Contributions
Abstract: EP1686
Type: ePoster
Abstract Category: Therapy - disease modifying - 28 Long-term treatment monitoring
Background: This study aimed to examine and compare patient persistence to all publicly-funded disease modifying therapies (DMTs) for relapsing-remitting multiple sclerosis (RRMS) in Australia.
Method: The Australian Government Medicare Database was used in this study. For patients to be eligible for the study they needed to have received a script for a reimbursed MS disease modifying therapy between September 2011 and February 2016. Patient demographics were summarized using mean and standard deviation or frequency percentage. Persistence was defined as a patient that remained on a DMT with a gap in scripts of no longer than 4 months. Individual patients could be included multiple times if they initiated a new DMT during the study period. Persistence was derived using the Kaplan-Meier method and hazard ratios (HR) calculated to compare persistence rates between different treatments; p-values were based on the log-rank test.
Results: A total of 720 unique patients were eligible for the study. The majority were female (73.5%) and aged between 36-65 (64%). These patients contributed 1827 observations that were used for analysis (i.e. 2.5 new initiations/patient). Overall the median persistence to therapy was 29.6 months with 67.7% of patients remaining on therapy for 12 months. The only DMT that had significantly better persistence compared to the overall average, was fingolimod (HR 0.65 (95%CI: 0.57-0.73; p< 0.001)). Patients had a median persistence of 60 months on fingolimod and 79.5% of patients were persistent at 12 months. Patients were significantly less persistent to interferon Beta-1a, interferon Beta-1b, glatiramer acetate and dimethyl fumarate (hazard ratios above 1.27 (p values all ≤ 0.001) whilst the remaining DMTs, teriflunomide and natalizumab, showed no significant difference from the average persistence.
Conclusion: In Australia, reimbursed MS patients were most persistent to fingolimod treatment amongst all DMTs. The implications of this superior persistence and how it may translate to differences in clinical effectiveness will be the subject of future studies.
Disclosure:
Eric Chung: received compensation from Novartis for research and authorship of this publication
Prabhjot Juneja: received compensation from Novartis for research and authorship of this publication.
Mark Schulz: nothing to disclose
Birendra Arora: nothing to disclose
Rob Walker: nothing to disclose
Stephane Verhaeghe: nothing to disclose
Tim Spelman: nothing to disclose
Simon Broadley: nothing to disclose
Abstract: EP1686
Type: ePoster
Abstract Category: Therapy - disease modifying - 28 Long-term treatment monitoring
Background: This study aimed to examine and compare patient persistence to all publicly-funded disease modifying therapies (DMTs) for relapsing-remitting multiple sclerosis (RRMS) in Australia.
Method: The Australian Government Medicare Database was used in this study. For patients to be eligible for the study they needed to have received a script for a reimbursed MS disease modifying therapy between September 2011 and February 2016. Patient demographics were summarized using mean and standard deviation or frequency percentage. Persistence was defined as a patient that remained on a DMT with a gap in scripts of no longer than 4 months. Individual patients could be included multiple times if they initiated a new DMT during the study period. Persistence was derived using the Kaplan-Meier method and hazard ratios (HR) calculated to compare persistence rates between different treatments; p-values were based on the log-rank test.
Results: A total of 720 unique patients were eligible for the study. The majority were female (73.5%) and aged between 36-65 (64%). These patients contributed 1827 observations that were used for analysis (i.e. 2.5 new initiations/patient). Overall the median persistence to therapy was 29.6 months with 67.7% of patients remaining on therapy for 12 months. The only DMT that had significantly better persistence compared to the overall average, was fingolimod (HR 0.65 (95%CI: 0.57-0.73; p< 0.001)). Patients had a median persistence of 60 months on fingolimod and 79.5% of patients were persistent at 12 months. Patients were significantly less persistent to interferon Beta-1a, interferon Beta-1b, glatiramer acetate and dimethyl fumarate (hazard ratios above 1.27 (p values all ≤ 0.001) whilst the remaining DMTs, teriflunomide and natalizumab, showed no significant difference from the average persistence.
Conclusion: In Australia, reimbursed MS patients were most persistent to fingolimod treatment amongst all DMTs. The implications of this superior persistence and how it may translate to differences in clinical effectiveness will be the subject of future studies.
Disclosure:
Eric Chung: received compensation from Novartis for research and authorship of this publication
Prabhjot Juneja: received compensation from Novartis for research and authorship of this publication.
Mark Schulz: nothing to disclose
Birendra Arora: nothing to disclose
Rob Walker: nothing to disclose
Stephane Verhaeghe: nothing to disclose
Tim Spelman: nothing to disclose
Simon Broadley: nothing to disclose