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Abstract Details

Treatment Patterns Among Patients With Multiple Sclerosis Newly Initiating Disease-Modifying Therapy
Multiple Sclerosis
P12 - Poster Session 12 (12:00 PM-1:00 PM)
9-004

Using real-world data, we describe treatment patterns and relapse outcomes among treatment-naive multiple sclerosis (MS) patients.
In naive patients who initiate DMTs, relapses can be reduced. However, poor treatment persistence and adherence can lead to sub-optimal outcomes.
Adults (≥18 years) initiating DMTs (index event) from 01/01/2009–09/30/2017 with 12 months of continuous enrollment pre-and post-index were identified from the Optum Clinformatics™ database. Eligible adults had ≥2 MS claims and no DMTs during the pre-index period. Treatment adherence was measured as percentage of days covered with index DMT during the 12-month post-index period using a threshold of 0.8. Time to treatment non-persistence was defined as index date until earliest date of discontinuation (>60 days without index DMT) or switch to different DMT. Relapses were defined using a validated claims-based algorithm.

In total, 5,906 MS patients were identified (mean age: 46.6 years; female: 74.2%). The majority initiated injectable DMTs (63.5%; n=3,748), followed by orals (28.8%; n=1,701) or infusions (7.7%; n=457). Of the DMT initiators, 45.3% were non-adherent and 39.4% were non-persistent within the 12-month follow-up. Oral DMT initiators had the shortest mean time (days) to non-persistence (114) vs injectable (142) and infusion (128). Overall, 25.1% of patients relapsed pre-index and 16.7% post-index. We observed a 46.2% decrease from the pre- to post-index period in the total number of patients experiencing relapses in the persistent group compared with only 15.8% in the non-persistent group. This difference was consistent between oral (45.4% vs 17.3%) and injectable (44.2% vs 15.0%) persistent patients compared with non-persistent patients.

DMT initiation among treatment-naive MS patients was associated with reductions in relapses. Regardless of route of administration, a large proportion of patients are non-adherent or non-persistent, impacting relapse reduction. In newly treated MS patients, an unmet need exists to improve adherence and persistence and further reduce MS relapse rates.
Authors/Disclosures

PRESENTER 		No disclosure on file
Leorah A. Freeman, MD, PhD (Dell Medical School, The University of Texas at Austin) Dr. Freeman has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Dr. Freeman has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Hoffman La-Roche. Dr. Freeman has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genentech, Inc. Dr. Freeman has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for EMD Serono. Dr. Freeman has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Horizon. Dr. Freeman has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi. Dr. Freeman has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for TG Therapeutics. Dr. Freeman has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Sanofi-Genzyme. Dr. Freeman has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Texas Neurological Society. Dr. Freeman has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for EMD Serono/ Merck. The institution of Dr. Freeman has received research support from Genentech. The institution of Dr. Freeman has received research support from PCORI. The institution of Dr. Freeman has received research support from EMD Serono. The institution of Dr. Freeman has received research support from Sanofi. The institution of Dr. Freeman has received research support from MSAA. The institution of Dr. Freeman has received research support from National Multiple Sclerosis Society.
Rina Mehta No disclosure on file
No disclosure on file