Randi C Haugstad
Haukeland University Hospital, Norway
Title: Why are patients with multiple sclerosis not offered disease-modifying treatment, or choose to refrain from treatment?
Biography
Biography: Randi C Haugstad
Abstract
Multiple sclerosis (MS) is a chronic neurological disease, and the cause of MS remains unknown. There is no cure for MS, but several disease-modifying treatments (DMT) are available to prevent disease progression for patients with relapsing remitting MS (RRMS). A national guideline recommended that patients with RRMS should be offered DMT to prevent further disability due to MS. A total of 11,000 people are living with MS in Norway today, and about 50% of the MS patients are using DMT. A study performed at a University Hospital in Norway, a total of 837 patients (female 560, male 277) had RRMS. Of this population, 750 (90%) patients had been offered DMT. For not being offered DMT, reasons were stabile MS, uncertainty about fulfilling the criterion for DMT, and unknown reason. Female gender and high age at inclusion were risk factors for not being offered DMT. Reasons for not using DMT were related to adverse events, pregnancy, generally not want to use, stabile MS and unknown reasons. A high adherence to the national guideline in the department was seen, by 90% of the RRMS patients were offered DMT. It is known that patients treated with DMT early in the disease course had delayed long-term disability, but DMT initiated late in the disease course gave better prognosis compared to patients never treated, and due to this knowledge, it is important to offer DMT also for older MS-patients with RRMS.