Abstract Details

Title Untreated Patients with Multiple Sclerosis: Prevalence and Characteristics in Denmark and in the United States

Topic Multiple Sclerosis

Presentation(s) P4 - Poster Session 4 (5:30 PM-6:30 PM)

Poster/Presentation
Number 15-060

Objective To assess numbers of untreated patients with multiple sclerosis (MS), and their demographic/clinical characteristics in Denmark and the United States (US).

Background Evidence suggests disease modifying therapies (DMTs) should be offered as soon as possible after MS diagnosis. Estimates of numbers of patients with MS who remain untreated post-diagnosis are few and variable.

Design/Methods Patients ≥18 years of age with MS were identified through the Danish Multiple Sclerosis Registry (incident MS cases, 1995-2015, index date: start of diagnosis year) and US MarketScan® Research Database (2011-2014, index date: first MS ICD-9 code). Patients with <12 months’ history prior to index date were excluded. Untreated MS cohorts were defined as patients without any DMT during follow-up.

Results Among 10,557 Danish MS patients, 2,994 (28.4%) were untreated (median follow-up 12 years; IQR, 7-17). Among 75,473 US patients, 32,434 (43.0%) remained untreated at time of observation (median follow-up 1.8 years; IQR, 0.9-2.9). Untreated Danish patients were older at time of diagnosis (median age 48 years (IQR, 40-55) vs 39 years (IQR, 31-48 in the overall MS cohort) and were diagnosed in the earlier years (1995-2004; 63.3% vs 45.5% in the overall cohort). Almost twice as many untreated Danish patients were diagnosed with primary progressive MS (PPMS) than relapsing-remitting MS. Untreated US patients were median 53 years of age (IQR, 44-61). Pre-index, 10.7% of untreated patients received hormone therapy (overall patients, 15.3%), 32.1% a glucocorticoid (overall patients, 36.8%), and 7.1% a DMT (overall patients, 43.3%). In prior DMT patients, 1,833 (79.1%) received immunomodulator-only treatment.

Conclusions Given evidence of benefits of early, effective treatment, these results may encourage more widespread early treatment for MS. The high proportion of untreated patients in the US and in the identified cohort from the Danish MS Registry may be due to a higher proportion of PPMS patients lacking treatment options during the study period.

Authors/Disclosures
PRESENTER	No disclosure on file
	No disclosure on file
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.
	No disclosure on file
	No disclosure on file
Finn Sellebjerg, MD (Copenhagen University Hospital Rigshospitalet)	Dr. Sellebjerg has received personal compensation for serving as an employee of Danish Multiple Sclerosis Society. Dr. Sellebjerg has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Novartis. Dr. Sellebjerg has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Sellebjerg has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Sellebjerg has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Sellebjerg has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi Genzyme. Dr. Sellebjerg has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Biogen. Dr. Sellebjerg has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Roche. Dr. Sellebjerg has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Novartis. Dr. Sellebjerg has received personal compensation in the range of $500-$4,999 for serving as an officer or member of the Board of Directors for Gangsted Foundation. Dr. Sellebjerg has received personal compensation in the range of $500-$4,999 for serving as an officer or member of the Board of Directors for Warwara Larsen Foundation. The institution of Dr. Sellebjerg has received research support from Biogen. The institution of Dr. Sellebjerg has received research support from Merck. The institution of Dr. Sellebjerg has received research support from Novartis. The institution of Dr. Sellebjerg has received research support from Sanofi Genzyme. Dr. Sellebjerg has received publishing royalties from a publication relating to health care.
Per Soelberg Sorensen	No disclosure on file
	No disclosure on file

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