Abstract Details

Title Treatment Persistence of Cladribine Tablets Versus Other Oral Disease-modifying Treatments for Multiple Sclerosis: Results from Danish, Norwegian, and Swedish Registries

Topic Multiple Sclerosis

Presentation(s) P10 - Poster Session 10 (11:45 AM-12:45 PM)

Poster/Presentation
Number 6-015

Objective Compare real-world time-to-treatment switch and discontinuation in adult patients receiving cladribine tablets (CladT; 3.5mg/kg cumulative dose over 2 years) versus other oral disease-modifying therapies (DMTs).

Background Generating Learnings In MultiPle SclErosis (GLIMPSE) is a longitudinal study of prospectively collected registry data to compare real-world treatment outcomes in patients with relapsing multiple sclerosis treated with CladT versus other oral DMTs (fingolimod [FING], dimethyl fumarate (DMF), and teriflunomide [TER]).

Design/Methods Data from Danish, Norwegian, and Swedish multiple sclerosis registries were pooled for treatment-naïve and first-switch patients. Differences in treatment persistence between first-line CladT and comparators were analysed using a propensity score based Inverse Probability of Treatment Weighted marginal Cox model. Outcome definitions: treatment switch=initiation of a new DMT within six months of interrupting index treatment; discontinuation=any treatment interruption with or without initiation of a subsequent DMT at any point.

Results In the treatment-naïve cohort (n=3621), CladT was significantly associated with a 73%, 72%, and 79% reduction in the rate of treatment switching vs FING (Hazard Ratio [HR] 0.27; 95% confidence interval [CI] 0.17–0.43), DMF (HR 0.28; 95%CI 0.20–0.40), and TER (HR 0.21; 95%CI 0.13–0.32), respectively. CladT was associated with 75%, 78%, and 82% reductions in the rate of treatment discontinuation vs FING (HR 0.25; 95%CI 0.16–0.39), DMF (HR 0.22; 95%CI 0.16–0.32), and TER (HR 0.18; 95%CI 0.12–0.28), respectively. In the first-switch cohort (n=1721), CladT was significantly associated with a 41% reduction in the rate of a subsequent switch vs FING (HR 0.59; 95%CI 0.40–0.88), a 56% reduction vs DMF (HR 0.44; 95%CI 0.31–0.64), and a 50% reduction vs TER (HR 0.50; 95%CI 0.34–0.74).

Conclusions After correcting for confounder imbalance, CladT was associated with significantly longer time-to-treatment switch and lower rate of discontinuation vs comparators, in both treatment-naïve and first-switch cohorts.

Authors/Disclosures
Gerard Harty (Merck KGaA) PRESENTER	Gerard Harty has received personal compensation for serving as an employee of Merck KGaA Darmstadt.
Timothy Spelman	No disclosure on file
Jan Harald Aarseth (Norwegian MS registry)	No disclosure on file
Elisabeth G. Celius, MD	Dr. Celius has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Celius has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi. Dr. Celius has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck. Dr. Celius has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Celius has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Celius has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Sanofi. Dr. Celius has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Merck. Dr. Celius has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Biogen. Dr. Celius has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Novartis. Dr. Celius has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Roche.
Stig Wergeland, MD, PhD (Haukeland University Hospital)	Dr. Wergeland has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Wergeland has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Janssen. Dr. Wergeland has received personal compensation in the range of $0-$499 for serving on a Speakers Bureau for Sanofi. Dr. Wergeland has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Janssen. Dr. Wergeland has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Biogen. The institution of Dr. Wergeland has received research support from Biogen.
Melinda Magyari, MD	Dr. Magyari has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Roche. Dr. Magyari has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Merck. Dr. Magyari has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Magyari has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck. Dr. Magyari has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Magyari has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi. Dr. Magyari has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion. Dr. Magyari has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Bristol Myers Squibb. The institution of Dr. Magyari has received research support from The Danish MS Society. The institution of Dr. Magyari has received research support from Biogen. The institution of Dr. Magyari has received research support from Novartis. The institution of Dr. Magyari has received research support from Roche. The institution of Dr. Magyari has received research support from Merck. The institution of Dr. Magyari has received research support from Sanofi.
Elisabeth Framke	No disclosure on file
Namita Tundia, PhD (EMD Serono)	Mrs. Tundia has received personal compensation for serving as an employee of EMD Serono.
Schiffon Wong	Schiffon Wong has received personal compensation for serving as an employee of EMD Serono.
Jan A. Hillert, MD (Karolinska Institute, Neurology R54)	Dr. Hillert has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Hillert has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Celgene. Dr. Hillert has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck. Dr. Hillert has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Hillert has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sandoz. Dr. Hillert has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi. The institution of Dr. Hillert has received research support from Biogen. The institution of Dr. Hillert has received research support from Celgene. The institution of Dr. Hillert has received research support from Merck. The institution of Dr. Hillert has received research support from Novartis. The institution of Dr. Hillert has received research support from Sanofi. The institution of Dr. Hillert has received research support from Roche.

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