Effectiveness of first-line treatment for relapsing-remitting multiple sclerosis in Brazil: a 16-year non-concurrent cohort study

Página do item simplificado
dc.creatorKathiaja Miranda Souza
dc.creatorIsabela Maia Diniz
dc.creatorLívia Lovato Pires de Lemos
dc.creatorNélio Gomes Ribeiro Junior
dc.creatorIsabella de Figueiredo Zuppo
dc.creatorJuliana Alvares Teodoro
dc.creatorFrancisco de Assis Acurcio
dc.creatorÁlvaro Nagib Atallah
dc.creatorAugusto Afonso Guerra Júnior
dc.date.accessioned2023-07-18T16:48:48Z
dc.date.accessioned2025-09-09T00:44:49Z
dc.date.available2023-07-18T16:48:48Z
dc.date.issued2020
dc.identifier.doihttps://doi.org/10.1371/journal.pone.0238476
dc.identifier.issn1932-6203
dc.identifier.urihttps://hdl.handle.net/1843/56588
dc.languagepor
dc.publisherUniversidade Federal de Minas Gerais
dc.relation.ispartofPLOS ONE
dc.rightsAcesso Aberto
dc.subjectSaúde Coletiva
dc.subjectEficácia
dc.subjectEsclerose multipla
dc.subject.otherEffectiveness
dc.subject.otherMultiple sclerosis
dc.subject.otherNon-concurrent cohort
dc.titleEffectiveness of first-line treatment for relapsing-remitting multiple sclerosis in Brazil: a 16-year non-concurrent cohort study
dc.typeArtigo de periódico
local.citation.epage16
local.citation.issue9
local.citation.spage1
local.citation.volume15
local.description.resumoBackground Relapsing-remitting multiple sclerosis (RRMM) is a chronic, progressive, inflammatory and immune-mediated disease that affects the central nervous system and is characterized by episodes of neurological dysfunction followed by a period of remission. The pharmacological strategy aims to delay the progression of the disease and prevent relapse. Interferon beta and glatiramer are commonly used in the Brazilian public health system and are available to patients who meet the guideline criteria. The scenario of multiple treatments available and in development brings the need for discussion and evaluation of the technologies already available before the incorporation of new drugs. This study analyses the effectiveness of first-line treatment of RRMS measured by real-world evidence data, from the Brazilian National Health System (SUS). Methods and findings We conducted a non-concurrent national cohort between 2000 and 2015. The study population consisted of 22,722 patients with RRMS using one of the following first-line drugs of interest: glatiramer or one of three presentations of interferon beta. Kaplan–Meier analysis was used to estimate the time to treatment failure. A univariate and multivariate Cox proportional hazard model was used to evaluate factors associated with treatment failure. In addition, patients were propensity score-matched (1:1) in six groups of comparative first-line treatments to evaluate the effectiveness among them. The analysis indicated a higher risk of treatment failure in female patients (HR = 1.08; P = 0,01), those with comorbidities at baseline (HR = 1.20; P<0,0001), in patients who developed comorbidities after starting treatment (i.e., rheumatoid arthritis—HR = 1.65; P<0,0001), those exclusive SUS patients (HR = 1.31; P<0,0001) and among patients using intramuscular interferon beta (IM βINF-1a) (28% to 60% compared to the other three treatments; P<0,0001). Lower risk of treatment failure was found among patients treated with glatiramer. Conclusions This retrospective cohort suggests that glatiramer is associated with greater effectiveness compared to the three presentations of interferon beta. When evaluating beta interferons, the results suggest that the intramuscular presentation is not effective in the treatment of multiple sclerosis.
local.identifier.orcidhttps://orcid.org/0000-0002-9054-4794
local.identifier.orcidhttps://orcid.org/0000-0003-2769-4615
local.identifier.orcidhttps://orcid.org/0000-0001-6185-2686
local.identifier.orcidhttps://orcid.org/0000-0003-0473-264X
local.identifier.orcidhttps://orcid.org/0000-0002-0210-0721
local.identifier.orcidhttps://orcid.org/0000-0002-0210-0721
local.identifier.orcidhttps://orcid.org/0000-0002-5880-5261
local.identifier.orcidhttps://orcid.org/0000-0003-0890-594X
local.identifier.orcidhttps://orcid.org/0000-0001-5256-0577
local.publisher.countryBrasil
local.publisher.departmentFAR - DEPARTAMENTO DE FARMÁCIA SOCIAL
local.publisher.initialsUFMG
local.url.externahttps://journals.plos.org/plosone/article?id=10.1371/journal.pone.0238476

Arquivos

Pacote original

Agora exibindo 1 - 1 de 1
Imagem de Miniatura
Nome:
Effectiveness of first-line treatment for relapsing-remitting multiple sclerosis in Brazil A 16-year non-concurrent cohort study.pdf
Tamanho:
31.72 MB
Formato:
Adobe Portable Document Format
Baixar

Licença do pacote

Agora exibindo 1 - 1 de 1
Imagem de Miniatura
Nome:
License.txt
Tamanho:
1.99 KB
Formato:
Plain Text
Descrição:
Baixar

Coleções

Artigo de Periódico

Logo UFMG