DMT15
Patient Characteristics and Treatment Patterns Prior to Initiating Cladribine Tablets: A US Retrospective Commercial Claims Analysis
Objectives: To evaluate patient characteristics and treatment patterns prior to initiating CladT.
Methods: Patients with ≥1 CladT claim from 4/1/2019–6/30/2021 (CladT initiation = index date), ≥2 multiple sclerosis (MS) diagnoses ≥30 days apart from 1/1/2012–6/30/2021, continuous commercial insurance 12 months prior to index date, and age 18–63 years from the IQVIA PharMetrics® Plus database were included. Patient characteristics evaluated were age, sex, geographic region, Charlson Comorbidity Index (CCI) score, select comorbidities, all-cause and MS-related emergency room (ER) visits and hospitalizations occurring in the 1-year pre-index period, prior disease-modifying therapy (DMT), and other medication use.
Results: Among 634 patients with ≥1 CladT claim, 380 met inclusion criteria. Mean (standard deviation [SD]) age was 45.8 (9.7) years, 77.1% female, and US geographical distribution was 38.9% South, 30.3% Midwest, 22.6% East, and 8.2% West. Mean (SD) CCI score was 0.57 (1.1). Common comorbidities in the 1-year pre-index included depression/anxiety (37.9%), chronic lung disease, (8.7%), diabetes (7.4%), and stroke/ischemic heart disease (4.5%). All-cause ER visit (24.7%; mean [SD] 3.2 [1.8] visits/patient) were frequent and 8.7% of patients had an all-cause hospitalization during the 1-year pre-index period. As for MS-specific healthcare resource utilization, 2.4% of patients had an MS-related ER visit (mean [SD] 2.3 [1.7] visits/patient) and 3.9% had an MS-related hospitalization 1-year pre-index. A total of 5.3% of patients had a 1-year pre-index MS relapse (as defined by a hospital/ER visit). About two-thirds of patients (66.8%%) had ≥1 DMT during the 1-year pre-index period. Of those on DMTs in the 1-year pre-index period, patients switched from ocrelizumab (12.1%), fingolimod (10.3%), dimethyl fumarate (11.3%), natalizumab (9.2%), glatiramer acetate (7.4%), teriflunomide (7.6%), and subcutaneous interferon-beta 1a (5.0%). Other common 1-year pre-index prescriptions were antidepressants (41.1%), spasticity/tremor medications (41.3%), glucocorticoids (36.6%), pain medications (27.6%), fatigue medications (25.8%), urinary anti-infectives (20.5%), bladder dysfunction medications (14.2%), and walking difficulty medications (8.7%).
Conclusions: These results provide a better understanding of real-world patient characteristics and treatment patterns among US commercially insured patients receiving CladT.