Saudi Journal of Medicine and Medical Sciences (Oct 2024)

Achievement of No Evidence of Disease Activity-3 with Oral Disease-Modifying Treatment in Patients with Relapsing–Remitting Multiple Sclerosis

  • Foziah Jabbar Gossab Alshamrani,
  • Azra Zafar,
  • Rahmah Majed Alsawad,
  • Zakia Yasawy,
  • Rizwana Shahid,
  • Saima Nazish,
  • Erum Shariff,
  • Nehad Mahmoud Soltan

DOI
https://doi.org/10.4103/sjmms.sjmms_148_24
Journal volume & issue
Vol. 12, no. 4
pp. 299 – 305

Abstract

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Background There is scant data regarding the use of oral disease-modifying treatments (oDMT) in patients with relapsing–remitting multiple sclerosis (PwRRMS) from Saudi Arabia. Objective This study aimed to identify the response rate to oDMT in PwRRMS compared to interferon (IFN) in terms of achieving no evidence of disease activity-3 (NEDA-3). Methods This retrospective study was conducted at a tertiary care hospital in Saudi Arabia and included all adult PwRRMS over a 2-year period who were on oDMTs or IFN for <1 year. The achievement of overall NEDA-3 and its components (namely, relapse, disability progression, and focal MRI activity) were assessed for each treatment. Results A total of 231 patients were included for the analysis of NEDA-3 status, of which 78 (33.8%) were on oDMTs (namely, dimethyl fumarate, teriflunomide, and fingolimod). NEDA-3 status was achieved in 51.3% (OR: 1.86, 95% CI: 1.28–2.71) of patients on oDMTs and in 32% of patients on IFN (OR: 0.72, 95% CI: 0.58–0.89) (P < 0.001). Compared to the IFN group, the oDMT group had significantly lower rates of clinical relapse (P < 0.001), disability progression (P = 0.004), and new focal MRI activity (P = 0.01). Patients on dimethyl-fumarate had higher odds of achieving NEDA-3 (OR: 2.18, 95% CI = 1.09–4.34; P =0.02) compared with those on fingolimod (OR 2.15, 95% CI = 0.70–6.58; P =0.16) and teriflunomide (OR: 1.53, 95% CI = 0.81–2.91; P =0.18). Conclusion More than half of the patients with relapsing–remitting multiple sclerosis on oral DMTs achieved NEDA-3 status in this study. Significant differences were observed in NEDA-3 status parameters and achievement between patients on oral DMTs and interferon, with the likeliness being highest among patients treated with dimethyl-fumarate.

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