A1 Refereed original research article in a scientific journal

Delays in treatment initiation for patients with relapsing-remitting multiple sclerosis—A nationwide population-based study



Authors: Savolainen, Maiju; Viitala, Matias; Kuutti, Katariina; Kuusisto, Hanna; Rauma, Ilkka; Ryytty, Mervi; Krüger, Johanna; Hartikainen, Päivi; Niiranen, Marja; Saarinen, Jukka; Soilu-Hänninen, Merja; Laakso, Sini M

Publisher: SAGE Publications

Publication year: 2025

Journal: Multiple Sclerosis Journal - Experimental, Translational and Clinical

Journal name in source: Multiple Sclerosis Journal – Experimental, Translational and Clinical

Article number: 20552173251360358

Volume: 11

ISSN: 2055-2173

eISSN: 2055-2173

DOI: https://doi.org/10.1177/20552173251360358

Web address : https://doi.org/10.1177/20552173251360358

Self-archived copy’s web address: https://research.utu.fi/converis/portal/detail/Publication/499951166


Abstract
Background

Early disease-modifying therapy (DMT) improves outcomes in patients with relapsing-remitting multiple sclerosis (pwRRMS), but reasons for delayed or absent initiation are unclear.

Objective

To investigate reasons and trends for delayed or absent DMT initiation among Finnish pwRRMS.

Methods

A nationwide retrospective study using the Finnish MS Registry identified 2363 pwRRMS diagnosed between 2010 and 2019 in the participating centers. Patients never receiving DMT or starting >2 years post-diagnosis were compared to those initiating DMT within a year of diagnosis.

Results

We identified 193 pwRRMS who never started DMT, 88 had delayed initiation over 2 years, and 1944 started within a year. The no/delayed DMT group was older at diagnosis (mean 38.7 vs 35.2 years, p < 0.001). Corticosteroid-treated relapses were more frequent among early initiators. Optic neuritis was more common in patients with delayed or no DMT. Treatment refusal was the primary reason for delayed/no DMT (35.6%), with 68% of refusers never starting. From 2010to 2019, delayed/no DMT initiation (p = 0.007) and treatment refusal (p = 0.004) decreased significantly.

Conclusion

Delayed or absent DMT initiation is linked to older age, optic neuritis, disease inactivity, and treatment refusal, which declined over time, likely due to expanded DMT options.


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Funding information in the publication: 
This study was supported by a grant from Finnish MS Foundation (to SML).


Last updated on 2025-19-09 at 13:36