{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T04:16:42Z","timestamp":1784693802243,"version":"3.55.0"},"reference-count":43,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2024,4,3]],"date-time":"2024-04-03T00:00:00Z","timestamp":1712102400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and purpose<\/jats:title><jats:p>Treatment persistence is the continuation of therapy over time. It reflects a combination of treatment efficacy and tolerability. We aimed to describe real\u2010world rates of persistence on disease\u2010modifying therapies (DMTs) for people with multiple sclerosis (pwMS) and reasons for DMT discontinuation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Treatment data on 4366 consecutive people with relapse\u2010onset multiple sclerosis (MS) were pooled from 13 UK specialist centres during 2021. Inclusion criteria were exposure to at least one MS DMT and a complete history of DMT prescribing. PwMS in blinded clinical trials were excluded. Data collected included sex, age at MS onset, age at DMT initiation, DMT treatment dates, and reasons for stopping or switching DMT. For pwMS who had received immune reconstituting therapies (cladribine\/alemtuzumab), discontinuation date was defined as starting an alternative DMT. Kaplan\u2013Meier survival analyses were used to express DMT persistence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In 6997 treatment events (1.6 per person with MS), median time spent on any single maintenance DMT was 4.3\u2009years (95% confidence interval\u2009=\u20094.1\u20134.5\u2009years). The commonest overall reasons for DMT discontinuation were adverse events (35.0%) and lack of efficacy (30.3%). After 10\u2009years, 20% of people treated with alemtuzumab had received another subsequent DMT, compared to 82% of people treated with interferon or glatiramer acetate.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Immune reconstituting DMTs may have the highest potential to offer a single treatment for relapsing MS. Comparative data on DMT persistence and reasons for discontinuation are valuable to inform treatment decisions and in personalizing treatment in MS.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ene.16289","type":"journal-article","created":{"date-parts":[[2024,4,3]],"date-time":"2024-04-03T08:59:09Z","timestamp":1712134749000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Real\u2010world persistence of multiple sclerosis disease\u2010modifying therapies"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3760-6634","authenticated-orcid":false,"given":"Emma C.","family":"Tallantyre","sequence":"first","affiliation":[{"name":"Division of Psychological Medicine and Clinical Neurosciences Cardiff University  Cardiff UK"},{"name":"Department of Neurology University Hospital of Wales  Cardiff UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2993-585X","authenticated-orcid":false,"given":"Ruth","family":"Dobson","sequence":"additional","affiliation":[{"name":"Preventive Neurology Unit, Wolfson Institute of Population Health Queen Mary University London  London UK"},{"name":"Department of Neurology, Royal London Hospital Barts Health NHS Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph L. 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M.","family":"Mathews","sequence":"additional","affiliation":[{"name":"Barts Health NHS Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gavin V.","family":"McDonnell","sequence":"additional","affiliation":[{"name":"MS Clinic Belfast City Hospital  Belfast UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naomi","family":"Mescall","sequence":"additional","affiliation":[{"name":"Queen Square Multiple Sclerosis Centre, Department of Neuroinflammation University College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sam","family":"Norris","sequence":"additional","affiliation":[{"name":"Aneurin Bevan University Health Board, Department of Neurology Royal Gwent Hospital  Newport UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen J.","family":"Ramsay","sequence":"additional","affiliation":[{"name":"MS Clinic Belfast City Hospital  Belfast 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