Highlights
- •Main features associated with treatment failure were analysed in 786 RRMS patients
- •Almost one in fourth RRMS patients experienced first line treatment failure
- •Young age at onset (<26) and EDSS ≥2 are the 2 main predictors of treatment failure
- •Higher relapse rate and gadolinium enhancing lesions also predict treatment failure
Abstract
Background
: The advent of new, potent, disease-modifying therapies has dramatically changed
the management of multiple sclerosis (MS). Along with these possibilities, it is crucial
to better recognize patients who are at risk of first line treatment (FLT) failure
and switch to highly effective therapies (HET).
Objectives
: To identify baseline prognostic factors associated with FLT failure in relapsing
remitting MS (RR-MS) patients.
Methods
: We included recently diagnosed RR-MS patients starting an FLT identified from 3
French MS centers databases. Baseline characteristics were included in a multivariable
Cox analysis to identify the main factors associated with FLT failure.
Results
: Eight hundred sixty-three patients were included. We observed an overall rate of
treatment failure of 23.5%. The main baseline characteristics associated with treatment
failure were age <26 years at treatment start (HR= 2.1, p<0.001), EDSS ≥2 (HR=2.1,
p<0.001) and ≥2relapses in the previous year (HR=1.5, p=0.04). The association with
the presence of gadolinium enhancement on MRI was not statistically significant. EDSS
progression was only significantly associated with age at treatment start and treatment
failure.
Conclusion
: Our series demonstrates that some clinical and imaging factors are associated with
treatment failure, and should be considered when planning treatment strategy in patients
with recently diagnosed RR-MS.
Keywords
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Article info
Publication history
Published online: December 12, 2020
Accepted:
December 3,
2020
Received in revised form:
November 24,
2020
Received:
August 12,
2020
Identification
Copyright
© 2020 Elsevier B.V. All rights reserved.
