Multiple Sclerosis

In MS, Switching Disease-Modifying Therapy Can Reduce Relapse Rate

Individuals with multiple sclerosis (MS) who are on a disease-modifying therapy (DMT) and who switch to a highly effective DMT due to disease breakthrough are more likely to have reduced annualized relapse rates compared with those who switch to a moderately effective DMT, according to a new study.

To reach this conclusion, the researchers analyzed data from The Danish MS Registry.

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All of the participants had relapsing-remitting MS with expanded disability status scale less than 6. The participants also all experienced disease breakthrough, defined as having at least 1 relapse within 12 months of their treatment switch.

Each group—those who switched to a highly effective DMT and those who switched to a moderately effective DMT—included 404 participants.

The researchers evaluated for annualized relapse rates, time to first confirmed relapse, time to first confirmed expanded disability status scale worsening, and time to first confirmed expanded disability status scale improvement.

 

After a median follow-up time of 3.2 years, the annualized relapse rate was 0.22 among the highly effective DMT and 0.32 among the moderately effective DMT.

 

Switching to a highly effective DMT also reduced the hazard of reaching a first relapse and delayed the first relapse.

 

Further, the researchers found no evidence of delayed disability worsening and weak evidence of disability improvement with a switch to highly effective DMT.

 

“Patients on DMT who experience relapses should escalate therapy to highly effective DMT,” the researchers concluded.

 

—Colleen Murphy

 

Reference:

Chalmer TA, Kalincik T, Laursen B, Sorensen PS, Magyari M; Danish Multiple Sclerosis Group. Treatment escalation leads to fewer relapses compared with switching to another moderately effective therapy [published online December 4, 2018]. J Neurol. https://doi.org/10.1007/s00415-018-9126-y.