Abstract Details

Title MS Therapy Adherence and Relapse Risk

Topic MS and Related Diseases

Presentation(s) P01 - (-)

Poster/Presentation
Number 193

Objective

Background BACKGROUND: Medication adherence is the extent that patients conform to recommendations about dosage and frequency of treatment. Evidence that therapy adherence is essential for patients to have fewer MS relapses is lacking.

Design/Methods DESIGN/METHODS: Enrollees in TOP MS, a prospective, open-label study, were diagnosed with MS and being treated with glatiramer acetate or a beta interferon dispensed by a specialty pharmacy. Signed informed consents were returned to the pharmacies. Study enrollment produced log-on instructions for the study website. Responses were entered beginning at baseline, and at regular intervals. Adherence, measured by medication possession ratio (MPR), was derived from pharmacy shipment records. Logistic regression examined the association between physician confirmed relapses and DMT, therapy MPR (< 0.5; >0.5 to <0.9; > 0.9), number of prior MS therapies, and time since first symptoms.

Results RESULTS: Across all therapies, the mean MPR for the interim completer cohort of 1,309 was 0.9 (range: 0.1 to 1.0), with 63.8% reaching a two-year MPR >=0.9. Evaluated by categories of MPR, the proportion of participants remaining relapse-free for 24 months increased with increasing MPR, and the proportion with one or more relapses declined with increasing levels of MPR (p < 0.003). Regression analysis revealed the odds of relapse for a patient in the MPR >=0.9 MPR group was 0.5058, 50% of that of a patient in the MPR <=0.5 category (p = 0.02). Being treated with one or more DMT prior to the current one increased the likelihood of relapse 1.7 times (odds ratio = 1.6933) compared to no prior treatments (p < 0.001).

Conclusions CONCLUSIONS: Better DMT adherence is associated with fewer MS relapses. Independent of adherence, one or more DMT changes increase the likelihood of relapses.

Authors/Disclosures
Bruce A. Cohen, MD, FAAN (Northwestern University, Feinberg School of Medicine) PRESENTER	Dr. Cohen has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Biogen. Dr. Cohen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Bristol Myers Squibb. Dr. Cohen has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for EMD Serono. Dr. Cohen has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Genentech. Dr. Cohen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Mylan. The institution of Dr. Cohen has received research support from Genentech. The institution of Dr. Cohen has received research support from MedDay. The institution of Dr. Cohen has received research support from Consortium of Multiple Sclerosis Centers.
Thomas Leist, MD, PhD, FAAN (Thomas Jefferson University)	Dr. Leist has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen. Dr. Leist has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Novartis. Dr. Leist has received personal compensation in the range of $500-$4,999 for serving as a Consultant for BMS. Dr. Leist has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for EMD Serono. Dr. Leist has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Horizon. Dr. Leist has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Genentech. Dr. Leist has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Sanofi. Dr. Leist has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Biogen. Dr. Leist has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Genentech. Dr. Leist has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Sanofi. Dr. Leist has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Horizon. Dr. Leist has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for EMD Seono. Dr. Leist has received personal compensation in the range of $10,000-$49,999 for serving as a Expert Wittness with DHHS HRSA.
Patricia K. Coyle, MD, FAAN (SUNY At Stony Brook)	Dr. Coyle has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Accordant. Dr. Coyle has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Amgen. Dr. Coyle has received personal compensation in the range of $50,000-$99,999 for serving as a Consultant for Sanofi Genzyme. Dr. Coyle has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Novartis. Dr. Coyle has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for GlaxoSmithKline. Dr. Coyle has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Horizon Therapeutics. The institution of Dr. Coyle has received research support from CorEvitas LLC. The institution of Dr. Coyle has received research support from Genentech/Roche. The institution of Dr. Coyle has received research support from NINDS. The institution of Dr. Coyle has received research support from Sanofi Genzyme. The institution of Dr. Coyle has received research support from Cleveland Clinic.
Heinz Reichmann, MD, FAAN (Dept. Neurology)	Dr. Reichmann has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Bial. Dr. Reichmann has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Zambon. Dr. Reichmann has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Kyowa. Dr. Reichmann has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Bial. Dr. Reichmann has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Zambon. Dr. Reichmann has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Kyowa. Dr. Reichmann has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Bial. Dr. Reichmann has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Zambon. Dr. Reichmann has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for UCB. Dr. Reichmann has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Thieme. Dr. Reichmann has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Wissenschaftsverlag.
Howard Zwibel, MD	No disclosure on file
Clyde E. Markowitz, MD (Hospital of the Univ of Pennsylvania)	No disclosure on file
Mark J. Tullman, MD (White Plains Hospital)	Dr. Tullman has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Viela Bio. Dr. Tullman has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Viela Bio.

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