July 28, 2022

Specialty pharmacists help reduce MS relapse risk

Just one-third of patients with relapsing multiple sclerosis remain on disease-modifying therapy, and specialty pharmacists are in a unique position to help coordinate therapy discontinuation or change and reduce the risk of relapse.

Relapsing multiple sclerosis (RMS) is the most common form of multiple sclerosis. Since there is no cure, patients are maintained on disease-modifying therapy (DMT) to help slow disease progression, reduce disease relapses, and limit new disease activity.

However, long-term persistence to DMTs is low, with many patients switching or discontinuing DMT treatment. Low DMT persistence increases the risk for relapse and relapse-related costs related to emergency department visits and inpatient admissions.

In a retrospective, cross-sectional study, reported in Multiple Sclerosis and Related Disorders, Miranda Kozlicki, PharmD, and colleagues discovered that over three years, only 36% of patients remained on index treatments. Some common reasons for discontinuing or switching DMTs were adverse events/side effects, insurance formulary changes, and lack of disease improvement.

The study found that specialty pharmacists, because of their direct, frequent contact with patients and providers, are in a unique position to identify the need for DMT discontinuation/switch, coordinate care during DMT transitions, and reduce the risk of relapse. 

Other VUMC authors of the study include Brandon Markley, PharmD, Nisha Shah, PharmD, and Autumn Zuckerman, PharmD, from the Department of Pharmaceutical Services, and Josh DeClercq, MS, and Leena Choi, PhD, from the Department of Biostatistics. The research was supported by National Institutes of Health grant MD010722 through the Vanderbilt-Meharry-Miami Center of Excellence in Precision Medicine and Population Health.