Adherence to MS Disease Modifying Therapy Improves Long-term Outcomes

Adherence to disease modifying therapy (DMT) in patients with multiple sclerosis (MS) was associated with a longer times before first relapse, mobility aids, and wheelchairs, and fewer visits to the emergency department, compared with nonadherence, according to a study published online in Multiple Sclerosis and Related Disorders.

“Our study underscores the negative impact of nonadherence to DMTs on long-term clinical and economic outcomes in MS,” wrote corresponding author Lilyana Amezcua, MD, of the University of Southern California in Los Angeles and study coauthors. 

Researchers investigated the long-term effect of DMT adherence on disease activity and health care resource use by analyzing insurance claims for 10,248 patients with MS. Among them, 58% were deemed adherent to DMT, with a proportion of days covered of at least 80%, and the remaining 42% were considered nonadherent to DMT. The two cohorts were matched based on propensity scoring and followed over an average of 5.3 years.

Compared with patients who were nonadherent to DMT, patients who were adherent experienced a longer time to first relapse (researchers reported a 0.83 hazard ratio), and longer lag times to cane/walker use (0.79 hazard ratio) and wheelchair use (0.68 hazard ratio). Patients who were adherent to DMT also had a lower annual relapse rate than nonadherent patients: 0.13 compared with 0.18, according to the study.

Adherence to DMT was also linked with fewer annual inpatient hospitalizations and emergency department visits, and lower total health care costs, compared with nonadherence.

“Sensitivity analyses showed,” researchers wrote, “that differences in disease activity and health care resource use were generally more pronounced between matched adherent and highly nonadherent pairs than between matched adherent and moderately nonadherent pairs.”

Reference:
Amezcua L, Livingston T, Hayward B, Zhou J, Williams MJ. Impact of adherence to disease modifying therapies on long-term clinical and economic outcomes in multiple sclerosis: a claims analysis of real-world data. Multiple Sclerosis and Related Disorders. 2023;104866. doi.org/10.1016/j.msard.2023.104866