The Rate and Pattern of Changes in MS Disease Modifying Drugs in Tehran, Iran; a Cross-Sectional Study from Tehran MS Registry

• Published in: Multiple sclerosis and related disorders 2023-03, Vol.71, p.104314, Article 104314
• Main Authors: Eskandarieh, Sharareh, Salehi, Zahra, Ebrahimitirtashi, Azadeh, Abbasi, Naghmeh, Khodaie, Faezeh, Madreseh, Elham, Nabavi, Seyed Massood, Moghadam, Nahid Beladi, Sahraian, Mohammad Ali, Ezabadi, Sajjad Ghane
• Format: Article
• Language: English
• ISSN: 2211-0348; 2211-0356
• DOI: 10.1016/j.msard.2022.104314

Disease-modifying drugs (DMDs) are an inseparable part of multiple sclerosis (MS) management, which have dramatically changed the prognosis and course of the disease . A change during DMD therapy, which includes switching or stopping (temporary or permanent) medication, can manipulate the goals and has various causes such as side effects, ineffectiveness of treatment, patient's preference, presence of concurrent diseases and pregnancy. Therefore, we aimed to investigate the patterns and causes of DMD change in patients with MS (PwMS) in Tehran, Iran. The understanding will help us identify opportunities to improve adherence and ultimately patient outcomes and health system efficiency through effective education, and recognition of more tolerable or simpler regimens. The aim of this study is to identify rate and pattern of DMDs among PwMS in Tehran. The study population of this cross-sectional was all PwMS in Tehran province who had changed their DMD for any reason in the last 5 years until June 2, 2022. The basic information was extracted through nationwide MS registry of Iran (NMSRI), Tehran, where all MS data including diagnosis had been confirmed by trained neurologists based on the 2017 revisions of the McDonald criteria. Moreover, supplementary unregistered data were gathered through telephone follow-ups carried out by 6 trained physicians with precise quality checks. The questionnaires covered 5 aspects of MS including demographics, disease history, diagnosis, progress and treatment. DMDs were classified into 10 general classes. All participants were asked to attribute the change to distinct categories following a written pre-existing consent. IBM SPSS (version 23) was used for statistical analysis. All the steps taken were in complete adherence with the tenets of the declaration of Helsinki. Among 1999 enrolled patients with a mean age of 36.9±9.4 and total disease duration of 7.06±5.8 years, 1315 experienced change (Group 1) during study period, while 684 did not (Group 2). There was no difference in terms of demographic characteristics between the two groups. On the other hand, Group 1 had longer disease durations and more comorbidities (P