Table 3.
Results of stratification of infusion DMT's/IS's according to disease activity.
| Name of Infusion DMT/IS or Oral DMT/IS | Planned number of CNSID's patients/Disease stratification(#) | Number of patients who received infusions | Number of patients who deferred by (3–6 months) infusions/oral/injectable DMT/IS | Number of patients who got alternative DMT's/IS out of those who deferred |
|---|---|---|---|---|
| Alemtuzumab (“A”) | 7 (6 relapsing MS, 1 Highly active relapsing secondary progressive MS) | 3 (2 maintenance & 1 new highly active case) | 4 | 3 given bridging interferon beta- 1a and 1 given cyclical IVIG (deferred “A” for 3–6 months) |
| Rituximab 4 new cases, 4 maintenance cases |
8 (4 MS Highly active, 4 NMO/NMOSD (1 as induction) | 6 {Decision to treat based on relapses, MRI brain & spine, EDSS and CD19,20/white cell enumeration studies (3)} | 1 deferred initially, then given as highly active, another 1 deferred for 3 months | Nil |
| Cyclophosphamide 1 new, 1 maintenance case |
2 (1 MS Highly active, 1 NMOSD) | 1(NMOSD) | 1 (MS) | Nil |
| Eculizumab 5 maintenance cases |
5 | 4 | Nil | 1 (changed to rituximab d/t cost) |
| Tocilizumab 1 maintenance case |
1 | 1 | Nil | Nil |
| Intravenous Immunoglobulins | 10 (4 active/Highly active MS) (4 NMO/NMOSD (active/Highly active) 2 MOGAD |
10 | Nil | Nil |
| Fingolimod | 2 Highly active MS | 1 | 1 | Interferon Beta |
| Cladiribine | 2 Highly active MS | 1 | 1 | Teriflunomide |
Abbreviations:MS: Multiple sclerosis; NMO/NMOSD:Neuromyelitis optica, neuromyelitis optica spectrum disorders; DMT/IS: Disease modifying therapies/Immunosuppressants; d/t: due to;IVIG: Intravenous Immunoglobulins, EDSS: Expanded disease status scale; MRI: Magnetic resonance imaging.
Disease activity stratification #: Active/Highly active or inactive stable: Based on definition in Clinical practice guidelines on Management of Multiple Sclerosis, Version 1, 2015 (Malaysian Clinical Practice 2015).