Contributions
Abstract: EP1694
Type: ePoster
Abstract Category: Therapy - disease modifying - 28 Long-term treatment monitoring
Background: The complex nature of Multiple Sclerosis (MS) creates a need for different therapeutic options. The oral delayed-release dimethyl fumarate (DMF; also known as gastro-resistant DMF) reduces inflammation and oxidative stress, peginterferon beta-1a (PEG) optimizes interferon-related signaling by reduced injection interval and daclizumab beta (DAC BETA) modulates interleukin-2 signaling by blocking CD25. In addition to MS related adherence barriers, each therapy is accompanied by different challenges based on application route and side effects. Patient support programs (PSPs) optimized for each therapy were thus developed. The objective of this retrospective cohort study is to evaluate the real-life situation for MS patients. Furthermore, the potential benefit of individual patient coaching is analysed.
Methods: From February 2014, September 2014 and August 2016 patients were recruited for DMF, PEG and DAC BETA, respectively. All patients signed a written consent form and were provided with a smartphone application with reminder function. Contents and coaching frequency were adapted according to challenges and patient needs.
Results: As of April 2017, 16480 patients were recruited. Data for 9561 and 4619 MS patients including 1472 and 1142 dropouts could be analyzed for DMF and PEG, respectively. Overall, gastrointestinal issues (GI) (24.6%) for DMF and flu-like symptoms (FLS) (36.6%) for PEG were reported as the most frequent dropout reason of the discontinuers. While GI was most frequent in the first three therapy months, FLS were consistently the main reason for PEG therapy discontinuation. Time to therapy discontinuation was differentiated for more intensively and less intensively coached patients. 5.9%, 10.4% and 18.0% of more intensively coached DMF patients stopped therapy after 3, 6, and 12 months compared to 10.4%, 15.9% and 25.3%, respectively. PEG therapy discontinuation after 6 months was reduced for more intensively coached patients by 4.1% (p=0.0003) compared to the less intensively coached group. The preliminary result for DAC BETA therapy discontinuation after 6 months is 4.3% (n=139, 6 dropouts).
Conclusion: Side effects reported in the phase III studies are the main reasons for discontinuing MS therapy. Patient coaching provides an essential contribution effectively address preventable or manageable side effects and promotes regular treatment monitoring, leading to supervised therapy continuation and treatment satisfaction.
Disclosure:
YBN: received funding for medical writing.
GN, MTB and BS: employees of and hold stock/stock options in Biogen.
MM: received honoraria from Biogen, Boehringer Ingelheim, Bayer Healthcare, Merck Serono, Genzyme, Sanofi Aventis, Talecris, Teva, Novartis.
Abstract: EP1694
Type: ePoster
Abstract Category: Therapy - disease modifying - 28 Long-term treatment monitoring
Background: The complex nature of Multiple Sclerosis (MS) creates a need for different therapeutic options. The oral delayed-release dimethyl fumarate (DMF; also known as gastro-resistant DMF) reduces inflammation and oxidative stress, peginterferon beta-1a (PEG) optimizes interferon-related signaling by reduced injection interval and daclizumab beta (DAC BETA) modulates interleukin-2 signaling by blocking CD25. In addition to MS related adherence barriers, each therapy is accompanied by different challenges based on application route and side effects. Patient support programs (PSPs) optimized for each therapy were thus developed. The objective of this retrospective cohort study is to evaluate the real-life situation for MS patients. Furthermore, the potential benefit of individual patient coaching is analysed.
Methods: From February 2014, September 2014 and August 2016 patients were recruited for DMF, PEG and DAC BETA, respectively. All patients signed a written consent form and were provided with a smartphone application with reminder function. Contents and coaching frequency were adapted according to challenges and patient needs.
Results: As of April 2017, 16480 patients were recruited. Data for 9561 and 4619 MS patients including 1472 and 1142 dropouts could be analyzed for DMF and PEG, respectively. Overall, gastrointestinal issues (GI) (24.6%) for DMF and flu-like symptoms (FLS) (36.6%) for PEG were reported as the most frequent dropout reason of the discontinuers. While GI was most frequent in the first three therapy months, FLS were consistently the main reason for PEG therapy discontinuation. Time to therapy discontinuation was differentiated for more intensively and less intensively coached patients. 5.9%, 10.4% and 18.0% of more intensively coached DMF patients stopped therapy after 3, 6, and 12 months compared to 10.4%, 15.9% and 25.3%, respectively. PEG therapy discontinuation after 6 months was reduced for more intensively coached patients by 4.1% (p=0.0003) compared to the less intensively coached group. The preliminary result for DAC BETA therapy discontinuation after 6 months is 4.3% (n=139, 6 dropouts).
Conclusion: Side effects reported in the phase III studies are the main reasons for discontinuing MS therapy. Patient coaching provides an essential contribution effectively address preventable or manageable side effects and promotes regular treatment monitoring, leading to supervised therapy continuation and treatment satisfaction.
Disclosure:
YBN: received funding for medical writing.
GN, MTB and BS: employees of and hold stock/stock options in Biogen.
MM: received honoraria from Biogen, Boehringer Ingelheim, Bayer Healthcare, Merck Serono, Genzyme, Sanofi Aventis, Talecris, Teva, Novartis.