Abstract Details

Title Variation in Time to First Disease Modifying Therapy in people with MS in the United States, United Kingdom, and Germany

Topic Multiple Sclerosis

Presentation(s) S29 - Multiple Sclerosis: Disease-modifying Therapy (2:12 PM-2:24 PM)

Poster/Presentation
Number 007

Objective To investigate the time to first Disease Modifying Therapy (DMT) after diagnosis in three large multiple sclerosis (MS) registry populations, NARCOMS, United Kingdom (UKMSR) and Germany (GMSR).

Background The number of DMT options in MS has increased over time. Recent EAN/ECTRIMS guidelines have highlighted the need for early introduction of DMT. [Montalban et al. 2018] Still comparable data for the time from MS diagnosis till the start of the first DMT is scare.

Design/Methods Each registry captures demographics, disability status (categorized as mild, moderate or severe) and treatment status. Inclusion criteria were a relapsing disease course, diagnosis in 2014-2018 and provided data on DMT and disability status. The overall and age-, gender- and disability-specific times to first DMT after diagnosis were summarized. Kaplan-Meier curves were used to examine the median time to first DMT (in years) and Cox regression models for covariates of interest (gender, age at diagnosis, disability) were performed. Participants were censored at the date of the last recorded visit. Comparisons between countries were evaluated in a meta-analytic approach.

Results 2700 participants (NARCOMS:306, UKMSR:675, GMSR:1719) fulfilled the inclusion criteria. The overall median time to first DMT was shortest in Germany [0.21 (0.08, 0.78)] followed by the UK [0.55 (0.25, 2.33) ] and NARCOMS [1.0 (0.33, 1.00)]. 4.5 years after diagnosis, a vast majority (93.5%) of NARCOMS participants received a DMT where as in Germany 16.4% and more than 36.1 % in the UK have not received a DMT by that point. Cox regressions showed that higher age (61+) [p<0.001] and moderate disability [e.g. EDSS > 3 & < 6, p<0.035] are associated with a longer time to first DMT.

Conclusions Time to first DMT varied across countries, however, a larger proportion of PwMS in NARCOMS did receive a DMT at last recorded visit within 5 years of diagnosis than in Germany and the UK.

Authors/Disclosures
PRESENTER	No disclosure on file
	No disclosure on file
Ruth-Ann Marrie, MD, PhD (University of Manitoba)	The institution of Dr. Marrie has received research support from CIHR. The institution of Dr. Marrie has received research support from MS Canada. The institution of Dr. Marrie has received research support from National MS Society. The institution of Dr. Marrie has received research support from Crohn's and Colitis Canada. The institution of Dr. Marrie has received research support from US Department of Defense. The institution of Dr. Marrie has received research support from The Arthritis Society. The institution of Dr. Marrie has received research support from CMSC.
Rod Middleton (Data Scienve Building)	The institution of Mr. Middleton has received research support from MS Society.
Richard S. Nicholas, FRCP (Imperial College Healthcare Trust)	Dr. Nicholas has nothing to disclose.
Jeff Rodgers	Jeff Rodgers has nothing to disclose.
Amber Salter, PhD (UT Southwestern Medical Center)	Dr. Salter has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Gryphon Bio. Dr. Salter has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Abata Therapeutics. Dr. Salter has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Sora Neuroscience. Dr. Salter has stock in Owl Therapeutics. The institution of Dr. Salter has received research support from National Multiple Sclerosis Society. The institution of Dr. Salter has received research support from Department of Defense Congressionally Directed Medical Research Program. The institution of Dr. Salter has received research support from Consortium of Multiple Sclerosis Centers. The institution of Dr. Salter has received research support from Multiple Sclerosis Society of Canada.

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