PO13
Treatment Patterns Associated with Relapsing-Remitting Multiple Sclerosis Patients on 1st-Line Injectable Disease Modifying Therapies

Thursday, June 2, 2016
Exhibit Hall
Jacqueline Nicholas, MD, MPH , Neuroscience, Ohio Health, Columbus, OH
John Ko, Pharm.D, MS , US Health Economics & Outcomes Research, Novartis Pharmaceuticals Corporation, East Hanover, NJ
Yujin Park, PharmD , Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, Baltimore, MD
Prakash Navaratnam, Rph, MPH, PhD , DataMed Solutions LLC., Hilliard, OH
Howard Friedman, PhD , DataMed Solutions LLC., Hilliard, OH
Frank Ernst, Pharm.D, MS , Health Economics & Outcomes Research, Indegene TTM, Kennesaw, GA
Erik Burton, MD , US Health Economics & Outcomes Research, Novartis Pharmaceuticals Corporation, East Hanover, NJ
Walter Hong, MD , US Health Economics & Outcomes Research, Novartis Pharmaceuticals Corporation, East Hanover, NJ
Vivian Herrera, DDS, MIA, MPH , US Health Economics & Outcomes Research, Novartis Pharmaceuticals Corporation, East Hanover, NJ
Prakash Navaratnam, Rph, MPH, PhD , DataMed Solutions LLC., Hilliard, OH



Background:

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.