To evaluate real-world persistence and adherence on DRF treatment in patients with MS in the Optum™ claims database.

DRF, a next-generation oral fumarate approved for relapsing forms of MS, has the same active metabolite (monomethyl fumarate) as dimethyl fumarate (DMF) and improved gastrointestinal (GI) tolerability versus DMF. Most discontinuations due to GI tolerability occur during the first 1-3 months of treatment. Early real-world pharmacy data shows high persistence and adherence in patients treated with DRF after 3 months.

This was a retrospective analysis of the Optum™ claims database. Eligible patients had ≥1 MS claim 01Oct2019–31Mar2021 and ≥6 months history before treatment with DRF or another disease-modifying therapy (DMT: DMF/teriflunomide/fingolimod/siponimod). Persistence was assessed as percentage of patients continuously treated during follow-up (allowable gap, 30 days). Adherence was estimated using proportion of days covered (PDC). Follow-up was calculated as treatment initiation to either loss of eligibility or end of data (31Mar2021).

Of 62,493 patients with ≥1 MS claim, 1985 met the inclusion criteria: (DRF, n=224; DMF, n=846; teriflunomide, n=601; fingolimod, n=182; siponimod, n=132). Mean (SD) age ranged from 45.7 (12.2) to 53.9 (11.9) years. Mean (SD) days follow-up for patients receiving DRF was 109.4 (101.3) and ranged from 95.9 (63.3) to 320.1 (130.3) for other DMTs. At 90-day, persistence rates were: DRF, 85%; DMF, 83%; teriflunomide, 90%; fingolimod, 89%; siponimod, 92%. During treatment, mean (SD) adherence rates based on PDC were: DRF, 0.85 (0.24); DMF, 0.6 (0.29); teriflunomide, 0.78 (0.28); fingolimod, 0.81 (0.28); siponimod, 0.83 (0.25).

Real-world claims data demonstrated high persistence on DRF after 90 days, supporting DRF as a well-tolerated treatment option. Adherence rates were high throughout time on treatment for patients on DRF. Outcomes for DRF are consistent with or higher than those for other DMTs observed in the same treatment period.

Study Supported by: Biogen