Contributions
Abstract: P661
Type: Poster
Abstract Category: Therapy - disease modifying - Immunomodulation/Immunosuppression
Background: Real-life experience with dimethyl fumarate (DMF) is limited. Data about tolerability and adherence are especially scarce.
Objective: We examined tolerability and adherence to DMF at two major MS centers in Denmark. Data were also compared between the two centers.
Methods: Adverse events (AEs), treatment duration, reason for discontinuation and basic demographics were examined in patients started on DMF from March 2014 until November 2016. The two centers are 143 km apart from each other, national guidelines on MS treatment are the same, and the MS populations are similar.
Results: A total of 253 patients were included: 103 patients from Center 1 (C1) and 150 from Center 2 (C2). Mean age at C1 was 40.9±10.9 years, and 76.7 % were female. Mean age at C2 was 40.2±10.7 years, and 64.7 % were female. No statistical difference was found with regards to age and gender. At C1, 18 patients were treatment naïve, 62 patients received injectable 1st line therapy and 23 patients received 2nd line therapy before switch to DMF. At C2, more patients were treatment naïve (n=56), 87 patients received injectable 1st line therapy and 7 patients were treated with 2nd line therapy before switch to DMF. Patients adherent to DMF were treated for mean 362±83 days at C1 and for mean 424±141 days at C2. Patients, who discontinued DMF were treated for mean 140±114 days at C1 and for mean 305±186 days at C2 (p< 0.0002). At C1, 44 patients stopped treatment because of AEs or disease breakthrough compared to 26 patients at C2, witch gives a converted odds ratio (OR) of 3.56 (p< 0.0001). Adverse event profile was comparable at the two centers.
Conclusion: Adherence to DMF differs highly within a small geographic area of Denmark at two large MS centers. It was more likely that patients at C1 had received 2nd line therapy than patients at C2. We found a significant OR of 3.56 of stopping treatment in C1 compared to C2. Discontinuation also happened earlier at C1 than at C2 but with same distribution af AEs in both centers. These data indicate that management and interaction between healthcare professionals and patients maybe especially important in the early phase of DMF treatment.
Disclosure: All authors have recieved travel grants, speaking fees and participated in advisory boards from Biogen Idec, Merck Serono, Sanofi-aventis/Genzyme, Teva Pharmaceuticals and Novartis.
Abstract: P661
Type: Poster
Abstract Category: Therapy - disease modifying - Immunomodulation/Immunosuppression
Background: Real-life experience with dimethyl fumarate (DMF) is limited. Data about tolerability and adherence are especially scarce.
Objective: We examined tolerability and adherence to DMF at two major MS centers in Denmark. Data were also compared between the two centers.
Methods: Adverse events (AEs), treatment duration, reason for discontinuation and basic demographics were examined in patients started on DMF from March 2014 until November 2016. The two centers are 143 km apart from each other, national guidelines on MS treatment are the same, and the MS populations are similar.
Results: A total of 253 patients were included: 103 patients from Center 1 (C1) and 150 from Center 2 (C2). Mean age at C1 was 40.9±10.9 years, and 76.7 % were female. Mean age at C2 was 40.2±10.7 years, and 64.7 % were female. No statistical difference was found with regards to age and gender. At C1, 18 patients were treatment naïve, 62 patients received injectable 1st line therapy and 23 patients received 2nd line therapy before switch to DMF. At C2, more patients were treatment naïve (n=56), 87 patients received injectable 1st line therapy and 7 patients were treated with 2nd line therapy before switch to DMF. Patients adherent to DMF were treated for mean 362±83 days at C1 and for mean 424±141 days at C2. Patients, who discontinued DMF were treated for mean 140±114 days at C1 and for mean 305±186 days at C2 (p< 0.0002). At C1, 44 patients stopped treatment because of AEs or disease breakthrough compared to 26 patients at C2, witch gives a converted odds ratio (OR) of 3.56 (p< 0.0001). Adverse event profile was comparable at the two centers.
Conclusion: Adherence to DMF differs highly within a small geographic area of Denmark at two large MS centers. It was more likely that patients at C1 had received 2nd line therapy than patients at C2. We found a significant OR of 3.56 of stopping treatment in C1 compared to C2. Discontinuation also happened earlier at C1 than at C2 but with same distribution af AEs in both centers. These data indicate that management and interaction between healthcare professionals and patients maybe especially important in the early phase of DMF treatment.
Disclosure: All authors have recieved travel grants, speaking fees and participated in advisory boards from Biogen Idec, Merck Serono, Sanofi-aventis/Genzyme, Teva Pharmaceuticals and Novartis.