title: Baseline predictors of persistence to first disease-modifying treatment in multiple sclerosis.
abstract: OBJECTIVE
  Patients with multiple sclerosis (MS) require lifelong therapy. However, success of disease-modifying therapies is dependent on patients' persistence and adherence to treatment schedules. In the setting of a large multicenter observational study, we aimed at assessing multiple parameters for their predictive power with respect to discontinuation of therapy.
  
  
  METHODS
  We analyzed 13 parameters to predict discontinuation of interferon beta-1b treatment during a 2-year follow-up period based on data from 395 patients with MS who were treatment-naïve at study onset. Besides clinical characteristics, patient-related psychosocial outcomes were assessed as well.
  
  
  RESULTS
  Among patients without clinically relevant fatigue, males showed a higher persistence rate than females (80.3% vs 64.7%). Clinically relevant fatigue scores decreased the persistence rate in men and especially in women (71.4% and 51.2%). Besides gender and fatigue, univariable and multivariable analyses revealed further factors associated with interferon beta-1b therapy discontinuation, namely lower quality of life, depressiveness, and higher relapse rate before therapy initiation, while higher education, living without a partner, and higher age improved persistence.
  
  
  CONCLUSIONS
  Patients with higher grades of fatigue and depressiveness are at higher risk to prematurely discontinue MS treatment; especially, women suffering from fatigue have an increased discontinuation rate.
authors: Department of Neurology, Neuroimmunology Section, University of Rostock, Rostock, Germany.
authors: U K
authors: UK
authors: Zettl
authors: Neurological Practice Center, Ulm, Germany.
authors: H
authors: H
authors: Schreiber
authors: Neurology, Immunology, and Ophthalmology, Bayer Vital GmbH, Leverkusen, Germany.
authors: U
authors: U
authors: Bauer-Steinhusen
authors: Neurology, Immunology, and Ophthalmology, Bayer Vital GmbH, Leverkusen, Germany.
authors: T
authors: T
authors: Glaser
authors: Institute Dr. Schauerte, München, Germany.
authors: K
authors: K
authors: Hechenbichler
authors: Department of Neurology, Neuroimmunology Section, University of Rostock, Rostock, Germany.
authors: M
authors: M
authors: Hecker
mesh_terms: D000276:Adjuvants, Immunologic / Q000627:therapeutic use*; D000328:Adult; D015331:Cohort Studies; D003863:Depression / Q000175:diagnosis / Q000188:drug therapy / Q000523:psychology; D005221:Fatigue / Q000175:diagnosis / Q000188:drug therapy / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D000068576:Interferon beta-1b / Q000627:therapeutic use*; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000276:Adjuvants, Immunologic; D000068576:Interferon beta-1b
keywords: depression; fatigue; interferon beta-1b; multiple sclerosis; prediction analysis; therapy persistence