Contributions
Abstract: EP1632
Type: Poster Sessions
Abstract Category: Therapy - Long-term treatment monitoring
Background: The complex nature of Multiple Sclerosis (MS) creates a need for long term treatment. Despite initial coaching, efficient therapy handling and long term adherence is not guaranteed and adherence barriers may change over time. The objective of this retrospective cohort study was to evaluate the real-life situation for MS patients. Furthermore, the potential benefit of individual coaching is analysed.
Methods: From February and September 2014 delayed-release dimethyl fumarate (DMF) and Peginterferon beta-1a (PEG) patients were recruited to the patient support program (PSP). All patients signed a written consent form. Contents and coaching frequency were adapted according to side effects as well as challenges and patient needs. Patients were stratified pursuant to individual adherence risks at therapy start and after each year of coaching.
Results: As of March 2018, 16996 patients have been recruited. Data for 9226 and 6081 MS patients including 3036 and 2554 dropouts could be analysed for DMF and PEG, respectively. Overall, gastrointestinal issues (GI) (23.9%) followed by changes of blood counts (18%) and ongoing disease activity (ODA) (16.8%) for DMF and flu-like symptoms (FLS) (36.6%) followed by ODA (15.9%) and injection site reactions (ISR) (13.3%) for PEG were reported as the most frequent dropout reasons of the discontinuers. After one year of individualized patient coaching changes in blood counts (29%) and ODA (22%) became the main discontinuation reasons for patients on DMF; no change to the main dropout reasons for PEG, though share of FLS was reduced, were observed. Evaluation of adherence risks after one year of individualized coaching showed a shift to the lower adherence subgroups for DMF and PEG. Time to therapy discontinuation was differentiated for more intensively and less intensively coached patients. Overall, 18.4%, 25% and 27.5% of more intensively coached DMF patients stopped therapy after 12, 24 and 36 months compared to 26.1%, 33.3% and 38.1%, respectively. PEG therapy discontinuation after 24 and 36 months was reduced for more intensively coached patients by 11.2% and 8% to 30.8% and 41.8%, respectively compared to the less intensively coached group.
Conclusion: GI for DMF as well as ISR and FLS for PEG can be efficiently addressed by intensively individualized coaching and side effect mitigation strategies. Individualized coaching may be a suitable tool to reduce adherence barriers and to promote treatment satisfaction.
Disclosure: YBN: received funding for medical writing.
RH: received funding for medical writing.
GN, MTG: 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: EP1632
Type: Poster Sessions
Abstract Category: Therapy - Long-term treatment monitoring
Background: The complex nature of Multiple Sclerosis (MS) creates a need for long term treatment. Despite initial coaching, efficient therapy handling and long term adherence is not guaranteed and adherence barriers may change over time. The objective of this retrospective cohort study was to evaluate the real-life situation for MS patients. Furthermore, the potential benefit of individual coaching is analysed.
Methods: From February and September 2014 delayed-release dimethyl fumarate (DMF) and Peginterferon beta-1a (PEG) patients were recruited to the patient support program (PSP). All patients signed a written consent form. Contents and coaching frequency were adapted according to side effects as well as challenges and patient needs. Patients were stratified pursuant to individual adherence risks at therapy start and after each year of coaching.
Results: As of March 2018, 16996 patients have been recruited. Data for 9226 and 6081 MS patients including 3036 and 2554 dropouts could be analysed for DMF and PEG, respectively. Overall, gastrointestinal issues (GI) (23.9%) followed by changes of blood counts (18%) and ongoing disease activity (ODA) (16.8%) for DMF and flu-like symptoms (FLS) (36.6%) followed by ODA (15.9%) and injection site reactions (ISR) (13.3%) for PEG were reported as the most frequent dropout reasons of the discontinuers. After one year of individualized patient coaching changes in blood counts (29%) and ODA (22%) became the main discontinuation reasons for patients on DMF; no change to the main dropout reasons for PEG, though share of FLS was reduced, were observed. Evaluation of adherence risks after one year of individualized coaching showed a shift to the lower adherence subgroups for DMF and PEG. Time to therapy discontinuation was differentiated for more intensively and less intensively coached patients. Overall, 18.4%, 25% and 27.5% of more intensively coached DMF patients stopped therapy after 12, 24 and 36 months compared to 26.1%, 33.3% and 38.1%, respectively. PEG therapy discontinuation after 24 and 36 months was reduced for more intensively coached patients by 11.2% and 8% to 30.8% and 41.8%, respectively compared to the less intensively coached group.
Conclusion: GI for DMF as well as ISR and FLS for PEG can be efficiently addressed by intensively individualized coaching and side effect mitigation strategies. Individualized coaching may be a suitable tool to reduce adherence barriers and to promote treatment satisfaction.
Disclosure: YBN: received funding for medical writing.
RH: received funding for medical writing.
GN, MTG: 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.