Abstract
BackgroundDespite trends towards the increased age of patients living with multiple sclerosis (MS), little is known about the response of older adults with MS to disease-modifying therapies (DMTs). Thus, a post-hoc analysis was undertaken using data from a 2-year, international, non-interventional, prospective cohort study (NCT00787657; BEACON: BEtaferon prospective study on Adherence, COping and Nurse support) of patients above the age of 40 years with MS and starting interferon beta-1b (IFNB-1b) treatment within 6 months before study entry.MethodsMiddle-aged and older patients with MS were divided into two sub-groups: 41–50 years and > 50 years. Treatment with IFNB-1b started within 6 months before study entry. Patients were followed-up for a 2-year observation period. Assessments included disease history and course, annualised relapse rate (ARR), Expanded Disability Scale Score (EDSS), treatment adherence, Hospital Anxiety and Depression Scale (HADS), and adverse events (AE).ResultsAt baseline, the intention-to-treat (ITT) population (n = 481) aged 41–50 years (n = 327) and > 50 years (n = 154), had mean (standard deviation [SD]) ages of 45.1 (2.8) and 56.2 (4.2) years, maximum age of 72 years, and duration of MS since onset of symptoms of 3.9 (5.2) and 5.9 (7.1) years, respectively. At baseline, the proportion of patients with relapsing–remitting MS (RRMS) was 96.3 and 94.9 %, and secondary progressive MS (SPMS) was 3.7 and 5.1 %, in the 41–50 and > 50 years sub-groups, respectively. The ARR in the 2 years before study start was 0.93 (0.48) and 0.86 (0.54) for the 41–50 and > 50 years groups, respectively, and decreased since study start to 0.20 (1.09) and 0.07 (0.37), respectively. The percentage of patients with anxiety and depression, as measured by HADS, were stable over the study period. Polypharmacy (five or more medications) was seen in 32.3 and 41.2 % of patients aged 41–50 and > 50 years. No unexpected AEs were reported.ConclusionsThis study provides observational data on patients between 40 and 72 years of age, suggesting that IFNB-1b can be an effective and well-tolerated treatment option in MS patients of advanced age.Trial registrationClinicalTrials.gov, NCT00787657.
Highlights
Multiple sclerosis (MS) is a chronic immune-mediated inflammatory disorder that affects the central nervous system (CNS)
In about 85 % of patients, it starts as a ‘relapsing–remitting’ MS (RRMS), typified by periodic clinical relapses usually followed by intervals of functional recovery, whilst 15 % of patients present without relapses but with a slowly progressive disease pattern called primary progressive multiple sclerosis (PPMS) [1, 2]
Over the years since the first disease-modifying therapy (DMT) were introduced, there has been a demographic shift in the MS patient population, with an increasingly larger proportion of older adults living with MS than ever before
Summary
Multiple sclerosis (MS) is a chronic immune-mediated inflammatory disorder that affects the central nervous system (CNS). Over the years since the first DMTs were introduced, there has been a demographic shift in the MS patient population, with an increasingly larger proportion of older adults living with MS than ever before. In British Columbia, Canada, the peak prevalence age range for patients diagnosed with MS increased from 45–49 years in the early 1990s to 55–59 years in 2008 [9]. Significant increases have occurred in the average age of patients with MS during the last two decades [11] This seems to be because of increased MS patient survival rates, as prevalence increased with somewhat less marked changes in MS incidence [10, 12, 14]. Despite trends towards the increased age of patients living with multiple sclerosis (MS), little is known about the response of older adults with MS to disease-modifying therapies (DMTs). A post-hoc analysis was undertaken using data from a 2-year, international, non-interventional, prospective cohort study (NCT00787657; BEACON: BEtaferon prospective study on Adherence, COping and Nurse support) of patients above the age of 40 years with MS and starting interferon beta-1b (IFNB-1b) treatment within 6 months before study entry
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