Contributions
Abstract: P1245
Type: Poster
Abstract Category: Therapy - disease modifying - 32 Others
Background: This study evaluated real-world relapse in patients newly initiating subcutaneous interferon β-1a (scIFNβ1a) vs oral disease-modifying drugs (DMDs; i.e. dimethyl fumarate, fingolimod, teriflunomide).
Methods: Patients from IMS Health Real World Data Adjudicated Claims - US database were selected from 1/1/2012 to 31/12/2014. Inclusion criteria were MS diagnosis (ICD-9-CM code: 340); initiation of scIFNβ1a, dimethyl fumarate, fingolimod or teriflunomide (1st DMD claim=index date); naive to DMDs 12 months pre-index; 12-month eligibility pre-/post-index; and age 18-63. Relapse was assessed 12 months post-index and was defined as an inpatient stay with MS diagnosis, emergency room visit with MS diagnosis, or outpatient visit with MS diagnosis and corticosteroid prescription within 7 days. Covariates in a logistic regression predicting relapse included demographics (age, sex, region), 12-month pre-index comorbidities (depression, thyroid and inflammatory/autoimmune, Charlson Comorbidity Index [CCI] score), 90-day pre-index resource use (neurologist visit and MRI), 90-day pre-index relapse, and 12-month pre-index all-cause costs.
Results: Inclusion criteria were met by 4475 patients: 21.9% scIFNβ1a, 51.0% dimethyl fumarate, 19.7% fingolimod, 7.4% teriflunomide. scIFNβ1a patients were younger than oral DMD patients. There were no significant differences in sex (~74% female). More scIFNβ1a patients were from the Midwest and fewer were from the West. Mean CCI score was greater in scIFNβ1a vs fingolimod patients; more oral DMD patients had depression-related comorbidities. Logistic regression analysis showed that teriflunomide patients had 1.357 (95% CI 1.000, 1.831; p=0.0477) greater odds of relapse than scIFNβ1a patients. There was no difference for fingolimod (OR 0.960; 95% CI 0.762, 1.209; p=0.7284) or dimethyl fumarate (OR 1.021; 95% CI 0.846, 1.234; p=0.8316) vs scIFNβ1a. There were statistically significant covariates associated with relapse. Older age was associated with lower odds of relapse. Midwest and South region, depression, 90-day pre-index neurologist visit, 90-day pre-index relapse, and higher 12-month pre-index all-cause costs were associated with higher odds of relapse.
Conclusions: In this real-world assessment, patients initiating scIFNβ1a had a lower likelihood of relapse in the first year than patients initiating teriflunomide. No significant differences were observed compared with patients initiating fingolimod or dimethyl fumarate.
Disclosure: JB received consultancy fees from Acorda Therapeutics, Biogen, EMD Serono, Genzyme, Genentech, Novartis, and Teva; received speaker fees from Acorda Therapeutics, Biogen, EMD Serono, Inc.,* Genentech, Novartis, and Teva; has research contracts with Acorda Therapeutics, Alexion, Alkermes, Allergan, Biogen, Genzyme, Genentech, GlaxoSmithKline, Novartis, Roche, and Sanofi-Aventis; and is a stockholder in Amgen. CMK performed the statistical analysis in the study funded by EMD Serono, Inc.* MG and ALP are employees of EMD Serono, Inc.,* Rockland, MA, USA. KT is an employee of Merck Serono Middle East, Dubai, UAE. *A business of Merck KGaA, Darmstadt, Germany.
Abstract: P1245
Type: Poster
Abstract Category: Therapy - disease modifying - 32 Others
Background: This study evaluated real-world relapse in patients newly initiating subcutaneous interferon β-1a (scIFNβ1a) vs oral disease-modifying drugs (DMDs; i.e. dimethyl fumarate, fingolimod, teriflunomide).
Methods: Patients from IMS Health Real World Data Adjudicated Claims - US database were selected from 1/1/2012 to 31/12/2014. Inclusion criteria were MS diagnosis (ICD-9-CM code: 340); initiation of scIFNβ1a, dimethyl fumarate, fingolimod or teriflunomide (1st DMD claim=index date); naive to DMDs 12 months pre-index; 12-month eligibility pre-/post-index; and age 18-63. Relapse was assessed 12 months post-index and was defined as an inpatient stay with MS diagnosis, emergency room visit with MS diagnosis, or outpatient visit with MS diagnosis and corticosteroid prescription within 7 days. Covariates in a logistic regression predicting relapse included demographics (age, sex, region), 12-month pre-index comorbidities (depression, thyroid and inflammatory/autoimmune, Charlson Comorbidity Index [CCI] score), 90-day pre-index resource use (neurologist visit and MRI), 90-day pre-index relapse, and 12-month pre-index all-cause costs.
Results: Inclusion criteria were met by 4475 patients: 21.9% scIFNβ1a, 51.0% dimethyl fumarate, 19.7% fingolimod, 7.4% teriflunomide. scIFNβ1a patients were younger than oral DMD patients. There were no significant differences in sex (~74% female). More scIFNβ1a patients were from the Midwest and fewer were from the West. Mean CCI score was greater in scIFNβ1a vs fingolimod patients; more oral DMD patients had depression-related comorbidities. Logistic regression analysis showed that teriflunomide patients had 1.357 (95% CI 1.000, 1.831; p=0.0477) greater odds of relapse than scIFNβ1a patients. There was no difference for fingolimod (OR 0.960; 95% CI 0.762, 1.209; p=0.7284) or dimethyl fumarate (OR 1.021; 95% CI 0.846, 1.234; p=0.8316) vs scIFNβ1a. There were statistically significant covariates associated with relapse. Older age was associated with lower odds of relapse. Midwest and South region, depression, 90-day pre-index neurologist visit, 90-day pre-index relapse, and higher 12-month pre-index all-cause costs were associated with higher odds of relapse.
Conclusions: In this real-world assessment, patients initiating scIFNβ1a had a lower likelihood of relapse in the first year than patients initiating teriflunomide. No significant differences were observed compared with patients initiating fingolimod or dimethyl fumarate.
Disclosure: JB received consultancy fees from Acorda Therapeutics, Biogen, EMD Serono, Genzyme, Genentech, Novartis, and Teva; received speaker fees from Acorda Therapeutics, Biogen, EMD Serono, Inc.,* Genentech, Novartis, and Teva; has research contracts with Acorda Therapeutics, Alexion, Alkermes, Allergan, Biogen, Genzyme, Genentech, GlaxoSmithKline, Novartis, Roche, and Sanofi-Aventis; and is a stockholder in Amgen. CMK performed the statistical analysis in the study funded by EMD Serono, Inc.* MG and ALP are employees of EMD Serono, Inc.,* Rockland, MA, USA. KT is an employee of Merck Serono Middle East, Dubai, UAE. *A business of Merck KGaA, Darmstadt, Germany.