PO13
Treatment Patterns Associated with Relapsing-Remitting Multiple Sclerosis Patients on 1st-Line Injectable Disease Modifying Therapies
This study aims to better understand treatment patterns associated with first-line injectable Disease Modifying Therapy (FLiDMT) [beta-interferons (Avonex®, Betaseron®, Rebif®, Extavia®) or glatiramer acetate (Copaxone®)] among patients newly diagnosed with relapsing-remitting multiple sclerosis (RRMS).
Objectives:
To provide insights into FLiDMT treatment patterns based on a retrospective review of the medical records of US patients with RRMS.
Methods:
In our study, 52 distinct medical records of RRMS patients initiated on injectable DMTs between 08/31/08 and 08/31/13 were abstracted from 6 US-based neurology clinics. Eligible patients had at least 3 visits: 1 visit prior to FLiDMT initiation (pre-index visit), 1 visit where FLiDMT agents were initiated (index visit), and >1 visit within the 24 months following FLiDMT initiation. Baseline demographics and clinical characteristics were collected at the pre-index and index visits. Disease progression indicators, relapse rate, FLiDMT treatment patterns (i.e. persistency, discontinuation, switching, and restart), and reasons for therapy change were tracked in the post-index visits at distinct time windows of 3, 6, 9, 12, 18, and 24 months. Descriptive statistics of FLiDMT treatment patterns and survival curves for persistency were generated.
Results:
Eligible patients were 71% female with a mean age of 38.4 years. The FLiDMT persistence rate was 81% at 12 months and 71% at 24 months. Over the 2 years of follow-up, 27% of patients on FLiDMT switched to another MS medication. Among those that switched, 36% switched within 6 months. While the main reason for switching within first 12 months were adverse events (50%), clinical events, such as lack of efficacy (27%), MRI evidence of disease progression (13%), and acute exacerbation (7%), were the main reasons for switching between 12-24 months. Only 4% of patients re-started on their initial treatment during the 24-month follow-up period.
Conclusions:
One third of patients were not persistent on their initial FLiDMT at 24 months. Understanding the reasons associated with FLiDMT non-persistence and switching may inform appropriate treatment selection to improve patient’s persistence to MS treatment.