Maiju Savolainen, Matias Viitala, Katariina Kuutti, Hanna Kuusisto, Ilkka Rauma, Mervi Ryytty, Johanna Krüger, Päivi Hartikainen, Marja Niiranen, Jukka Saarinen, Merja Soilu-Hänninen, Sini M Laakso
{"title":"复发缓解型多发性硬化症患者开始治疗的延迟——一项基于全国人群的研究","authors":"Maiju Savolainen, Matias Viitala, Katariina Kuutti, Hanna Kuusisto, Ilkka Rauma, Mervi Ryytty, Johanna Krüger, Päivi Hartikainen, Marja Niiranen, Jukka Saarinen, Merja Soilu-Hänninen, Sini M Laakso","doi":"10.1177/20552173251360358","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Early disease-modifying therapy (DMT) improves outcomes in patients with relapsing-remitting multiple sclerosis (pwRRMS), but reasons for delayed or absent initiation are unclear.</p><p><strong>Objective: </strong>To investigate reasons and trends for delayed or absent DMT initiation among Finnish pwRRMS.</p><p><strong>Methods: </strong>A nationwide retrospective study using the Finnish MS Registry identified 2363 pwRRMS diagnosed between 2010 and 2019 in the participating centers. Patients never receiving DMT or starting >2 years post-diagnosis were compared to those initiating DMT within a year of diagnosis.</p><p><strong>Results: </strong>We identified 193 pwRRMS who never started DMT, 88 had delayed initiation over 2 years, and 1944 started within a year. The no/delayed DMT group was older at diagnosis (mean 38.7 vs 35.2 years, <i>p</i> < 0.001). Corticosteroid-treated relapses were more frequent among early initiators. Optic neuritis was more common in patients with delayed or no DMT. Treatment refusal was the primary reason for delayed/no DMT (35.6%), with 68% of refusers never starting. From 2010to 2019, delayed/no DMT initiation (<i>p</i> = 0.007) and treatment refusal (<i>p</i> = 0.004) decreased significantly.</p><p><strong>Conclusion: </strong>Delayed or absent DMT initiation is linked to older age, optic neuritis, disease inactivity, and treatment refusal, which declined over time, likely due to expanded DMT options.</p>","PeriodicalId":18961,"journal":{"name":"Multiple Sclerosis Journal - Experimental, Translational and Clinical","volume":"11 3","pages":"20552173251360358"},"PeriodicalIF":2.3000,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12322356/pdf/","citationCount":"0","resultStr":"{\"title\":\"Delays in treatment initiation for patients with relapsing-remitting multiple sclerosis-A nationwide population-based study.\",\"authors\":\"Maiju Savolainen, Matias Viitala, Katariina Kuutti, Hanna Kuusisto, Ilkka Rauma, Mervi Ryytty, Johanna Krüger, Päivi Hartikainen, Marja Niiranen, Jukka Saarinen, Merja Soilu-Hänninen, Sini M Laakso\",\"doi\":\"10.1177/20552173251360358\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Early disease-modifying therapy (DMT) improves outcomes in patients with relapsing-remitting multiple sclerosis (pwRRMS), but reasons for delayed or absent initiation are unclear.</p><p><strong>Objective: </strong>To investigate reasons and trends for delayed or absent DMT initiation among Finnish pwRRMS.</p><p><strong>Methods: </strong>A nationwide retrospective study using the Finnish MS Registry identified 2363 pwRRMS diagnosed between 2010 and 2019 in the participating centers. Patients never receiving DMT or starting >2 years post-diagnosis were compared to those initiating DMT within a year of diagnosis.</p><p><strong>Results: </strong>We identified 193 pwRRMS who never started DMT, 88 had delayed initiation over 2 years, and 1944 started within a year. The no/delayed DMT group was older at diagnosis (mean 38.7 vs 35.2 years, <i>p</i> < 0.001). Corticosteroid-treated relapses were more frequent among early initiators. Optic neuritis was more common in patients with delayed or no DMT. Treatment refusal was the primary reason for delayed/no DMT (35.6%), with 68% of refusers never starting. From 2010to 2019, delayed/no DMT initiation (<i>p</i> = 0.007) and treatment refusal (<i>p</i> = 0.004) decreased significantly.</p><p><strong>Conclusion: </strong>Delayed or absent DMT initiation is linked to older age, optic neuritis, disease inactivity, and treatment refusal, which declined over time, likely due to expanded DMT options.</p>\",\"PeriodicalId\":18961,\"journal\":{\"name\":\"Multiple Sclerosis Journal - Experimental, Translational and Clinical\",\"volume\":\"11 3\",\"pages\":\"20552173251360358\"},\"PeriodicalIF\":2.3000,\"publicationDate\":\"2025-08-04\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12322356/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Multiple Sclerosis Journal - Experimental, Translational and Clinical\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1177/20552173251360358\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/7/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Multiple Sclerosis Journal - Experimental, Translational and Clinical","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1177/20552173251360358","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/7/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
Delays in treatment initiation for patients with relapsing-remitting multiple sclerosis-A nationwide population-based study.
Background: Early disease-modifying therapy (DMT) improves outcomes in patients with relapsing-remitting multiple sclerosis (pwRRMS), but reasons for delayed or absent initiation are unclear.
Objective: To investigate reasons and trends for delayed or absent DMT initiation among Finnish pwRRMS.
Methods: A nationwide retrospective study using the Finnish MS Registry identified 2363 pwRRMS diagnosed between 2010 and 2019 in the participating centers. Patients never receiving DMT or starting >2 years post-diagnosis were compared to those initiating DMT within a year of diagnosis.
Results: We identified 193 pwRRMS who never started DMT, 88 had delayed initiation over 2 years, and 1944 started within a year. The no/delayed DMT group was older at diagnosis (mean 38.7 vs 35.2 years, p < 0.001). Corticosteroid-treated relapses were more frequent among early initiators. Optic neuritis was more common in patients with delayed or no DMT. Treatment refusal was the primary reason for delayed/no DMT (35.6%), with 68% of refusers never starting. From 2010to 2019, delayed/no DMT initiation (p = 0.007) and treatment refusal (p = 0.004) decreased significantly.
Conclusion: Delayed or absent DMT initiation is linked to older age, optic neuritis, disease inactivity, and treatment refusal, which declined over time, likely due to expanded DMT options.
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