Prescription trends of disease-modifying treatments for multiple sclerosis in Iran over the past 30 years

Prescription trends of disease-modifying treatments for multiple sclerosis in Iran over the past 30 years


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دانشگاه علوم پزشکی تبریز
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نویسندگان: سمانه حسینی

کلمات کلیدی: multiple sclerosis, disease-modifying treatment (DMT), prescription, Iran

نشریه: 24643 , 2022 , 61 , 2022

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نویسنده ثبت کننده مقاله سمانه حسینی
مرحله جاری مقاله تایید نهایی
دانشکده/مرکز مربوطه مرکز تحقیقات علوم اعصاب
کد مقاله 78394
عنوان فارسی مقاله Prescription trends of disease-modifying treatments for multiple sclerosis in Iran over the past 30 years
عنوان لاتین مقاله Prescription trends of disease-modifying treatments for multiple sclerosis in Iran over the past 30 years
ناشر 24
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نوع مقاله Original Article
نحوه ایندکس شدن مقاله ایندکس شده سطح یک – ISI - Web of Science
آدرس لینک مقاله/ همایش در شبکه اینترنت

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Background: Iran, as a middle income country, is one of the places with high and rising prevalence of multiple sclerosis (MS). Regarding the substantial economic burden, reviewing the trend in prescribed disease modifying treatments (DMTs) could be of help. Here we studied the DMT information of nearly 14000 MS cases and its trends change for 30 years to improve health services to patients Methods: The population base of this descriptive-analytical (cross-sectional) study consisted of all MS patients in nationwide MS registry of Iran (NMSRI), up to August 1, 2021. Registrars from 15 provinces, 24 cities, 13 hospitals,8 MS associations, 16 private offices, and 7 clinics had entered the data Results: Overall, 14316 cases were enrolled. The majority (76.1%) were female. The youngest and eldest patients were 5 and 78 years old, respectively. Diagnosis delay was under one year in most cases (median: 0, IQR: 0 – 1). Most (61.4%) involved RRMS. Generally, platform injectables (IFN beta, glatiramer acetate) were the most used DMTs until 2010. It seems that introduction of newer agents (antiCD20s and oral DMTs) resulted in a decrease in the use of former drugs since around 2015. Some unusual practices are prominent such as using not approved DMTs for PPMS over the years, or administering high efficacy drugs like natalizumab for CIS. The results indicate the remaining popularity of first line injectable DMTs in female and pediatric patients Discussion: Mean age (SD) at onset in our study (29 ± 8.8) is near the statistics in Asia and Oceania (28 ± 0.7). Concerns about COVID-19 had a noticeable impact on administering high efficacy drugs like rituximab and fingolimod. However, in male patients this approach has not been the case. It may be related to more aggressive disease course in this group. The other possible explanation could be planning for pregnancy in female cases. The popularity of platform injectable drugs in pediatric MS may be related to its favorable safety profile over the years. Another point in this group, is the superiority of rituximab over other highly efficient medications.

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