The Use of Immunosuppressant Therapy for Multiple Sclerosis in Italy: A Multicenter Retroprospective Study

PLoS One. 2016 Jun 27;11(6):e0157721. doi: 10.1371/journal.pone.0157721. eCollection 2016.

Abstract

Introduction: Immunosuppressive agents (ISA) have been used in multiple sclerosis (MS) for decades, frequently as off label licensed therapies. Given the new MS treatment landscape, what place do ISA have in combating MS?

Methods: We conducted a retrospective multicentre study to investigate the frequency of ISA prescription in 17 Italian MS centres, and to describe the clinical factors related to ISA use.

Results: Out of 6,447 MS patients, 2,034 (31.6%) were treated with ISA, with Azathioprine being the most frequently used ISA overall. MS patients treated with ISA alone were more frequently affected by the progressive course (both primary and secondary) of the disease (RRR 5.82, 95% CI 4.14-8.16, p<0.0001), had higher EDSS (RRR 3.69, 95% CI 2.61-5.21, p<0.0001), higher assignment age (RRR 1.04, 95% CI 1.03-1.06, p<0.0001) than patients treated with only disease modifying drugs (DMDs).

Conclusions: Progressive course, higher EDSS, higher assignment age were the strongest predictors of ISA prescription and use in our population.

Publication types

  • Clinical Trial
  • Controlled Clinical Trial
  • Multicenter Study

MeSH terms

  • Adult
  • Azathioprine / administration & dosage
  • Azathioprine / adverse effects
  • Azathioprine / therapeutic use*
  • Female
  • Humans
  • Immunosuppression Therapy / adverse effects*
  • Immunosuppression Therapy / methods
  • Immunosuppressive Agents / administration & dosage
  • Immunosuppressive Agents / adverse effects
  • Immunosuppressive Agents / therapeutic use*
  • Interferons / administration & dosage
  • Interferons / adverse effects
  • Interferons / therapeutic use
  • Male
  • Multiple Sclerosis / drug therapy
  • Multiple Sclerosis / therapy*
  • Retrospective Studies

Substances

  • Immunosuppressive Agents
  • Interferons
  • Azathioprine

Grants and funding

Merck supported iMED which is the software program used by for data acquisition at each collaborating centre and did not impact on the studies derived from data collected by this program. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.