title: [Change of treatment in patients with multiple sclerosis and its consequences in clinical practice].
abstract: BACKGROUND
  Thirty per cent of patients with multiple sclerosis (MS) present a suboptimal response to treatment in the first few years. The real impact of the change of treatment has still not been well established.
  
  
  OBJECTIVE
  To describe our clinical practice with regard to the change of treatment in MS patients with a suboptimal response and to analyse their progress depending on our therapeutic decisions.
  
  
  METHODS
  The study is observation-based and retrospective. The sample was made up of patients with relapsing-remitting MS and at least one event after establishing immunomodulatory treatment. Both the intention to change treatment and the delays until the actual change took place were taken into account. The theoretical consequences of these strategies were measured by the changes in the expected curve of the Multiple Sclerosis Severity Scale (MSSS).
  
  
  RESULTS
  A comparison of those who changed immunomodulator with those that did not showed that 64.3% versus 35.3%, respectively, improved on the expected curve of the MSSS (p > 0.05). Patients who improved the expected curve of the MSSS had changed treatment before those who did not improve (1.9 months versus 6 months), although the differences were not significant. The mean time that elapsed between taking the decision to change and actually changing the treatment was 2.70 ± 3.55 months.
  
  
  CONCLUSIONS
  Despite limitations due to the size of the sample, the patients with a suboptimal response who changed treatment early could benefit from an improvement in their expected progression on the MSSS.
authors.affiliation: Hospital Clinico Universitario de Valladolid, 47005 Valladolid, Espana. adefraile@hotmail.com
authors.forename: A
authors.initials: A
authors.lastname: Fraile
authors.forename: N
authors.initials: N
authors.lastname: Tellez
authors.forename: M J
authors.initials: MJ
authors.lastname: Neri
authors.forename: M F
authors.initials: MF
authors.lastname: Munoz
authors.forename: R
authors.initials: R
authors.lastname: Fernandez-Herranz
mesh_terms: D000328:Adult; D018501:Antirheumatic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D015986:Confounding Factors, Epidemiologic; D019468:Disease Management; D005260:Female; D000068717:Glatiramer Acetate; D006801:Humans; D007155:Immunologic Factors / Q000008:administration & dosage / Q000627:therapeutic use*; D000068576:Interferon beta-1b; D016899:Interferon-beta / Q000008:administration & dosage / Q000627:therapeutic use; D008297:Male; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000188:drug therapy* / Q000628:therapy; D010455:Peptides / Q000008:administration & dosage / Q000627:therapeutic use; D012189:Retrospective Studies; D018401:Sample Size; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D018501:Antirheumatic Agents; D007155:Immunologic Factors; D010455:Peptides; D000068576:Interferon beta-1b; D000068717:Glatiramer Acetate; D016899:Interferon-beta