Real-life outcomes for oral disease-modifying treatments of relapsing-remitting multiple sclerosis patients: Adherence and adverse event profiles from Marmara University

SÜNTER, GÜLIN; Vural, Ezgi; ENGİN, ESİN; Agan, Kadriye; GÜNAL, DILEK

doi:10.55730/1300-0144.5640

Real-life outcomes for oral disease-modifying treatments of relapsing-remitting multiple sclerosis patients: Adherence and adverse event profiles from Marmara University

Ezgi VURAL, (Marmara Üniversitesi, Tıp Fakültesi, Nöroloji Anabilim Dalı, İstanbul, Türkiye)

Esin ENGİN, (Marmara Üniversitesi, Tıp Fakültesi, Nöroloji Anabilim Dalı, İstanbul, Türkiye)

Gülin SÜNTER, (Marmara Üniversitesi, Tıp Fakültesi, Nöroloji Anabilim Dalı, İstanbul, Türkiye)

Kadriye AGAN, (Marmara Üniversitesi, Tıp Fakültesi, Nöroloji Anabilim Dalı, İstanbul, Türkiye)

Dilek İnce GÜNAL (Marmara Üniversitesi, Tıp Fakültesi, Nöroloji Anabilim Dalı, İstanbul, Türkiye)

Turkish Journal of Medical Sciences

2 0

Yıl: 2023 Cilt: 53 Sayı: 3 Sayfa Aralığı: 771 - 779 Metin Dili: İngilizce DOI: 10.55730/1300-0144.5640 İndeks Tarihi: 02-08-2023

Real-life outcomes for oral disease-modifying treatments of relapsing-remitting multiple sclerosis patients: Adherence and adverse event profiles from Marmara University

Öz:

Background/aim: Disease-modifying treatments (DMT) are used to prevent future relapses and disability. High long-term adherence to treatment is important to achieve disease control. This study aims to investigate and compare adherence, adverse event (AE) profiles, and frequencies, main reasons for treatment discontinuation under Teriflunomide (TERI), Dimethyl Fumarate (DMF), and Fingolimod (FNG) for relapsing-remitting MS (RRMS) patients. This study is designed to explore patient-reported experiences in real-life settings. Materials and methods: Patients who were older than 18 years with a definite diagnosis of RRMS and no history of stem-cell transplantation were included. Outpatient clinic data files at the Neurology Department of Marmara University from June 2012 to June 2019 were examined retrospectively. Results: One hundred and ninety MS patients were enrolled. 118 FNG, 51 DMF, 44 TERI treatment cycles were recorded. Time since disease onset, time since diagnosis, and treatment duration were significantly longer for FNG (p = 0.012, p = 0.004, p < 0.001). 72.8% of all the treatment cycles were continued. There was no significant difference in treatment continuity between the 3 DMT groups. The most common reasons for treatment discontinuation in order of frequency were adverse events, the progression of the disease, and the persistence of relapses. No significant difference was found for treatment discontinuation reasons. 32% of the patients reported at least one AE. 28% FNG, 49 % DMF, and 27.3% TERI using patients reported AEs. AEs were much more frequently reported for DMF (p = 0.015). The most common adverse events for each DMT were alopecia (n = 6, 13.6%) for TERI, flushing for DMF (n = 20, 39.2%), and persistent lymphopenia for FNG (n = 9, 7.6%). No severe or life-threatening AE was reported for DMF, one patient experienced pancreatitis under TERI, and 11 (9.3%) patients using FNG had to stop treatment due to serious or life-threatening AEs including cardiac adverse events, opportunistic infections, and dysplasia. Conclusion: Overall treatment discontinuation because of AEs is as low as 10.3% in this study. However, AEs are still the main reason for treatment drop-out.

