Contributions
Abstract: EP1497
Type: ePoster
Abstract Category: Therapy - disease modifying - Immunomodulation/Immunosuppression
Background: Intramuscular (IM) interferon (IFN) beta-1a is one of the disease-modifying therapies approved for the treatment of relapsing-forms of multiple sclerosis (MS). Investigation of outcomes following a switch from one IFN therapy to another IFN therapy or staying on therapy using real-world data can help guide treatment decisions.
Objectives: To use real-world claims data to compare outcomes of stable IM IFN beta-1a MS patients who stay on therapy vs. switching to another IFN therapy.
Methods: This analysis used MarketScan Commercial administrative claims data from January 1, 2010 to March 31, 2015 for patients aged 18 to 64 years who were relapse-free (stable) over one year while continuously treated with IM IFN beta-1a. Relapses were defined as any MS hospitalizations or any MS outpatient visit within 30 days of an IV steroid use, ACTH, oral steroid daily dose of >= 500 mg prednisone or total plasma exchange. Patients were propensity-score matched 3:1 using age, gender, previous interferon, adherence, and month and year (first claim=index date) for patients who stayed on IM IFN beta-1a (No Switch) to patients who switched to another IFN therapy (Switch). Patients had to be continuously enrolled for one year prior to the index date (baseline) and one year after the index date (follow-up). Relapses were recorded for all patients during the follow-up period.
Results: After matching, 90 patients were included in the Switch group and 270 in the No Switch group. Baseline characteristics were well matched between groups (46-47 years of age; 80% female; 2-3% any inpatient stays; 11-12% any ER visits). The proportion of patients experiencing a relapse during the follow-up year was significantly higher in the Switch group compared with the No Switch group (14.4% vs. 5.9%, p=0.010). The annual relapse rate was also significantly higher in the Switch group compared with the No Switch group (0.14 vs. 0.07, p=0.012). During the follow-up period, 65.5% of patients in the Switch group continued on the second IFN therapy, while 15.6% subsequently switched to another DMT, 14.4% discontinued and 4.4% returned to IM IFN beta-1a.
Conclusions: Stable IM IFN beta-1a patients who remain on therapy had significantly better outcomes, as measured by less than half the proportion of patients with relapses and half the annual relapse rate, than patients who switched to another IFN. This supports the benefits of allowing patients to remain on current IFN therapy when stable.
Disclosure:
Supported by: Biogen
Author disclosures:
Stanley Cohan: support from Biogen, Genzyme, Novartis, Genentech, Mallinckrodt and Opexa. Kyle Smoot: support from Acorda, Biogen, EMD Serono, Genzyme, Novartis, and Teva. Kiren Kresa-Reahl: speaker bureaus for Biogen, Novartis, Teva, EMD Serono, Mallinckrodt, Genzyme-Sanofi; consultant for Biogen, EMD Serono, Genentech-Roche; support from Biogen, Novartis, Mallinckrodt, Genzyme-Sanofi, Genentech-Roche. Jon Kendter: employee and stockholder of Biogen. Robert Garland: employee and stockholder of Biogen at the time the study was carried out. Danny Yeh: employee and stockholder of Biogen. Ning Wu: employee and stockholder of Biogen. Peter Serafini: employee of Biogen. Crystal Watson: employee and stockholder of Biogen.
Abstract: EP1497
Type: ePoster
Abstract Category: Therapy - disease modifying - Immunomodulation/Immunosuppression
Background: Intramuscular (IM) interferon (IFN) beta-1a is one of the disease-modifying therapies approved for the treatment of relapsing-forms of multiple sclerosis (MS). Investigation of outcomes following a switch from one IFN therapy to another IFN therapy or staying on therapy using real-world data can help guide treatment decisions.
Objectives: To use real-world claims data to compare outcomes of stable IM IFN beta-1a MS patients who stay on therapy vs. switching to another IFN therapy.
Methods: This analysis used MarketScan Commercial administrative claims data from January 1, 2010 to March 31, 2015 for patients aged 18 to 64 years who were relapse-free (stable) over one year while continuously treated with IM IFN beta-1a. Relapses were defined as any MS hospitalizations or any MS outpatient visit within 30 days of an IV steroid use, ACTH, oral steroid daily dose of >= 500 mg prednisone or total plasma exchange. Patients were propensity-score matched 3:1 using age, gender, previous interferon, adherence, and month and year (first claim=index date) for patients who stayed on IM IFN beta-1a (No Switch) to patients who switched to another IFN therapy (Switch). Patients had to be continuously enrolled for one year prior to the index date (baseline) and one year after the index date (follow-up). Relapses were recorded for all patients during the follow-up period.
Results: After matching, 90 patients were included in the Switch group and 270 in the No Switch group. Baseline characteristics were well matched between groups (46-47 years of age; 80% female; 2-3% any inpatient stays; 11-12% any ER visits). The proportion of patients experiencing a relapse during the follow-up year was significantly higher in the Switch group compared with the No Switch group (14.4% vs. 5.9%, p=0.010). The annual relapse rate was also significantly higher in the Switch group compared with the No Switch group (0.14 vs. 0.07, p=0.012). During the follow-up period, 65.5% of patients in the Switch group continued on the second IFN therapy, while 15.6% subsequently switched to another DMT, 14.4% discontinued and 4.4% returned to IM IFN beta-1a.
Conclusions: Stable IM IFN beta-1a patients who remain on therapy had significantly better outcomes, as measured by less than half the proportion of patients with relapses and half the annual relapse rate, than patients who switched to another IFN. This supports the benefits of allowing patients to remain on current IFN therapy when stable.
Disclosure:
Supported by: Biogen
Author disclosures:
Stanley Cohan: support from Biogen, Genzyme, Novartis, Genentech, Mallinckrodt and Opexa. Kyle Smoot: support from Acorda, Biogen, EMD Serono, Genzyme, Novartis, and Teva. Kiren Kresa-Reahl: speaker bureaus for Biogen, Novartis, Teva, EMD Serono, Mallinckrodt, Genzyme-Sanofi; consultant for Biogen, EMD Serono, Genentech-Roche; support from Biogen, Novartis, Mallinckrodt, Genzyme-Sanofi, Genentech-Roche. Jon Kendter: employee and stockholder of Biogen. Robert Garland: employee and stockholder of Biogen at the time the study was carried out. Danny Yeh: employee and stockholder of Biogen. Ning Wu: employee and stockholder of Biogen. Peter Serafini: employee of Biogen. Crystal Watson: employee and stockholder of Biogen.