title: [Compliance of the guidelines of the Spanish Neurology Society in the treatment of patients with multiple sclerosis].
abstract: BACKGROUND
  Treatment of multiple sclerosis is based on the administration of the disease modifying drugs (DMD), used to slow the natural course of the disease.
  
  
  OBJECTIVE
  To assess the degree of compliance of Spanish neurologists with 2010 Spanish Neurology Society (SEN) treatment guidelines.
  
  
  METHODS
  Observational, retrospective and multicenter study of 218 adult patients with at least five years of disease evolution and under treatment with DMD. Data on their past/current management was obtained from their medical records and descriptively compared to SEN recommendations.
  
  
  RESULTS
  According to SEN 2010 guidelines, 82% of patients had an adequate clinical response and 18% had an inadequate clinical response to their current DMD; 94% and 92%, respectively, maintained that treatment. Patients in which inadequate clinical response did not motivate a change in the current DMD more frequently had higher disability decline and higher number of relapses during previous treatments, and longer treatment duration with their current DMD. Regarding the sequence of DMDs used, 48% of patients initiated first-line treatment with interferon beta-1a administered through subcutaneous (29%) or intramuscular injections (19%), followed by interferon beta-1b, and glatiramer acetate. Some patients received second-line treatments as second/third option (15% and 28% respectively), but these treatments (mostly natalizumab) were only widespread from fourth treatment onwards.
  
  
  CONCLUSIONS
  In accordance with SEN 2010 guidelines, the majority of patients from the study had an adequate clinical response. A high percentage of patients with an inadequate clinical response remained with their current treatment. An explanation to this phenomenon could be found in the chronic, complex and variable nature of multiple sclerosis.
authors.forename: Celia
authors.initials: C
authors.lastname: Oreja-Guevara
authors.affiliation: Hospitals Vall d'Hebron, 08035 Barcelona, Espana.
authors.forename: Jordi
authors.initials: J
authors.lastname: Río
authors.forename: Ana L
authors.initials: AL
authors.lastname: Gobartt
mesh_terms: D000328:Adult; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D019468:Disease Management; D004359:Drug Therapy, Combination; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D008297:Male; D008875:Middle Aged; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000188:drug therapy*; D009462:Neurology / Q000592:standards; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies; D012720:Severity of Illness Index; D012955:Societies, Medical / Q000592:standards; D013030:Spain
chemical_list: D018501:Antirheumatic Agents