Abstract Details

Title Characteristics of Relapsing-Remitting Multiple Sclerosis (RRMS) Patients Switching First-Line Therapies for Different Reasons

Topic MS and Related Diseases

Presentation(s) P01 - (-)

Poster/Presentation
Number 212

Objective

Background BACKGROUND: Multiple Sclerosis (MS) is a chronic and progressive disease. Multiple reasons could lead to switches between DMT.

Design/Methods DESIGN/METHODS: Data for 944 RRMS patients with 3 or more years of follow-up and on either interferon beta or glatiramer as first therapy were extracted from the longitudinal New York State MS Consortium registry. Patients were grouped into 3 categories: switchers due to unsatisfactory efficacy, tolerability/safety or other factors. Unsatisfactory efficacy included increased frequency of relapses, worsening of MRI, deterioration of cognitive function, development of neutralizing antibodies and disease progression. Tolerability/safety factors included injection site reactions, flu-like symptoms, infusion and hypersensitivity reactions, depression or abnormal liver function. And other factors included all other reasons like reimbursement issues, patient preference, etc.

Results RESULTS: Of the 419 (44.4% of total) patients who switched, 56.8% switched due to unsatisfactory efficacy, 26.9% tolerability/safety and 16.3% other factors. Women were 2.7 times (95% CI 1.5, 4.9) more likely than men to switch due to tolerability/safety. Compared to the tolerability/safety (33.6%) or "other" cohort (41.2%), significantly more patients in the unsatisfactory efficacy cohort (47.9%) initiated DMT earlier defined as DMT initiation within 5 years from diagnosis (p=.014). Women who switched due to tolerability/safety factors compared to efficacy factors, had a longer duration from disease onset to DMT initiation and a shorter duration from DMT initiation to switch with means and standard deviations of 10.3 years (7.4) and 36.1 months (33.3), (p <.000) respectively.

Conclusions CONCLUSIONS: Unsatisfactory efficacy was the main reason for switching first-line DMT. Women were more likely to switch due to tolerability/safety reasons than men. Patients initiating DMT earlier switched more likely due to unsatisfactory efficacy than tolerability or other factors.

Authors/Disclosures
Barbara Teter, PhD MPH (SUNY-University of Buffalo Neurology) PRESENTER	No disclosure on file
Neetu Agashivala (Novartis Pharmaceutical Corporation)	No disclosure on file
Ron Hashmonay, MD	No disclosure on file
Bianca Weinstock-Guttman, MD (Department of Neurology, University At Buffalo)	Dr. Weinstock-Guttman has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Biogen. Dr. Weinstock-Guttman has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Genentech. Dr. Weinstock-Guttman has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Novartis . Dr. Weinstock-Guttman has received personal compensation in the range of $500-$4,999 for serving as a Consultant for EMD Serono. Dr. Weinstock-Guttman has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Abbvie. Dr. Weinstock-Guttman has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genzyme &Sanofi. Dr. Weinstock-Guttman has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Janssen . Dr. Weinstock-Guttman has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Bayer. Dr. Weinstock-Guttman has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Horizon. Dr. Weinstock-Guttman has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genentech. Dr. Weinstock-Guttman has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Weinstock-Guttman has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Biogen. Dr. Weinstock-Guttman has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Janssen. Dr. Weinstock-Guttman has received personal compensation in the range of $0-$499 for serving as a Reviewer with NIH.
Stefan M. Pulst, MD, FAAN (University of Utah)	Dr. Pulst has received personal compensation in the range of $500-$4,999 for serving as a Consultant for venrock. Dr. Pulst has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Arrowhead. Dr. Pulst has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Leverna. Dr. Pulst has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for AAN. Dr. Pulst has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Leninthal LLC. The institution of Dr. Pulst has received research support from NINDS. Dr. Pulst has received intellectual property interests from a discovery or technology relating to health care.

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