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Disease-modifying treatments (DMTs) for relapsing-remitting multiple sclerosis (RRMS) are often prescribed over long time periods and their effectiveness may be limited due to high treatment discontinuation rates. A systematic literature review (SLR) was conducted to summarise the DMT discontinuation data in adults with RRMS and describe the reasons for DMT discontinuation when available. Methods: The SLR was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. English-language publications of approved RRMS DMTs were searched from inception until December 2016 in the following databases: EMBASE, MEDLINE, MEDLINE In-process, and Cochrane Central Register of Controlled Trials. Results: A total of 82 studies met the initial pre-specified criteria of the SLR. After applying additional selection criteria, 24 studies (from 37 publications) remained that reported discontinuation rates as a key objective, with the majority (14 studies) evaluating only injectable DMTs. Data were reported in a qualitative/narrative manner. Conclusion: Few studies specifically investigated treatment discontinuation in RRMS. Particularly with the introduction of new treatment options, this is a critical consideration when selecting DMTs. The most common reasons for discontinuing treatment were adverse events, lack of efficacy, and pregnancy, highlighting the importance of the risk/benefit profile when determining the appropriate therapy for RRMS.

Discontinuation of Disease-modifying Treatments in Relapsing-remitting Multiple Sclerosis – A Systematic Literature Review of Observational Studies