Adherence to laboratory monitoring among people taking oral drugs for multiple sclerosis: A Canadian population-based study.

Publication date: Mar 06, 2020

To examine laboratory testing adherence by persons initiating an oral disease-modifying therapy (DMT) for multiple sclerosis (MS).

Population-based health administrative and laboratory data were accessed in British Columbia, Canada, to identify everyone filling their first prescription for dimethyl fumarate (DMF), fingolimod or teriflunomide (2011-2015). The proportion of people adherent to each drug monograph’s recommended laboratory monitoring schedule, pre- and on-DMT, was estimated. The association between patient characteristics and adherence was examined using multivariable logistic regression.

A total of 1016 people were included (DMF 567, fingolimod 253 and teriflunomide 196). The proportions of people adherent to pre-DMT liver and lymphocyte tests ranged from 88% to 91% and 91% to 94%, respectively, while 77% adhered to pre-DMF urinalysis. Adherence to the first on-DMT liver test was 89% for DMF (within 6?months), 61% for fingolimod (within 3?months) and 40% for teriflunomide (within 1?month). Men were less likely than women to have pre-DMF urinalysis (adjusted odds ratio (aOR); 95% confidence interval (CI): 0.40-0.95) or on-DMF liver (aOR: 0.46; 95% CI: 0.23-0.95) or lymphocyte (aOR: 0.47; 95% CI: 0.22-0.98) tests.

Adherence to recommended laboratory testing was high (>77%) before oral DMT initiation, but lower once on drug. There is a need to understand the long-term consequences of suboptimal laboratory monitoring and sex differences in the DMT-treated MS population.

Ng, H.S., Kingwell, E., Zhu, F., Zhang, T., Marrie, R.A., Carruthers, R., and Tremlett, H. Adherence to laboratory monitoring among people taking oral drugs for multiple sclerosis: A Canadian population-based study. 20373. 2020 Mult Scler.

Concepts Keywords
AOR Administrative Multiple sclerosis
British Columbia Oral disease
Canada MS
Canadian Organic compounds
Confidence Interval Chemistry
DMF Immunosuppressants
DMT Functional groups
Fingolimod Anilides
Liver Enols
Logistic Regression Nitriles
Lymphocyte Sanofi
Monograph Teriflunomide
Multiple Sclerosis Dimethyl fumarate
Odds Ratio Fingolimod
Urinalysis Multiple sclerosis

Semantics

Type Source Name
disease MESH multiple sclerosis
drug DRUGBANK Dimethyltryptamine
drug DRUGBANK Dimethyl fumarate
drug DRUGBANK Fingolimod
drug DRUGBANK Teriflunomide
disease MESH Men

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