Anahtar Kelime: Multiple sclerosis disease-modifying therapies adverse event treatment adherence treatment drop-out

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

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APA	Vural E, ENGİN E, SÜNTER G, Agan K, GÜNAL D (2023). Real-life outcomes for oral disease-modifying treatments of relapsing-remitting multiple sclerosis patients: Adherence and adverse event profiles from Marmara University. , 771 - 779. 10.55730/1300-0144.5640
Chicago	Vural Ezgi,ENGİN ESİN,SÜNTER GÜLIN,Agan Kadriye,GÜNAL DILEK Real-life outcomes for oral disease-modifying treatments of relapsing-remitting multiple sclerosis patients: Adherence and adverse event profiles from Marmara University. (2023): 771 - 779. 10.55730/1300-0144.5640
MLA	Vural Ezgi,ENGİN ESİN,SÜNTER GÜLIN,Agan Kadriye,GÜNAL DILEK Real-life outcomes for oral disease-modifying treatments of relapsing-remitting multiple sclerosis patients: Adherence and adverse event profiles from Marmara University. , 2023, ss.771 - 779. 10.55730/1300-0144.5640
AMA	Vural E,ENGİN E,SÜNTER G,Agan K,GÜNAL D Real-life outcomes for oral disease-modifying treatments of relapsing-remitting multiple sclerosis patients: Adherence and adverse event profiles from Marmara University. . 2023; 771 - 779. 10.55730/1300-0144.5640
Vancouver	Vural E,ENGİN E,SÜNTER G,Agan K,GÜNAL D Real-life outcomes for oral disease-modifying treatments of relapsing-remitting multiple sclerosis patients: Adherence and adverse event profiles from Marmara University. . 2023; 771 - 779. 10.55730/1300-0144.5640
IEEE	Vural E,ENGİN E,SÜNTER G,Agan K,GÜNAL D "Real-life outcomes for oral disease-modifying treatments of relapsing-remitting multiple sclerosis patients: Adherence and adverse event profiles from Marmara University." , ss.771 - 779, 2023. 10.55730/1300-0144.5640
ISNAD	Vural, Ezgi vd. "Real-life outcomes for oral disease-modifying treatments of relapsing-remitting multiple sclerosis patients: Adherence and adverse event profiles from Marmara University". (2023), 771-779. https://doi.org/10.55730/1300-0144.5640

APA	Vural E, ENGİN E, SÜNTER G, Agan K, GÜNAL D (2023). Real-life outcomes for oral disease-modifying treatments of relapsing-remitting multiple sclerosis patients: Adherence and adverse event profiles from Marmara University. Turkish Journal of Medical Sciences, 53(3), 771 - 779. 10.55730/1300-0144.5640
Chicago	Vural Ezgi,ENGİN ESİN,SÜNTER GÜLIN,Agan Kadriye,GÜNAL DILEK Real-life outcomes for oral disease-modifying treatments of relapsing-remitting multiple sclerosis patients: Adherence and adverse event profiles from Marmara University. Turkish Journal of Medical Sciences 53, no.3 (2023): 771 - 779. 10.55730/1300-0144.5640
MLA	Vural Ezgi,ENGİN ESİN,SÜNTER GÜLIN,Agan Kadriye,GÜNAL DILEK Real-life outcomes for oral disease-modifying treatments of relapsing-remitting multiple sclerosis patients: Adherence and adverse event profiles from Marmara University. Turkish Journal of Medical Sciences, vol.53, no.3, 2023, ss.771 - 779. 10.55730/1300-0144.5640
AMA	Vural E,ENGİN E,SÜNTER G,Agan K,GÜNAL D Real-life outcomes for oral disease-modifying treatments of relapsing-remitting multiple sclerosis patients: Adherence and adverse event profiles from Marmara University. Turkish Journal of Medical Sciences. 2023; 53(3): 771 - 779. 10.55730/1300-0144.5640
Vancouver	Vural E,ENGİN E,SÜNTER G,Agan K,GÜNAL D Real-life outcomes for oral disease-modifying treatments of relapsing-remitting multiple sclerosis patients: Adherence and adverse event profiles from Marmara University. Turkish Journal of Medical Sciences. 2023; 53(3): 771 - 779. 10.55730/1300-0144.5640
IEEE	Vural E,ENGİN E,SÜNTER G,Agan K,GÜNAL D "Real-life outcomes for oral disease-modifying treatments of relapsing-remitting multiple sclerosis patients: Adherence and adverse event profiles from Marmara University." Turkish Journal of Medical Sciences, 53, ss.771 - 779, 2023. 10.55730/1300-0144.5640
ISNAD	Vural, Ezgi vd. "Real-life outcomes for oral disease-modifying treatments of relapsing-remitting multiple sclerosis patients: Adherence and adverse event profiles from Marmara University". Turkish Journal of Medical Sciences 53/3 (2023), 771-779. https://doi.org/10.55730/1300-0144.5640