Factors Influencing Time Delays in Initiating High-Efficacy Treatment in Multiple Sclerosis: Valentin Krüger, MD

WATCH TIME: 4 minutes

“Patients with progressive disease phenotypes, more disability, or chronic conditions experienced longer delays in starting high-efficacy treatments, while those with more active disease showed shorter delays.”

Research shows that early initiation of high-efficacy treatment (HET) in patients with multiple sclerosis (MS) and related neuroinflammatory diseases is linked with better long-term prognosis. In a new study presented at the 2024 European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) Congress, September 18-20, in Copenhagen, Denmark, investigators identified factors associated with longer time intervals between recommendation and initiation of HET among patients with MS and related disorders.¹

The study retrospectively analyzed health record data from 160 patients who received a recommendation for HET at the University Hospital Frankfurt between 2015 and August 2023. Researchers reported that age (r = .211; p = .006), Expanded Disability Status Scale at recommendation and treatment initiation (r = .281; P = .001; r = .411; P <.001) as well as the number of relapses during the last 12 months prior to treatment recommendation (r = -0.292; P <.001) and the number of prior disease modifying treatments (r = .207; P = .009) revealed significant correlations with time delay in HET initiation.

Presented by lead author Valentin Krüger, MD, additional significant factors observed were the recommendation for HET initiation before full completion of immunization status (P <.001), a progressive disease phenotype (P <.001), newly diagnosed chronic diseases (P = .015), and the presence of a relapse at the timepoint of HET indication (P <.001). Authors noted that further analysis will center on exploring the dynamics of these factors and time delay periods across the different years, representing the accumulation of specific knowledge on the advantages of early HET initiation.

At the Congress, Krüger, a neurology resident at the University Hospital Frankfurt in Germany, sat down with NeurologyLive^® in an interview to discuss the specific patient factors found to contribute to a longer time delay in initiating HET for MS. He also talked about how relapses or increased disease activity influence the time delay between treatment recommendation and initiation. Moreover, Krüger shared some of the steps that can be taken to reduce the time delay for patients who may experience prolonged waiting periods before starting their treatment.

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REFERENCES
1. Krüger V, Zeltner R, Yalachkov Y. Determinants of time delay between recommendation for and start of high-efficacy treatment in Multiple Sclerosis. Presented at: 2024 ECTRIMS; September 18-20; Copenhagen, Denmark. Abstract P798.