Contributions
Abstract: P346
Type: Poster
Abstract Category: Clinical aspects of MS - 5 Epidemiology
Background: Three oral disease-modifying therapies (DMTs) for multiple sclerosis became available in Canada between 2011 and 2014 (fingolimod, dimethyl fumarate (DMF), and teriflunomide). An understanding of their uptake at the population-level is needed to guide future pharmacovigilance research.
Objective: To describe the uptake of the new oral DMTs by sex and age, and to compare their use with that of the established first generation DMTs.
Methods: In this retrospective cohort study, we used prospectively collected population-based health administrative data (1996-2015) from British Columbia, Canada to identify persons with multiple sclerosis (PwMS) using a previously validated algorithm based on hospital and physician generated diagnostic (International Classification of Disease) codes. Using province-wide drug prescription records, we estimated the rate of new users for each oral DMT and the proportion of PwMS who used each DMT among all those living in British Columbia, annually and over five years (2011-2015). The analyses were also stratified by age group and sex.
Results: Between 2011 and 2015, among an average of 12,272 PwMS in British Columbia, there were 1,019 new users of at least one oral DMT, equivalent to a rate of 16 (95%CI: 15.6-17.7) per 1,000 PwMS per year. The proportion of PwMS using fingolimod increased from 2.4 (95%CI: 1.6-3.5) to 19.4 (95%CI: 17.1-21.9), DMF from 6.2 (95%CI: 5.0-7.7) to 39.5 (95%CI: 36.2-43.0), and teriflunomide from 4.2 (95%CI: 3.2-5.5) to 16.0 (95%CI: 13.9-18.4) per 1,000 PwMS during the first year that each drug became available until 2015. Conversely, use of the first-generation, non-oral DMTs (beta interferon and glatiramer acetate) decreased by 31% from 1608, or 133.5 (95%CI: 127.5-139.7) per 1,000 PwMS, in 2011 to 1,117, or 87.0 (95%CI: 82.2-92.0) per 1,000 PwMS, in 2015. The uptake or use of the oral DMTs did not differ between men and women. PwMS aged ≤45 years were more likely than those aged >45 to fill a new prescription for an oral DMT and to be current users of any DMT.
Conclusion: The uptake and use of the new oral DMTs increased substantially over the first 2 to 5 years after their introduction. With the increasing uptake and use of the new oral DMTs it will be important to monitor their risks and benefits in the real world, population-based setting.
Disclosure: This study was funded by a grant from the MS Society of Canada (PI: Tremlett; RG#:2624).
SS was funded (in part) through research grants from the National Multiple Sclerosis Society and the MS society of Canada.
EK was funded through a research grant from the MS Society of Canada for her contribution to this work.
FZ was funded through a research grant from the MS Society of Canada for his contribution to this work.
XZ was funded through a research grant from the MS Society of Canada for her contribution to this work.
TZ was funded by a Post-Doctoral Fellowship from the Multiple Sclerosis Society of Canada.
RAM receives research funding from CIHR, the MS Society of Canada, the National MS Society, CMSC, Crohn's and Colitis Canada, Research Manitoba, the MS Scientific Research Foundation, and the Waugh Family Chair in Multiple Sclerosis.
RC is the site PI for clinical trials funded by the Guthy-Jackson Charitable Foundation, Novartis and MedImmune. He has received research support from Teva, and consulting/speaking fees from Roche, EMD Serono, Sanofi, Biogen, Novartis and Teva.
HT is the Canada Research Chair for Neuroepidemiology and Multiple Sclerosis and received research support for this study from the MS Society of Canada; other sources of funding in the last year included from: the Canadian Institutes of Health Research, the National Multiple Sclerosis Society and the Multiple Sclerosis Scientific Research Foundation.
Abstract: P346
Type: Poster
Abstract Category: Clinical aspects of MS - 5 Epidemiology
Background: Three oral disease-modifying therapies (DMTs) for multiple sclerosis became available in Canada between 2011 and 2014 (fingolimod, dimethyl fumarate (DMF), and teriflunomide). An understanding of their uptake at the population-level is needed to guide future pharmacovigilance research.
Objective: To describe the uptake of the new oral DMTs by sex and age, and to compare their use with that of the established first generation DMTs.
Methods: In this retrospective cohort study, we used prospectively collected population-based health administrative data (1996-2015) from British Columbia, Canada to identify persons with multiple sclerosis (PwMS) using a previously validated algorithm based on hospital and physician generated diagnostic (International Classification of Disease) codes. Using province-wide drug prescription records, we estimated the rate of new users for each oral DMT and the proportion of PwMS who used each DMT among all those living in British Columbia, annually and over five years (2011-2015). The analyses were also stratified by age group and sex.
Results: Between 2011 and 2015, among an average of 12,272 PwMS in British Columbia, there were 1,019 new users of at least one oral DMT, equivalent to a rate of 16 (95%CI: 15.6-17.7) per 1,000 PwMS per year. The proportion of PwMS using fingolimod increased from 2.4 (95%CI: 1.6-3.5) to 19.4 (95%CI: 17.1-21.9), DMF from 6.2 (95%CI: 5.0-7.7) to 39.5 (95%CI: 36.2-43.0), and teriflunomide from 4.2 (95%CI: 3.2-5.5) to 16.0 (95%CI: 13.9-18.4) per 1,000 PwMS during the first year that each drug became available until 2015. Conversely, use of the first-generation, non-oral DMTs (beta interferon and glatiramer acetate) decreased by 31% from 1608, or 133.5 (95%CI: 127.5-139.7) per 1,000 PwMS, in 2011 to 1,117, or 87.0 (95%CI: 82.2-92.0) per 1,000 PwMS, in 2015. The uptake or use of the oral DMTs did not differ between men and women. PwMS aged ≤45 years were more likely than those aged >45 to fill a new prescription for an oral DMT and to be current users of any DMT.
Conclusion: The uptake and use of the new oral DMTs increased substantially over the first 2 to 5 years after their introduction. With the increasing uptake and use of the new oral DMTs it will be important to monitor their risks and benefits in the real world, population-based setting.
Disclosure: This study was funded by a grant from the MS Society of Canada (PI: Tremlett; RG#:2624).
SS was funded (in part) through research grants from the National Multiple Sclerosis Society and the MS society of Canada.
EK was funded through a research grant from the MS Society of Canada for her contribution to this work.
FZ was funded through a research grant from the MS Society of Canada for his contribution to this work.
XZ was funded through a research grant from the MS Society of Canada for her contribution to this work.
TZ was funded by a Post-Doctoral Fellowship from the Multiple Sclerosis Society of Canada.
RAM receives research funding from CIHR, the MS Society of Canada, the National MS Society, CMSC, Crohn's and Colitis Canada, Research Manitoba, the MS Scientific Research Foundation, and the Waugh Family Chair in Multiple Sclerosis.
RC is the site PI for clinical trials funded by the Guthy-Jackson Charitable Foundation, Novartis and MedImmune. He has received research support from Teva, and consulting/speaking fees from Roche, EMD Serono, Sanofi, Biogen, Novartis and Teva.
HT is the Canada Research Chair for Neuroepidemiology and Multiple Sclerosis and received research support for this study from the MS Society of Canada; other sources of funding in the last year included from: the Canadian Institutes of Health Research, the National Multiple Sclerosis Society and the Multiple Sclerosis Scientific Research Foundation.