Abstract Details

Title Comparing First-line Natalizumab and Ocrelizumab Use for the Treatment of Multiple Sclerosis: A Komodo Health Claims Database Study

Topic Multiple Sclerosis

Presentation(s) P7 - Poster Session 7 (5:00 PM-6:00 PM)

Poster/Presentation
Number 1-012

Objective To compare the difference of post-treatment initiation relapse outcomes as well as non-disease-modifying therapy (DMT) healthcare resource utilization (HCRU) and healthcare costs (HCC), in patients with multiple sclerosis (MS) who were treated with first-line natalizumab (NTZ, TYSABRI^®) or ocrelizumab (OCR).

Background MS relapses contribute to disability accumulation which impacts HCRU and HCC. Early use of high-efficacy DMTs like NTZ and OCR in newly-diagnosed MS patients have been shown to improve clinical outcomes. More studies comparing NTZ and OCR as first-line treatments are needed.

Design/Methods This retrospective observational study utilized data from a US healthcare claims database. Eligible patients were aged 18-64, newly diagnosed with MS between January 1, 2017 and March 31, 2022, and began first-line treatment with either NTZ or OCR ≤2 years of the initial MS diagnosis claim. Propensity score matching of NTZ and OCR cohorts was performed (1:2 ratio). Outcomes included annualized relapse rate (ARR) and non-DMT HCRU and HCC (inpatient [IP] admissions, emergency department [ED] and outpatient visits) estimated by generalized linear models.

Results After matching, 1261 NTZ and 2522 OCR patients were included. NTZ patients, versus OCR patients, had significantly lower ARR (mean 0.2 vs. 0.28, p<0.001), all-cause and MS-related non-DMT IP admissions (mean 0.06 vs. 0.09 admissions per person per year [PPPY], p=0.003; 0.05 vs. 0.08 PPPY, p=0.002) and ED visits (mean 0.39 vs. 0.48 PPPY, p=0.015; 0.17 vs. 0.22 PPPY, p=0.013), as well as all-cause and MS-related non-DMT IP associated costs (mean $15,924 vs. $23,124 PPPY, p=0.011; mean $15,623 vs. $22,317 PPPY, p=0.023).

Conclusions First-line NTZ was associated with significantly lower ARR, IP and ED HCRU, and IP HCC versus first-line OCR. With the increasing use of high-efficacy therapies early in the disease course, this study adds to the evidence that NTZ is a clinically and cost effective first-line therapy for newly diagnosed MS patients.

Authors/Disclosures
Danette J. Rutledge, PhD PRESENTER	Ms. Rutledge has received personal compensation for serving as an employee of Biogen. Ms. Rutledge has stock in Biogen.
Jeffrey M. Kaplan, MD (Kansas City MS and Headache Center)	Dr. Kaplan has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Lundbeck. Dr. Kaplan has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for EMD Serono. Dr. Kaplan has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for biohaven. Dr. Kaplan has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi. Dr. Kaplan has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Bristol Myers Squibb. Dr. Kaplan 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. Kaplan has received personal compensation in the range of $50,000-$99,999 for serving on a Speakers Bureau for Allergan. Dr. Kaplan has received personal compensation in the range of $50,000-$99,999 for serving on a Speakers Bureau for Lilly. Dr. Kaplan has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for EMD Serono. Dr. Kaplan has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Teva. Dr. Kaplan has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Alexion. Dr. Kaplan has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Sanofi. Dr. Kaplan has received personal compensation in the range of $50,000-$99,999 for serving on a Speakers Bureau for Biogen. Dr. Kaplan has received personal compensation in the range of $50,000-$99,999 for serving on a Speakers Bureau for Amgen. Dr. Kaplan has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Viela. Dr. Kaplan has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Biohaven. Dr. Kaplan has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Lundbeck.
Dana Beenstock, NP (CentraState Medical Center)	Mrs. Beenstock has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for TG Therapeutics. Mrs. Beenstock has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Bristol Meyer Squibb. Mrs. Beenstock has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Janssen.
Martin I. Belkin, DO (Michigan Institute for Neurological Disorders)	Dr. Belkin has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Bristol Meyers Squibb. Dr. Belkin has received personal compensation in the range of $500-$4,999 for serving as a Consultant for EMD Serono. Dr. Belkin has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Biogen. Dr. Belkin has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genzyme. Dr. Belkin has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Biogen. Dr. Belkin has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for EMD serono. Dr. Belkin has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Alexion. Dr. Belkin has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Genentech. Dr. Belkin has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Genzyme. Dr. Belkin has received stock or an ownership interest from Biogen.
Heidi J. Crayton, MD	The institution of Dr. Crayton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Bristol Myers Squibb. The institution of Dr. Crayton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for TG Therapeutics. The institution of Dr. Crayton has received personal compensation in the range of $100,000-$499,999 for serving on a Speakers Bureau for EMD Serono. The institution of Dr. Crayton has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for BMS. The institution of Dr. Crayton has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Biogen. The institution of Dr. Crayton has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Sandoz. The institution of Dr. Crayton has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for TG Therapeutics. The institution of Dr. Crayton has received research support from EMD Serono. The institution of Dr. Crayton has received research support from Sanofi. The institution of Dr. Crayton has received research support from Atara.
Christopher P. Eckstein, MD	The institution of Dr. Eckstein has received research support from Biogen. The institution of Dr. Eckstein has received research support from Genzyme.
Ruth K. Fredericks, MD (St. Domonic Health Services)	Dr. Fredericks has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Biogen. Dr. Fredericks has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Alexion.
Boyang Bian	Boyang Bian has received personal compensation for serving as an employee of Biogen. Boyang Bian has stock in Biogen.
Nicholas Belviso, PhD, PharmD	Dr. Belviso has received personal compensation for serving as an employee of Biogen.
Daphne Ni, PharmD	Dr. Ni has received personal compensation for serving as an employee of Biogen. Dr. Ni has stock in Biogen.

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