Evaluation of long-term efficacy of disease-modifying agents in patients with relapsing-remitting multiple sclerosis

Abstract

Objective. Disease-modifying therapy (DMT) still remains a
fundamental treatment for relapsing-remitting multiple sclerosis.
However, data about their resudual effect and relapse severity
after the discontinuation of treatment remain scarce. The
objective of this study was to evaluate the presence of residual
effect of metenkefalin and tridecactide, as a novel disease-modifying
agent (DMT), in treatment of relapsing-remitting multiple
sclerosis (RRMS).
Materials and methods. A retrospective observational study
was conducted to examine number and severity of relapses in
a two-year period after the discontinuation of DMT. Data of
total of 40 patients were included in the study analysis. Of that
number, 32 received combination of metenkefalin and tridecactide,
while 8 patients received interferon-β–1b (IFN-β-1b). The
objective parameter for relapse severity was Expanded Disability
Status Scale (EDSS) score.
Results. 8 out of 40 patients who received DMT were hospitalized
for relapses in a two-year period after the end of treatment.
All of them after discountinuation of treatment with
combination of metenkefalin and tridecactide. The median age
of patients was 41.38±10.1 years (range from 26 to 60 years).
Two thirds of these patients (6 patients) had only one relapse.
The median time from the end of the treatment to relapse was
8.15±3.65 months (range from 1.5 from 14.7 months). The
median value of EDSS score during the relapses was 3.25 (3.0-
4.25) and it was significantly higher than the median value of
EDSS score at the end of metenkefalin and tridecactide treatment
[2.5(1.38-3.0)] (p=0.041; p>0.05).
Conclusion. The results of our study indicate some residual effect
of metenkefalin and tridecactide treatment on relapse rate
that should be further explored.
Keywords: multiple sclerosis, disease-modifying therapy, metenkefalin
and tridecactide, relapse