Contributions
Abstract: P1212
Type: Poster Sessions
Abstract Category: Therapy - Immunomodulation/Immunosuppression
Treatment options and guidelines are lacking for progressive multiple sclerosis (PMS). The first approved treatment for primary progressive MS (PPMS) was introduced in 2017, and therapies for secondary progressive MS (SPMS) are anticipated soon. A study in 2011 found that U.S. neurologists lacked a consistent approach for these disease subtypes.
Evaluate how U.S. neurologists are treating progressive forms of MS over time, in regard to a high-efficacy vs. safety-first approach.
To identify how disease-modifying therapy (DMT) switching patterns among patients with PMS have changed with access to increasing monoclonal antibody (mAb) DMT options, including most recently ocrelizumab.
To identify how disease-modifying therapy (DMT) switching patterns among patients with PMS have changed with access to increasing monoclonal antibody (mAb) DMT options, including most recently ocrelizumab.
Annualized relapse rate between RRMS (1.05) and aSPMS (1.07) patients was similar (p=0.88). Compared to RRMS patients (22%), more aSPMS (48%, p< 0.001) and PPMS (65%, p< 0.001) patients had progressing disability. Switches to mAb DMTs were most common in PPMS (84%) and aSPMS (44%), compared to RRMS (23%) and naSPMS (16%). Compared to prior years, more first switches among PPMS patients were from an injectable to mAb DMTs (62% vs. 18% in Q1 2017 vs. 15% in Q4 2015), with ocrelizumab representing 69% of all first PPMS switches. For aSPMS, mAb DMTs were the most commonly switched to class, whereas interferons (28%) and teriflunomide (16%) were among the more common switches for naSPMS. Neurologists rated the need for high-efficacy agents as outweighing safety risk higher for aSPMS compared to RRMS (p=0.046), for aSPMS compared to naSPMS (p=0.036), and for PPMS compared to naSPMS (p=.049) patients. Efficacy was the most frequent driver of aSPMS switches (51%) and PPMS switches (69%), while tolerability was the most common factor in naSPMS switches (36%).
U.S. neurologists appear to have a lower threshold for use of the high-efficacy mAb DMTs for aSPMS and PPMS patients, compared to RRMS and naSPMS patients. As relapse rates were similar between RRMS and aSPMS, disability progression, as opposed to clinical activity, appears to be important in the selection of mAb DMTs among recently switched patients.
Disclosure: Robert T. Naismith consults for Acorda, Alkermes, Biogen, EMD Serono, Genentech, Genzyme, Novartis, Teva.
Jennifer Robinson is the founder of Spherix Global Insights, an independent market intelligence firm and has received no industry funding to conduct and report on this study.
Virginia R. Schobel is an employee of Spherix Global Insights, an independent market intelligence firm and has received no industry funding to conduct and report on this study.
Abstract: P1212
Type: Poster Sessions
Abstract Category: Therapy - Immunomodulation/Immunosuppression
Treatment options and guidelines are lacking for progressive multiple sclerosis (PMS). The first approved treatment for primary progressive MS (PPMS) was introduced in 2017, and therapies for secondary progressive MS (SPMS) are anticipated soon. A study in 2011 found that U.S. neurologists lacked a consistent approach for these disease subtypes.
Evaluate how U.S. neurologists are treating progressive forms of MS over time, in regard to a high-efficacy vs. safety-first approach.
To identify how disease-modifying therapy (DMT) switching patterns among patients with PMS have changed with access to increasing monoclonal antibody (mAb) DMT options, including most recently ocrelizumab.
To identify how disease-modifying therapy (DMT) switching patterns among patients with PMS have changed with access to increasing monoclonal antibody (mAb) DMT options, including most recently ocrelizumab.
Annualized relapse rate between RRMS (1.05) and aSPMS (1.07) patients was similar (p=0.88). Compared to RRMS patients (22%), more aSPMS (48%, p< 0.001) and PPMS (65%, p< 0.001) patients had progressing disability. Switches to mAb DMTs were most common in PPMS (84%) and aSPMS (44%), compared to RRMS (23%) and naSPMS (16%). Compared to prior years, more first switches among PPMS patients were from an injectable to mAb DMTs (62% vs. 18% in Q1 2017 vs. 15% in Q4 2015), with ocrelizumab representing 69% of all first PPMS switches. For aSPMS, mAb DMTs were the most commonly switched to class, whereas interferons (28%) and teriflunomide (16%) were among the more common switches for naSPMS. Neurologists rated the need for high-efficacy agents as outweighing safety risk higher for aSPMS compared to RRMS (p=0.046), for aSPMS compared to naSPMS (p=0.036), and for PPMS compared to naSPMS (p=.049) patients. Efficacy was the most frequent driver of aSPMS switches (51%) and PPMS switches (69%), while tolerability was the most common factor in naSPMS switches (36%).
U.S. neurologists appear to have a lower threshold for use of the high-efficacy mAb DMTs for aSPMS and PPMS patients, compared to RRMS and naSPMS patients. As relapse rates were similar between RRMS and aSPMS, disability progression, as opposed to clinical activity, appears to be important in the selection of mAb DMTs among recently switched patients.
Disclosure: Robert T. Naismith consults for Acorda, Alkermes, Biogen, EMD Serono, Genentech, Genzyme, Novartis, Teva.
Jennifer Robinson is the founder of Spherix Global Insights, an independent market intelligence firm and has received no industry funding to conduct and report on this study.
Virginia R. Schobel is an employee of Spherix Global Insights, an independent market intelligence firm and has received no industry funding to conduct and report on this study.