PND120 TREATMENT PATTERNS AMONG PATIENTS WITH MULTIPLE SCLEROSIS INITIATING SECOND-LINE DISEASE-MODIFYING THERAPY

Background Availability of oral disease-modifying therapy (DMT) for relapsing–remitting multiple sclerosis (RRMS) may affect injectable DMT (iDMT) treatment patterns. Objective The objective of this paper is to evaluate iDMT persistency, reasons for persistency lapses, and outcomes among newly diagnosed RRMS patients. Methods Medical records of 300 RRMS patients initiated on iDMT between 2008 and 2013 were abstracted from 18 US-based neurology clinics. Eligible patients had ≥3 visits: pre-iDMT initiation, iDMT initiation (index), and ≥1 visit within 24 months post-index. MS-related symptoms, relapses, iDMT treatment patterns (i.e. persistency, discontinuation, switching, and restart), and reasons for non-persistency were tracked for 24 months. Results At 24 months, iDMT persistency was 61.0%; 28.0% of patients switched to another DMT, 8.0% discontinued, and 3.0% stopped and restarted the same iDMT. The most commonly identified reasons for non-persistency were perceived lack of efficacy (22.2%), adverse events (18.8%), and fear of needles/self-injecting (9.4%). At 24 months, 38.0% of patients had experienced a relapse and 11.0% had changes in MRI lesion counts. Patients without MS-related symptoms at index reported increases in the incidence of these symptoms at 24 months. Conclusions Non-persistency with iDMT remains an issue in the oral DMT age. Many patients still experienced relapses and disease progression, and should consider switching to more effective therapies.

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Treatment Patterns, Healthcare Resource Utilization, and Costs Among Medicare Patients with Multiple Sclerosis in Relation to Disease-Modifying Therapy and Corticosteroid Treatment

Neurology and Therapy ◽

10.1007/s40120-018-0123-y ◽

2018 ◽

Vol 8 (1) ◽

pp. 121-133 ◽

Cited By ~ 3

Author(s):

Marie Sanchirico ◽

Amanda Caldwell-Tarr ◽

Pallavi Mudumby ◽

Lobat Hashemi ◽

Robert Dufour

Keyword(s):

Multiple Sclerosis ◽

Resource Utilization ◽

Healthcare Resource ◽

Corticosteroid Treatment ◽

Healthcare Resource Utilization ◽

Treatment Patterns ◽

Disease Modifying Therapy ◽

Medicare Patients ◽

Disease Modifying

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Assessment of Serum Nitrogen Species and Inflammatory Parameters in Relapsing-Remitting Multiple Sclerosis Patients Treated with Different Therapeutic Approaches

BioMed Research International ◽

10.1155/2016/4570351 ◽

2016 ◽

Vol 2016 ◽

pp. 1-11 ◽

Cited By ~ 5

Author(s):

Natalia Niedziela ◽

Monika Adamczyk-Sowa ◽

Jacek T. Niedziela ◽

Bogdan Mazur ◽

Ewa Kluczewska ◽

...

Keyword(s):

Multiple Sclerosis ◽

Second Line ◽

Nitrogen Species ◽

First Line ◽

Inflammatory Parameters ◽

Disease Modifying Therapy ◽

Relapsing Remitting ◽

Disease Modifying ◽

Multiple Sclerosis Patients ◽

Relapsing Remitting Multiple Sclerosis

The role of nitric oxide and its reactive derivatives (NOx) is well known in the pathogenesis of multiple sclerosis, which is an inflammatory disease whileNOxseems to be important in coordinating inflammatory response. The purpose of the present study was to assess serumNOxas one of the nitrogen species and inflammatory parameters in relapsing-remitting multiple sclerosis patients and to compare the effectiveness of various types of disease-modifying therapies that reduce nitric oxide and inflammatory biomarkers. ElevatedNOxlevel was observed in patients who received the first-line disease-modifying therapy (interferons beta-1a and beta-1b) in comparison with the subjects treated with the second-line disease-modifying therapy (natalizumab; fingolimod) and healthy controls without significant differences in C-reactive protein and interleukin-1 beta. A negative correlation was observed between serumNOxlevel and the duration of multiple sclerosis confirmed in the whole study population and in subjects treated with the first-line agents. Only serumNOx, concentration could reveal a potential efficacy of disease-modifying therapy with a better reduction inNOxlevel due to the second-line agents of disease-modifying therapy.

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Treatment Patterns in Disease-Modifying Therapy for Patients With Multiple Sclerosis in the United States

Clinical Therapeutics ◽

10.1016/j.clinthera.2013.07.330 ◽

2013 ◽

Vol 35 (10) ◽

pp. 1501-1512 ◽

Cited By ~ 17

Author(s):

Machaon M. Bonafede ◽

Barbara H Johnson ◽

Madé Wenten ◽

Crystal Watson

Keyword(s):

United States ◽

Multiple Sclerosis ◽

The United States ◽

Treatment Patterns ◽

Disease Modifying Therapy ◽

Disease Modifying

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Utilization and Treatment Patterns of Disease-Modifying Therapy Among Pediatric Patients With Multiple Sclerosis in the United States

International Journal of MS Care ◽

10.7224/1537-2073.2019-095 ◽

2020 ◽

Author(s):

Greenberg Benjamin ◽

Scott Kolodny ◽

Mengru Wang ◽

Chinmay Deshpande

Keyword(s):

Multiple Sclerosis ◽

Index Date ◽

Pediatric Patients ◽

Treatment Options ◽

The United States ◽

Treatment Patterns ◽

Considerable Proportion ◽

Newly Diagnosed ◽

Disease Modifying Therapy ◽

Disease Modifying

Abstract Background: The current landscape and treatment patterns of disease-modifying therapy (DMT) use among pediatric patients with multiple sclerosis (MS) is not yet well understood. This study examined DMT utilization and treatment patterns among pediatric patients newly diagnosed with MS. Methods: Pediatric patients (<18 years) with 2 MS diagnosis claims from January 1, 2010, to December 31, 2016, were identified from the MarketScan Commercial Database. Index date was defined as the date of first MS diagnosis and patients were followed up for 1-year post-index date. Outcomes evaluated included percentage of patients who initiated treatment after MS diagnosis, different DMTs initiated, treatment discontinuation, and switching treatment over the follow-up period. Results: Of the 182,057 newly diagnosed MS patients, 288 pediatric patients (mean age: 14 years; females: 61%) were identified. Within the first year of diagnosis, 188 patients (65.3%) did not receive any DMT. The most commonly first initiated treatments were interferons and glatiramer acetate (83%), but 28% of patients switched or discontinued from first initiated treatment within 6 months of treatment initiation. Conclusions: This study suggests that a considerable proportion of pediatric MS patients remain untreated within one year. Patients most commonly initiated injectables as their first DMT. Overall approximately 1 in 3 patients failed on therapy early. Thus, the study warrants urgency in treating these patients with currently approved treatment options.

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