Contributions
Abstract: EP1733
Type: ePoster
Abstract Category: Therapy - disease modifying - 29 Risk management for disease modifying treatments
Background: Biweekly pegylated interferon beta-1a (PEG-IFN, Plegridy) is an attractive treatment option for multiple sclerosis (MS) patients currently treated with interferons. However, the efficacy and tolerability of PEG-IFN treatment in this population is unknown, as only 1% of the patients in the pivotal trial of PEG-IFN were previously treated with interferons, and a subsequent interferon-to-PEG-IFN switch study focused primarily on flu-like symptoms and their management.
Objective: To evaluate the efficacy, tolerability and 12-month discontinuation rates of PEG-IFN among MS patients previously stable on another interferon.
Methods: In this retrospective two-centre study, we reviewed the medical records of 116 MS patients who initiated treatment with PEG-IFN between November 2014 and March 2016. We limited the analysis to 73 patients who were previously treated with interferons with no evidence of disease activity (as determined by the absence of relapses and/or MRI lesions) prior to initiation of PEG-IFN. The primary outcome was the rate of PEG-IFN discontinuation in the first 12 months. Secondary outcomes were the reasons for PEG-IFN discontinuation and evaluation of MS activity (relapse or new MRI lesions) during the initial
12 months of PEG-IFN treatment. Chi-square and t-test were used to assess differences between categorical and continuous variables, respectively.
Results: The study population consisted of 73 patients (85% female) previously treated with interferon for 7.4+/-4.7 years, with no evidence of relapses or MRI changes for median 18 months (range 6-58 months from last MRI prior to PEG-IFN initiation). Within the first 12 months of switching to PEG-IFN, 29 (40%) discontinued PEG-IFN, due to poor tolerability (n=19, 26%) and MS relapses (n=10, 14%). Median time to discontinuation was 134 days (range 21-350 days); 69 days for those who discontinued due to intolerability, and 179 days for disease activity. The patients with and without MS activity on PEG-IFN could not be distinguished in terms of age, duration of disease, or duration or type of prior interferon therapy.
Conclusion: The observed high rate of discontinuation of PEG-IFN due to tolerability and MS relapses among previously stable interferon-treated patients was unexpected given the within-class therapy switch. These findings mandate a cautious reevaluation of risks and benefits of switching previously stable interferon-treated patients to PEG-IFN.
Disclosure:
P Repovic served as a consultant or speaker for Acorda, Biogen, EMD Serono, Genentech, Sanofi and Teva; received research funding from Novartis. K Smoot served as a consultant or speaker for Acorda, Biogen, EMD Serono, Genzyme, Genentech, Novartis and Teva; received research funding from Genentech.
L Grote holds equity in Roche.
C Chen: nothing to disclose.
MM Napier: nothing to disclose.
J Bowen served as a consultant or speaker for Acorda, Biogen, EMD Serono, Genyme, Genentech, Novartis and Teva; holds equity in Amgen.
Abstract: EP1733
Type: ePoster
Abstract Category: Therapy - disease modifying - 29 Risk management for disease modifying treatments
Background: Biweekly pegylated interferon beta-1a (PEG-IFN, Plegridy) is an attractive treatment option for multiple sclerosis (MS) patients currently treated with interferons. However, the efficacy and tolerability of PEG-IFN treatment in this population is unknown, as only 1% of the patients in the pivotal trial of PEG-IFN were previously treated with interferons, and a subsequent interferon-to-PEG-IFN switch study focused primarily on flu-like symptoms and their management.
Objective: To evaluate the efficacy, tolerability and 12-month discontinuation rates of PEG-IFN among MS patients previously stable on another interferon.
Methods: In this retrospective two-centre study, we reviewed the medical records of 116 MS patients who initiated treatment with PEG-IFN between November 2014 and March 2016. We limited the analysis to 73 patients who were previously treated with interferons with no evidence of disease activity (as determined by the absence of relapses and/or MRI lesions) prior to initiation of PEG-IFN. The primary outcome was the rate of PEG-IFN discontinuation in the first 12 months. Secondary outcomes were the reasons for PEG-IFN discontinuation and evaluation of MS activity (relapse or new MRI lesions) during the initial
12 months of PEG-IFN treatment. Chi-square and t-test were used to assess differences between categorical and continuous variables, respectively.
Results: The study population consisted of 73 patients (85% female) previously treated with interferon for 7.4+/-4.7 years, with no evidence of relapses or MRI changes for median 18 months (range 6-58 months from last MRI prior to PEG-IFN initiation). Within the first 12 months of switching to PEG-IFN, 29 (40%) discontinued PEG-IFN, due to poor tolerability (n=19, 26%) and MS relapses (n=10, 14%). Median time to discontinuation was 134 days (range 21-350 days); 69 days for those who discontinued due to intolerability, and 179 days for disease activity. The patients with and without MS activity on PEG-IFN could not be distinguished in terms of age, duration of disease, or duration or type of prior interferon therapy.
Conclusion: The observed high rate of discontinuation of PEG-IFN due to tolerability and MS relapses among previously stable interferon-treated patients was unexpected given the within-class therapy switch. These findings mandate a cautious reevaluation of risks and benefits of switching previously stable interferon-treated patients to PEG-IFN.
Disclosure:
P Repovic served as a consultant or speaker for Acorda, Biogen, EMD Serono, Genentech, Sanofi and Teva; received research funding from Novartis. K Smoot served as a consultant or speaker for Acorda, Biogen, EMD Serono, Genzyme, Genentech, Novartis and Teva; received research funding from Genentech.
L Grote holds equity in Roche.
C Chen: nothing to disclose.
MM Napier: nothing to disclose.
J Bowen served as a consultant or speaker for Acorda, Biogen, EMD Serono, Genyme, Genentech, Novartis and Teva; holds equity in Amgen.