Clinical and epidemiological characteristics of multiple sclerosis patients receiving disease-modifying treatment in Poland

Abstract

Aim of study. The aim of this study was to collect and analyse data on relapsing-remitting multiple sclerosis (RRMS) patients receiving disease-modifying therapies (DMTs) in Poland. Material and methods. This observational, multicentre study with prospective data collection included RRMS patients receiving DMTs reimbursed by the National Health Fund (NFZ) in Poland, monitored by the Therapeutic Programme Monitoring System (SMPT). Demographic profiles, disability status, and treatment modalities were analysed. Results. Data from 11,632 RRMS patients (from 15,368 new prescriptions) was collected including 10,649 patients in the first-line and 983 in the second-line therapeutic programme of DMTs. The proportion of females to males was 2.39 in the first-line and 1.91 in the second-line. The mean age at DMTs start was 36.6 years in the first-line and 35.1 in the second-line. The median time from the first symptoms to MS diagnosis was 7.4 months, and from MS diagnosis to treatment it was 18.48 months. A total of 43.4% of MS patients started DMT during the 12 months following diagnosis. There was a positive correlation between the duration from MS diagnosis to the start of DMT and a higher initial EDSS value [correlation 0.296 (p < 0.001)]. About 10% of patients stopped DMTs. In Poland, about one third of all MS patients are treated in both lines of therapeutic programmes, and the choice of first-line treatment depends on the region of the country. Conclusions. In Poland there is a need to increase MS patient access to DMTs by improving the organisation of therapeutic programmes.

John Cunningham Virus Status, Seroconversion Rate, and the Risk of Progressive Multifocal Leukoencephalopathy in Polish John Cunningham Virus-Seronegative Patients with Relapsing-Remitting Multiple Sclerosis

“…Before establishment of NFZ drug program, 4 cases of PML in patients treated with NAT in clinical trials were diagnosed. Our study showed that NAT therapy in JCVAb-seronegative RRMS patients living in Poland in a high-risk area for MS is safe and results in the absence of PML cases [7, 8]. Although seronegative patients have a low risk of PML, repeated measurements of JCVAb are necessary to exclude the possibility of seroconversion during treatment [9, 10] since a case of PML was diagnosed in a patient who had been seronegative for JCVAb 2 weeks before symptoms of this opportunistic infection [10, 11].…”

Assessment of Disability Progression Independent of Relapse and Brain MRI Activity in Patients with Multiple Sclerosis in Poland

“…Data from every patient treated in the drug programs were collected prospectively in the Therapeutic Program Monitoring System from 2014 to January 2018. The RRMS patients are included in the National Health Fund drug programs (first- or second-line) according to clearly described rules based on brain MRI activity, relapses, and disability progression [ 8 , 9 ]. Neurological examination including EDSS scoring was performed at baseline and then every 12 months.…”

System-Level Variation in Multiple Sclerosis Care Outcomes: Initial Findings from the Multiple Sclerosis Continuous Quality Improvement Research Collaborative

“…This aligns with the expectation that younger persons and persons with RRMS are more likely to be on DMT. [46][47][48][49][50] Beginning treatment at an early age also is important because treatment is most effective longitudinally when started soon after diagnosis. Gross and Watson reported a significant difference in reported DMT use between individuals with SPMS and persons with RRMS.…”

“…This observation runs counter to an overwhelming trend established in the literature supporting a relationship between DMT treatment and decreased relapse rates. [49][50][51][52][53][54][55] In contrast, the expected associations between DMT use and imaging are intuitive and DMT utilization was not generally associated with increased hospitalizations or UC utilization, except in the RRMS subgroup, which had higher odds of ED utilization. Thomas et al demonstrated that DMT treatment was associated with decreased ED 56 and Burks et al reported that DMT adherence was associated with a 42% reduction in relapses, 52% reduction in hospitalizations, and 38% reduction in emergency care visits.…”