Many US multiple sclerosis (MS) patients aren't receiving the latest drug therapies, according to research published in the online journal BMC Medicine. Immunomodulatory agents (IMAs) could slow the progress of the disease, but are only prescribed in a minority of cases, and mostly by neurologists.
Jagannadha Avasarala from Kansas Neurological Consultants, Wichita analysed treatment trends between 1998 and 2004 for all Federal Drug Administration (FDA) approved IMA drugs, together with colleagues from Wake Forest University School of Medicine, NC, and Ohio State University Medical Center. They used National Ambulatory Medical Care Survey (NAMCS) data to evaluate prescribing trends as well as type of physician and geographic location.
Avasarala found that an estimated 6.7million MS patient visits occurred during the study timescale: 3.4 visits per 1000 persons each year. Women were seen four times as often as men and Caucasians had a higher visit rate than African Americans (90% vs 8%). This may because MS is more prevalent amongst Caucasian women than any one ethnic group. Neurologists prescribed IMAs more often than family practitioners or internists, with urban patients visited neurologists than their rural counterparts. The NAMCS data showed that 62% of established MS patients evaluated by neurologists and 92% of those seeing family medicine practitioners or internists were not being treated with IMAs. The higher treatment rate among neurologists probably reflects greater awareness of these drugs and familiarity with MS cases.
"Strategies for educating both neurologists and non-neurologists about the benefits of initiating IMA use in MS patients and in continuing their use remain critical to improving long-term patient outcomes in treatment of MS" Says Avasarala.
MS is among the leading causes of disability in young adults, and accumulates over time. IMAs can reduce the frequency of new lesions, relapses and the rate of cerebral atrophy.
Article:
Analysis of NAMCS data for Multiple Sclerosis 1998-2004
Jagannadha R. Avasarala, Cormac A. O'Donovan, Steve E. Roach, Fabian Camacho and Steven Feldman
BMC Medicine (In Press)
Journal
BMC Medicine