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Abstract Details

Impact of drug diversity on patient care in RRMS in Germany between 2010 and 2018
Multiple Sclerosis
P9 - Poster Session 9 (12:00 PM-1:00 PM)
9-011
Adherence, relapse activity and 6months-confirmed-disability-progression (6mCDP) were compared between time periods 2010-2012, 2013-2015 and 2016-2018 overall and for strata injectable/oral/infusion DMTs.

The impact of the increasing number of disease-modifying-therapies (DMTs) in RRMS on clinical efficacy and adherence is unknown.

Data were extracted from the German NeuroTransdata (NTD) doctor´s owned MS-registry including  17.460 RRMS patients between 2010-2018. Means, percentages and risk rates (cumulative incidence) were analyzed.

Results per 3years-periods 2010-2012/2013-2015/2016-2018 and % difference between means of 2010-2012 and 2016-2018:

  • Percentage of patients on DMT:                                               68%/75%/77%/+13%  
  • Percentage of patients with DMT switch:                              16%/24%/13%/NA
  • Annualized relapse rate (mean):                  all                      0.23/0.17/0.14/-39%,
                                                                               injectables       0.25/0.21/0.15/-39%,
                                                                               orals                 0.20/0.16/0.14/-30%,
                                                                               infusions          0.11/0.16/0.11/   0%.
  • Percentage with 6mCDP reaching EDSS >=3-5:                     all 0.77%/0.67%/0.71%/ -8%,
  • Percentage with 6mCDP reaching EDSS    >=5:                     all 0.25%/0.20%/0.21%/-16%
  • Months until 6mCDP and EDSS >=3-5 (mean):                      all 129/126/171/+33%,
                                                  EDSS >=5    (mean):                       all 178/225/224/+26%
  • Months until NEDA 2 failure on DMT (mean):                       all  6.9/7.0/7.3/+5.2%,
                            NEDA 3 failure on DMT (mean):                       all  6.7/7.1/7.3/+9.3%.
  • Percentage of patients on DMT progressing to SPMS:        all 4.2/1.8/1.2/-70%
  • Months from diagnosis RRMS until SPMS (mean):              all 203/219/219/+7.8%

    Risk rates for injectables/orals/infusion per 3years-periods 2010-2012/2013-2015/2016-2018

  • first relapse on DMT
    injectables    0,46/0,34/0,26

    orals               0,48/0,32/0,24
    infusions       0,31/0,28/0,20 

  • 6mCDP
    injectables    0,03/0,03/0,02
    orals               0,05/0,04/0,01
    infusions       0,02/0,03/0,01
  • Progression to SPMS

injectables    0,004/0,003/0,004
orals               0,006/0,005/0,004
infusions       0,009/0,000/0,009

Discontinuation of DMT
injectables    0,59/0,54/0,33
orals               0,45/0,32/0,18
infusions       0,59/0,37/0,17
In parallel with increasing numbers of DMTs higher proportion of patients were treated, clinical efficacy improved for ARR, progression to 6mCDP, worsening of EDSS higher than 3 and 5, respectively, duration until NEDA 2 and 3 failure and progression to SPMS. Overall improvements were similar for all types of DMTs indicating better allocation of single DMTs in individual patients  showing a trend to level in the latest period. Additional initiatives are required to further improve personalized efficient allocation of DMTs.
Authors/Disclosures
Arnfin Bergmann
PRESENTER 		Dr. Bergmann has nothing to disclose.
Stefan Braune (Gemeinschaftspraxis) Stefan Braune has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for NeuroTransData. Stefan Braune has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi. Stefan Braune has received personal compensation in the range of $5,000-$9,999 for serving as an officer or member of the Board of Directors for NeuroTransData.
No disclosure on file
Arnfin Bergmann Dr. Bergmann has nothing to disclose.