Contributions
Abstract: EP1646
Type: Poster Sessions
Abstract Category: Therapy - Long-term treatment monitoring
Introduction: In a previous study of treatment persistence in multiple sclerosis it was demonstrated that age, in addition to other factors, was independently associated with higher rates of treatment discontinuation1.
Objectives: We previously reported persistence in the overall MS population2 and the current study examines the impact of age on persistence for all reimbursed DMTs for RRMS in Australia.
Methods: The Pharmaceutical Benefits Scheme (PBS) 10% sample supplied by the Department of Human Services was used in this study. Eligible patients must have received a script for a reimbursed DMT for RRMS between September 2011 and February 2016. Patients were classified into five age-groups (ages 18-30; 31-40; 41-50; 51-60; 61+) and defined as persistent if their DMT script was filled within 4 months. Persistence was derived using the Kaplan-Meier method and hazard ratios (HR) to represent the relative rate of drop-off of different age groups.
Results: A total of 1866 treatment episodes were eligible for the study. Overall the median persistence to therapy was 30 months with 68% of patients remaining on therapy for 12 months. Patients aged 18-30 had the shortest persistence (18 months) and a 44% increased risk of discontinuation when compared to the 'all ages' cohort (HR 1.44 (95%CI: 1.22-1.72) and was identified as a 'high-risk' group. For all other age-groups, when compared to Product Average, hazard ratios were between 1.08 and 0.92.
For patients aged 18-30 there was statistically significant lower persistence (median 9 months) on injectable therapy (glatiramer acetate, interferon beta-1a, interferon beta-1b) when compared to the persistent product average (median 18 months) with a hazard ratio of 1.95 (95% CI: 1.35-2.81). Patients on non-injectables (dimethyl fumarate, fingolimod, natalizumab, teriflunomide; n=188) had a median persistence of 24 months and this result was not significantly different from the product average (HR 0.81 (95% CI: 0.65-1.02). A larger sample has been requested to explore discontinuation rates of individual DMTs.
Conclusions: In this analysis of PBS sample data, patients aged 18-30 were least persistent to treatment when compared to the product average. The persistence on injectable therapy was significantly lower compared to all drugs in this high-risk group.
1. Warrender-Sparkes et al. Multiple Sclerosis Journal. 2016; 22(4): 520-532
2. Spelman et al. 7th Joint Congress of the ECTRIMS-ACTRIMS. October 25-28, 2017, P1193
Disclosure: T Spelman serves on steering committees for trials conducted by Biogen and has received honoraria and consulting fees from Biogen and Novartis
A Kornberg has served on scientific advisory boards for Novartis
M Schulz is an employer of Novartis
B Arora is an employer of Novartis
E Chung received compensation from Novartis for research and authorship of this publication
P Juneja received compensation from Novartis for research and authorship of this publication
R Walker is an employer of Novartis
S Verhaeghe is an employer of Novartis
A van der Walt has served on scientific advisory boards for Novartis, Merck and Sanofi and has received travel support from Novartis, Biogen, Merck and Teva. She has received research support from Novartis, Merck and the NHMRC Australia
H Butzkueven has served on scientific advisory boards for Biogen, Roche, Merck, Novartis, Teva and Sanofi and has received conference travel support from Novartis, Biogen and Merck. He serves on steering committees for trials conducted by Merck, Biogen and Novartis, and has received research support from Novartis, Biogen, NHMRC Australia, MS Research Australia and the UK MS Trust
Abstract: EP1646
Type: Poster Sessions
Abstract Category: Therapy - Long-term treatment monitoring
Introduction: In a previous study of treatment persistence in multiple sclerosis it was demonstrated that age, in addition to other factors, was independently associated with higher rates of treatment discontinuation1.
Objectives: We previously reported persistence in the overall MS population2 and the current study examines the impact of age on persistence for all reimbursed DMTs for RRMS in Australia.
Methods: The Pharmaceutical Benefits Scheme (PBS) 10% sample supplied by the Department of Human Services was used in this study. Eligible patients must have received a script for a reimbursed DMT for RRMS between September 2011 and February 2016. Patients were classified into five age-groups (ages 18-30; 31-40; 41-50; 51-60; 61+) and defined as persistent if their DMT script was filled within 4 months. Persistence was derived using the Kaplan-Meier method and hazard ratios (HR) to represent the relative rate of drop-off of different age groups.
Results: A total of 1866 treatment episodes were eligible for the study. Overall the median persistence to therapy was 30 months with 68% of patients remaining on therapy for 12 months. Patients aged 18-30 had the shortest persistence (18 months) and a 44% increased risk of discontinuation when compared to the 'all ages' cohort (HR 1.44 (95%CI: 1.22-1.72) and was identified as a 'high-risk' group. For all other age-groups, when compared to Product Average, hazard ratios were between 1.08 and 0.92.
For patients aged 18-30 there was statistically significant lower persistence (median 9 months) on injectable therapy (glatiramer acetate, interferon beta-1a, interferon beta-1b) when compared to the persistent product average (median 18 months) with a hazard ratio of 1.95 (95% CI: 1.35-2.81). Patients on non-injectables (dimethyl fumarate, fingolimod, natalizumab, teriflunomide; n=188) had a median persistence of 24 months and this result was not significantly different from the product average (HR 0.81 (95% CI: 0.65-1.02). A larger sample has been requested to explore discontinuation rates of individual DMTs.
Conclusions: In this analysis of PBS sample data, patients aged 18-30 were least persistent to treatment when compared to the product average. The persistence on injectable therapy was significantly lower compared to all drugs in this high-risk group.
1. Warrender-Sparkes et al. Multiple Sclerosis Journal. 2016; 22(4): 520-532
2. Spelman et al. 7th Joint Congress of the ECTRIMS-ACTRIMS. October 25-28, 2017, P1193
Disclosure: T Spelman serves on steering committees for trials conducted by Biogen and has received honoraria and consulting fees from Biogen and Novartis
A Kornberg has served on scientific advisory boards for Novartis
M Schulz is an employer of Novartis
B Arora is an employer of Novartis
E Chung received compensation from Novartis for research and authorship of this publication
P Juneja received compensation from Novartis for research and authorship of this publication
R Walker is an employer of Novartis
S Verhaeghe is an employer of Novartis
A van der Walt has served on scientific advisory boards for Novartis, Merck and Sanofi and has received travel support from Novartis, Biogen, Merck and Teva. She has received research support from Novartis, Merck and the NHMRC Australia
H Butzkueven has served on scientific advisory boards for Biogen, Roche, Merck, Novartis, Teva and Sanofi and has received conference travel support from Novartis, Biogen and Merck. He serves on steering committees for trials conducted by Merck, Biogen and Novartis, and has received research support from Novartis, Biogen, NHMRC Australia, MS Research Australia and the UK MS Trust