Disease-modifying treatment patterns among multiple sclerosis patients: a Brazilian descriptive study

Abstract

Introduction. Multiple sclerosis (MS) is an autoimmune disease that leads to demyelination of the central nervous system, compromising its functions. Although the course of MS is variable, it is a naturally progressive disease, which has accelerated neurological deterioration in most patients. Treatment pattern studies are important to understand the real-world practice and clinical outcomes. Objective. The aim of this study was to describe treatment patterns among patients with MS in the Brazilian public healthcare system. Method. A retrospective cohort study was carried out through the analysis of secondary data from 2008 to 2020. To compare the clinical practice with that recommended by the Clinical Protocols and Therapeutic Guidelines (PCDT) over the years, the treatment analyzes were fragmented into 2008-2014, 2015-2017, and 2018-2020. The data was obtained from Brazilian National Health System, which is a real-world anonymized database. Results. MS patients were identified by the G35 code on International Classification of the Diseases 10th edition and with code 340 on 9th edition. The incidence and prevalence rates were calculated by years, in 2020 the incidence rate was 1.7 per 100,000 population. Conclusions. Regarding the treatment patterns, beta-interferon was the most common first-line prescribed medication for MS in all the three analyzed periods, followed by glatiramer acetate. Glatiramer was the most frequently prescribed second-line treatment only in the first extracted period (2008–2014).