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Abstract Details

MS Therapy Persistence and Treatment Patterns
MS and Related Diseases
P03 - (-)
200
BACKGROUND: With the accumulation of safety and effectiveness data for disease-modifying therapies (DMT) and the introduction of new therapies for MS, treatment patterns are changing.
DESIGN/METHODS: Potential participants for TOP MS, a prospective, observational study, were identified at specialty pharmacies beginning in December 2008. Enrollees had a MS diagnosis; half were being treated with glatiramer acetate (GA) and half with beta interferon (IFN). Signed informed consents were returned to the pharmacies. Study enrollment produced log-on instructions for the study website where responses were entered. DMT use was assessed each month. Drug holidays, persistence, and therapy changes (including stopping) and reasons were recorded.
RESULTS: Of the 2530 participants with a minimum of one year of follow-up, 2293 (90.6%) continued to use the same DMT. More users of GA than IFN persisted on therapy (Chi square 19.4; p < 0.004). Among those who persisted, 24 patients took drug holidays averaging 2.4 months (most often for financial reasons or common side effects) before resuming their DMT. Those who discontinued their initial DMT stopped for similar reasons. There were 172 therapy changes among 156 patients (6.2%): 32.6% of the changes originated with GA while 65.6% of the changes originated with IFN. Nearly 50% of DMT changes were to the newer therapies (natalizumab, INF beta-1b [Extavia], fingolimod); 29% to IFN and 22% to GA. Predominant reasons for changing therapies were ineffectiveness, worsening of symptoms, and doctor preferred a different medication.
CONCLUSIONS: Persistence on the same DMT is high among patients on therapy for a year or more. For those with a change of therapy, there was a marked shift in prescribing toward the newer therapies in response to signs of therapy ineffectiveness.
Authors/Disclosures
Clyde E. Markowitz, MD (Hospital of the Univ of Pennsylvania)
PRESENTER 		No disclosure on file
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.
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.
Bruce A. Cohen, MD, FAAN (Northwestern University, Feinberg School of Medicine) 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.
Howard Zwibel, MD 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.
Clifford R. Jack, Jr., MD (Mayo Clinic) The institution of Dr. Jack has received research support from NIH. The institution of Dr. Jack has received research support from Alexander Family Alzheimer's Disease Research Professorship of the Mayo Clinic.