title: Relapsing-remitting multiple sclerosis: patterns of response to disease-modifying therapies and associated factors: a national survey.
abstract: BACKGROUND
  Current treatments for relapsing-remitting multiple sclerosis (RRMS) are only partially effective. The objective of this study was to characterize treatment response in RRMS patients in Portugal to 12-month therapy with first-line disease-modifying therapies.
  
  
  METHODS
  In this retrospective study, neurologists at participating centers completed survey questionnaires using records of patients with RRMS who had received first-line treatment with one of five European Medicine Agency-approved agents in the 12 months prior to inclusion in the survey. Sub-optimal responders included patients treated for at least 1 year, and who had ≥1 relapse(s) or an increase of 1.5 points on the Expanded Disability Status Scale (EDSS; if baseline EDSS was 0) or an increase of ≥0.5 points (baseline EDSS ≥1). Optimal responders included patients treated for at least 1 year without relapse and who had an increase of <1.5 points on EDSS (if baseline EDSS was 0) or no increase in EDSS (baseline EDSS ≥1).
  
  
  RESULTS
  Data for 1,131 patients from 15 centers were analyzed. Twenty-six percent (95% confidence interval 23-28%) of patients had sub-optimal treatment response. Duration of therapy (P < 0.001), age at the start of therapy (P = 0.03), and baseline EDSS score (P < 0.001), were significantly different among treatments. Sub-optimal treatment response appeared to be related only to a more severe EDSS score at baseline and did not differ among therapies.
  
  
  CONCLUSIONS
  Neurologists should closely monitor patients to optimize treatment strategies and better control disease, improving prognosis.
authors.affiliation: Centro Hospitalar São João, Alameda Prof. Hernani Monteiro, 4200-319 Porto, Portugal ; Faculdade de Ciências da Saúde, Universidade Fernando Pessoa, Porto, Portugal.
authors.forename: Maria José
authors.initials: MJ
authors.lastname: Sá
authors.affiliation: Centro Hospitalar Lisboa Norte, Hospital Santa Maria, Lisbon, Portugal.
authors.forename: João
authors.initials: J
authors.lastname: de Sá
authors.affiliation: Centro Hospitalar e Universitário de Coimbra, Hospitais da Universidade de Coimbra, Coimbra, Portugal.
authors.forename: Lívia
authors.initials: L
authors.lastname: Sousa
keywords: Disease-modifying therapies; Glatiramer acetate; Neurology; Relapsing–remitting multiple sclerosis; β-Interferons