity15 ( @entity15 ). Long-term persistence with treatment is important to optimize treatment benefit. This long-term, cohort study was conducted at the Calgary @entity15 Clinic. All consenting adults with relapsing-remitting @entity15 who started either @entity1638 (GA) or interferon-b 1a/1b ( @entity2391 ) between January 1st, 1996 and July 1st, 2011 were included. Follow-up continued to February 1st, 2014. Time-to-discontinuation of the initial and subsequently-prescribed DMTs (switches) was analysed using Kaplan-Meier survival analyses. Group differences were compared using log-rank tests and multivariable Cox regression models. Analysis included 1471 @entity1 ; 906 were initially prescribed GA and 565 were initially prescribed @entity2391 . Follow-up information was available for 87%; 29 (2%) were lost to follow-up and 160 (11%) moved from Southern Alberta while still using @entity15093 . Median time-to-discontinuation of all injectable DMTs was 11.1 years. @entity1 with greater disability at treatment initiation, those who started treatment before age 30, and those who started between 2006 and 2011 were more likely to discontinue use of all injectable DMTs. Median time-to-discontinuation of the initial @entity15093 was 8.6 years. Those initially prescribed GA remained on treatment longer. Of 610 @entity1 who discontinued injectable @entity15093 , 331 (54%) started an oral @entity15093 , or a second-line @entity15093 , or resumed injectable @entity15093 after 90 days. Persistence with injectable DMTs was high in this long-term population-based study. Most @entity1 who discontinued injectable @entity15093 did not remain untreated. Further research is required to understand treatment outcomes and outcomes after stopping @entity15093 .
