Contributions
Abstract: P649
Type: Poster
Abstract Category: Therapy - disease modifying - Immunomodulation/Immunosuppression
Background: Disease modifying treatments (DMTs) for multiple sclerosis (MS) have been shown to reduce the risk for disease progression, and patients who have been persistent with and adherent to DMTs have a lower risk of relapse. Therefore, adherence and persistence are essential for optimizing treatment outcomes.
Objectives: To evaluate adherence and persistence among MS patients in Sweden initiating delayed-release dimethyl fumarate (DMF; also known as gastro-resistant DMF) compared to those initiating interferons (IFN β-1a or β-1b) or glatiramer acetate (GA).
Methods: Patients initiated on DMTs (DMF, IFN, or GA) in or after 2013 were identified in the nationwide Swedish Drug Prescribed Registry data between 1 January 2013 and 31 February 2016. Adherence and non-persistence rate of initiated DMT in 1 year after initiation were assessed based on pharmacy dispense records. Non-persistence was defined as having a treatment gap of ≥90 days, or switching to another treatment. Adherence was calculated as the Medication Possession Ratio (MPR) and Proportion Days Covered (PDC).
Results: A total of 2,149 patients were initiated on studied DMTs during the study period. Of these, 1,076 (50.1%) patients initiated DMF, 805 (37.5%) initiated IFN, and 268 (12.5%) initiated GA. The non-persistence rate within 1 year of initiation was significantly lower in DMF cohort (27.2%) than in IFN (47.3%) and GA (47.4%) cohorts (both p< 0.01). Compared with patients initiated on DMF, the hazard ratios adjusted for calendar period and treatment history for non-persistence were 3.17 (95% confidence interval [CI]: 2.52-3.98) for those on IFN, and 2.66 (95% CI: 2.10-3.38) for those on GA. The mean MPR for DMF cohort was significantly higher than that of the IFN cohort (0.94 vs. 0.70, p< 0.01), and similar to that in the GA cohort (0.94 vs 0.93, p=0.26). The mean PDC of DMF cohort was significantly higher than that of IFN (0.76 vs 0.52) and GA (0.76 vs. 0.66) cohorts (both p< 0.01).
Conclusions: Preliminary findings of this analysis of real-world data in Swedish MS patients indicated that patients treated with DMF had higher rates of persistence and adherence compared with those treated with IFN. DMF had higher rates of persistence than GA, with similar adherence as assessed by MPR and higher rates of adherence as assessed by PDC.
Disclosure:
Anders Berglund is an employee of, and holds stock/stock options in Biogen
Ning Wu is an employee of, and holds stock/stock options in Biogen
Sara Berkö is an employee of, and holds stock/stock options in Biogen
Leif Lohm is an employee of, and holds stock/stock options in Biogen
Mats Ekelund is an employee of, and holds stock/stock options in Biogen
Abstract: P649
Type: Poster
Abstract Category: Therapy - disease modifying - Immunomodulation/Immunosuppression
Background: Disease modifying treatments (DMTs) for multiple sclerosis (MS) have been shown to reduce the risk for disease progression, and patients who have been persistent with and adherent to DMTs have a lower risk of relapse. Therefore, adherence and persistence are essential for optimizing treatment outcomes.
Objectives: To evaluate adherence and persistence among MS patients in Sweden initiating delayed-release dimethyl fumarate (DMF; also known as gastro-resistant DMF) compared to those initiating interferons (IFN β-1a or β-1b) or glatiramer acetate (GA).
Methods: Patients initiated on DMTs (DMF, IFN, or GA) in or after 2013 were identified in the nationwide Swedish Drug Prescribed Registry data between 1 January 2013 and 31 February 2016. Adherence and non-persistence rate of initiated DMT in 1 year after initiation were assessed based on pharmacy dispense records. Non-persistence was defined as having a treatment gap of ≥90 days, or switching to another treatment. Adherence was calculated as the Medication Possession Ratio (MPR) and Proportion Days Covered (PDC).
Results: A total of 2,149 patients were initiated on studied DMTs during the study period. Of these, 1,076 (50.1%) patients initiated DMF, 805 (37.5%) initiated IFN, and 268 (12.5%) initiated GA. The non-persistence rate within 1 year of initiation was significantly lower in DMF cohort (27.2%) than in IFN (47.3%) and GA (47.4%) cohorts (both p< 0.01). Compared with patients initiated on DMF, the hazard ratios adjusted for calendar period and treatment history for non-persistence were 3.17 (95% confidence interval [CI]: 2.52-3.98) for those on IFN, and 2.66 (95% CI: 2.10-3.38) for those on GA. The mean MPR for DMF cohort was significantly higher than that of the IFN cohort (0.94 vs. 0.70, p< 0.01), and similar to that in the GA cohort (0.94 vs 0.93, p=0.26). The mean PDC of DMF cohort was significantly higher than that of IFN (0.76 vs 0.52) and GA (0.76 vs. 0.66) cohorts (both p< 0.01).
Conclusions: Preliminary findings of this analysis of real-world data in Swedish MS patients indicated that patients treated with DMF had higher rates of persistence and adherence compared with those treated with IFN. DMF had higher rates of persistence than GA, with similar adherence as assessed by MPR and higher rates of adherence as assessed by PDC.
Disclosure:
Anders Berglund is an employee of, and holds stock/stock options in Biogen
Ning Wu is an employee of, and holds stock/stock options in Biogen
Sara Berkö is an employee of, and holds stock/stock options in Biogen
Leif Lohm is an employee of, and holds stock/stock options in Biogen
Mats Ekelund is an employee of, and holds stock/stock options in Biogen