Immunomodulatory treatment in multiple sclerosis: experience at a Brazilian center with 390 patients

Abstract

Since 1993 the Federal Drug Administration approved the use of immunomodulatory therapy in multiple sclerosis (MS), modifying the natural course of disease, as demonstrate our experience in treatment of MS patients at the MS Treatment Center (CATEM). OBJECTIVE: To evaluate patient behavior using immunomodulatory therapy for a period of five years treatment. METHOD: We selected 390 patients in CATEM with relapsing-remitting MS (RRMS) and secondary progressive MS (SPMS) with relapses. RESULTS: At initial treatment 292 (61.5%) patients presented RRMS, 98 (20.6%) SPMS with relapses, 27 SPMS (5.6%) and 58 (12.1%) primary progressive MS (PPMS). In RRMS 182 (62.5%) used the interferon beta 1a SC, 15 (5.2%) interferon beta 1a IM, 85 (29%) interferon beta 1b and 10 (3.3%) glatiramer acetate. In SPMS 63 (64.3%) used interferon beta 1a SC, 4 (4.1%) interferon beta 1a IM and 31 (31.4%) interferon beta 1b. We observed that in this period 195 (50%) migrated between drugs, 35 (9%) gave up therapy and 160 (41%) continued the initial therapy. CONCLUSION: Stopping the immunomodulatory therapy emerges as a problem in the second year of treatment and it can be a subset of interferon non responsive or development of neutralizing antibodies.

Immunomodulator therapy migration in relapsing remitting multiple sclerosis: a study of 152 cases

“…This study aimed to complement the Brazilian center previous report 3 on the experience with patients using these drugs evaluating the rates of immunomodulatory drugs migration at CATEM. We evaluated the occurrence of: withdrawal, pregnancy, conversion from RR kind to PSMS and adherence in the three groups.…”

“…It has high prevalence in Great Britain, Scandinavia, north of the United States and Canada. It is the most common cause for long time neurological disability in young adults [1][2][3][4][5] . Although it is not direct inherited, MS usually attacks susceptible people who seem to be more sensitive to certain stimulus or agents.…”

Professor Emeritus Charles Peter Tilbery [1944-2020]

“…Studies on specific aspects of MS, from its pathology to its immunology, epidemiology, multidisciplinary approach, and treatment 8,9,10,11,12,13,14,15,16,17,18 . Collaborative studies on the prevalence of MS in the city of São Paulo 19,20 .…”