Dataset Information

Rates of Early Treatment for US Veterans With Multiple Sclerosis.

ABSTRACT: Early treatment of patients with multiple sclerosis (MS) may prevent neurological damage and reduce the risk of disability. However, little is known about the timing of treatment initiation following diagnosis and long-term outcomes in the general population of the Department of Veterans Affairs (VA) benefits-eligible patients. Our objective was to characterize treatment for MS patients in the VA at various time points following diagnosis date. In our historical database cohort study of US veterans, we calculated the proportion of MS patients from 1999 through 2010 with at least one prescription for a medication used to treat the condition at 6, 12, 24, 36, 48, 60, and 72 months following the index date. We also stratified the treatments given into 3 categories based on their role within the course of the disease: disease modifying, relapse, and symptom. Finally, we performed our calculations separately by MS subtype: relapsing-remitting, secondary-progressive, primary-progressive, and progressive-relapsing. A total of 6803 patients were included in the analysis. Only 27.4% of MS patients received a prescription for MS medication within the first 6 months after diagnosis. The most common treatments were interferon β-1a, glatiramer, amantadine, and prednisone, with disease-modifying agents being more than twice as frequently prescribed as medications for relapse or symptoms. Patients with relapsing-remitting MS were the most likely to be treated, followed by progressive-relapsing MS. Our results suggest that treatment rates are low in VA MS patients in the 6 years following their first diagnosis of MS.

SUBMITTER: Xie Y

PROVIDER: S-EPMC5998732 | biostudies-other | 2016 Aug

REPOSITORIES: biostudies-other

ACCESS DATA

Similar Datasets

Project description:Background and purposeThe considerable clinical effect of natalizumab in patients with relapsing-remitting multiple sclerosis might be explained by its possible beneficial effect on axonal functioning. In this longitudinal study, the effect of natalizumab on absolute concentrations of total N-acetylaspartate, a marker for neuronal integrity, and other brain metabolites is investigated in patients with relapsing-remitting multiple sclerosis by using MR spectroscopic imaging.Materials and methodsIn this explorative observational study, 25 patients with relapsing-remitting multiple sclerosis initiating natalizumab treatment were included and scanned every 6 months for 18 months. Additionally 18 matched patients with relapsing-remitting multiple sclerosis continuing treatment with interferon-β or glatiramer acetate were included along with 12 healthy controls. Imaging included short TE 2D-MR spectroscopic imaging with absolute metabolite quantification of total N-acetylaspartate, creatine and phosphocreatine, choline-containing compounds, myo-inositol, and glutamate. Concentrations were determined for lesional white matter, normal-appearing white matter, and gray matter.ResultsAt baseline in both patient groups, lower concentrations of total N-acetylaspartate and creatine and phosphocreatine were found in lesional white matter compared with normal-appearing white matter and additionally lower glutamate in lesional white matter of patients receiving natalizumab. In those patients, a significant yearly metabolite increase was found for lesional white matter total N-acetylaspartate (7%, P < .001), creatine and phosphocreatine (6%, P = .042), and glutamate (10%, P = .028), while lesion volumes did not change. In patients receiving interferon-β/glatiramer acetate, no significant change was measured in lesional white matter for any metabolite, while whole-brain normalized lesion volumes increased.ConclusionsPatients treated with natalizumab showed an increase in total N-acetylaspartate, creatine and phosphocreatine, and glutamate in lesional white matter. These increasing metabolite concentrations might be a sign of enhanced axonal metabolism.

Dataset Information

Rates of Early Treatment for US Veterans With Multiple Sclerosis.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets