Contributions
Abstract: P688
Type: Poster
Abstract Category: Therapy - disease modifying - Long-term treatment monitoring
Background: The availability of a wider range of treatment options for multiple sclerosis (MS) offers the possibility of a dynamic treatment approach with switching between drug classes. In this context, it is important to document treatment persistence and understand the factors associated with treatment discontinuation.
Objectives: To document treatment persistence in patients with a diagnosis of relapsing-remitting MS starting glatiramer acetate (GA) in everyday care in France and to identify factors associated with persistence.
Methods: All neurologists in France were invited to participate in the study. All patients starting treatment with GA for the first time were eligible. Patients were enrolled between November 2005 and October 2008 and followed up according to French national guidelines with at least one study visit/year. Persistence was evaluated using Kaplan-Meier survival analysis and variables associated with persistence identified using a Cox proportional hazard model.
Results: 852 patients (mean age 39.9 years, mean disease duration 8.1 years; mean EDSS score 2.4) were enrolled. At the end of the 5-year treatment period, 325 (38%) had discontinued GA but were still in the study. Median treatment duration was longer in patients discontinuing treatment for inadequate efficacy (527 days) or for personal convenience (504 days) than in those discontinuing for poor local (141 days) or general (198 days) tolerability. 13 patients discontinuing GA at some stage restarted, 226 (50%) received no further treatment, 96 (21%) were switched to interferon-β and 81 (18%) to natalizumab. Factors independently associated with a higher probability of discontinuing were having stopped work (HR: 1.45 [95%CI: 1.08; 1.93], younger age (0.98/year [0.97; 0.99]), higher EDSS score at inclusion (1.11 [1.03; 1.20]) and ≥5 previous relapses at inclusion (1.54 [1.25; 1.90]).
Conclusions: Overall, 38% of patients had discontinued GA treatment at 5 years. Patients who discontinue for tolerability issues do so more rapidly than do those discontinuing for efficacy reasons. Half the patients stopping GA received no further treatment. The principal factor associated with discontinuation was more severe disease at inclusion. Personal convenience was also an important reason given for discontinuation.
Disclosure:
CLF has received consultancy or speakers fees from Biogen Idec, Merck Serono, Genzyme, Almirall, Allergan, Teva, Sanofi, Bayer Schering
AM has received consultancy fees from Sanofi and Teva
CPD has received consultancy fees from Sanofi and Teva
TM has received consultancy fees or speaking fees from Biogen Idec, Sanofi, Genzyme, Teva Pharma, Bayer Schering, Merck Serono, Roche, Almirall and Novartis
BS and FM are employees of Teva Pharma
Source of funding: Teva.Pharma
Abstract: P688
Type: Poster
Abstract Category: Therapy - disease modifying - Long-term treatment monitoring
Background: The availability of a wider range of treatment options for multiple sclerosis (MS) offers the possibility of a dynamic treatment approach with switching between drug classes. In this context, it is important to document treatment persistence and understand the factors associated with treatment discontinuation.
Objectives: To document treatment persistence in patients with a diagnosis of relapsing-remitting MS starting glatiramer acetate (GA) in everyday care in France and to identify factors associated with persistence.
Methods: All neurologists in France were invited to participate in the study. All patients starting treatment with GA for the first time were eligible. Patients were enrolled between November 2005 and October 2008 and followed up according to French national guidelines with at least one study visit/year. Persistence was evaluated using Kaplan-Meier survival analysis and variables associated with persistence identified using a Cox proportional hazard model.
Results: 852 patients (mean age 39.9 years, mean disease duration 8.1 years; mean EDSS score 2.4) were enrolled. At the end of the 5-year treatment period, 325 (38%) had discontinued GA but were still in the study. Median treatment duration was longer in patients discontinuing treatment for inadequate efficacy (527 days) or for personal convenience (504 days) than in those discontinuing for poor local (141 days) or general (198 days) tolerability. 13 patients discontinuing GA at some stage restarted, 226 (50%) received no further treatment, 96 (21%) were switched to interferon-β and 81 (18%) to natalizumab. Factors independently associated with a higher probability of discontinuing were having stopped work (HR: 1.45 [95%CI: 1.08; 1.93], younger age (0.98/year [0.97; 0.99]), higher EDSS score at inclusion (1.11 [1.03; 1.20]) and ≥5 previous relapses at inclusion (1.54 [1.25; 1.90]).
Conclusions: Overall, 38% of patients had discontinued GA treatment at 5 years. Patients who discontinue for tolerability issues do so more rapidly than do those discontinuing for efficacy reasons. Half the patients stopping GA received no further treatment. The principal factor associated with discontinuation was more severe disease at inclusion. Personal convenience was also an important reason given for discontinuation.
Disclosure:
CLF has received consultancy or speakers fees from Biogen Idec, Merck Serono, Genzyme, Almirall, Allergan, Teva, Sanofi, Bayer Schering
AM has received consultancy fees from Sanofi and Teva
CPD has received consultancy fees from Sanofi and Teva
TM has received consultancy fees or speaking fees from Biogen Idec, Sanofi, Genzyme, Teva Pharma, Bayer Schering, Merck Serono, Roche, Almirall and Novartis
BS and FM are employees of Teva Pharma
Source of funding: Teva.Pharma