Patient on hospital bed prescribed DMTs for MS

Not taking DMTs for MS as prescribed may increase risk of death by 7.5%

Not taking disease-modifying therapies as prescribed may increase risk of death in people with multiple sclerosis (MS), a new study has found.

For medications to be as effective as possible, they need to be taken as prescribed in terms of frequency and time. Someone taking a medication as prescribed is said to be adherent to the prescription.

Scientists looked at data from 279 people with MS. These were divided into groups based on how closely they adhered to their prescriptions. A total of 118 people were put into the good adherence group, because they took their drugs as prescribed. A group of 13 were classed as having poor adherence, meaning they took their medication but not as frequently as recommended, and the remaining 148 people were non-adherent, meaning they took their medication on less than 80% of the days they were directed to, for reasons such as perceived lack of efficacy, or side effects.

During the 20-year study, 56 of the MS patients died. These had expected differences when compared to the surviving patients – they were in average over a decade older and had more advanced disability.

The majority of those who died (89.3%) were not taking, or had never taken, a disease-modifying therapy, compared with 44.4% of patients who were alive.

In the group said to have good adherence, people lived for a median of 52 years after they were diagnosed, whereas in the non-adherence group the average was 35 years. 94.9% of the good adherence group were alive at the end of the study, compared with 66.9% of the non-adherence group.

The median average survival time for the poor-adherence group was 62 years, but the researchers said this group, with just 13 members, was too small to give reliable data.

After the researchers had adjusted for factors such as disease duration, age, and type of MS, the non-adherence group had a 7.5 times higher risk of death than the good-adherence group – the poor adherence were omitted.

Limitations included the fact that most of the patients were non-Hispanic white men, so generalising to the whole MS population couldn’t be guaranteed. The study was also relatively small and was in a real-world setting, they said.