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).
To provide insights into FLiDMT treatment patterns based on a retrospective review of the medical records of US patients with RRMS.
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.
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.
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.