Abstract Details

Title Real-world Treatment Outcomes in People with Multiple Sclerosis Switched from Platform MS Treatments to Fumarates Versus Other Oral Disease-modifying Therapies

Topic Multiple Sclerosis

Presentation(s) P8 - Poster Session 8 (8:00 AM-9:00 AM)

Poster/Presentation
Number 1-010

Objective Assess the real-world effectiveness of fumarates (FUM) compared to sphingosine 1-phosphate receptor modulators (S1Ps) and cladribine (CLAD) in people with multiple sclerosis (MS) switching from platform MS disease-modifying therapies (DMTs) by evaluating annualized relapse rates (ARR), healthcare resource utilization (HCRU), and healthcare costs (HCC).

Background MS is a chronic autoimmune disease causing significant morbidity and healthcare utilization. The varying benefit/risk profiles of DMTs complicate treatment choices. Real-world data on relapse rates and HCRU in patients switching from IFN, GA, or TERI to FUM versus S1P or CLAD are limited.

Design/Methods This retrospective study of the Komodo Health Claims Database included patients (18-64 years) with ≥1 claim for MS diagnosis. Patients were required to have a first claim for FUM, S1P, or CLAD ≤90 days after the last platform DMT claim between 01-Jan-2017 to 31-May-2022. Patients were followed until treatment discontinuation (>45-day gap), DMT switch, disenrollment, or death. ARR, time to first relapse, HCRU, and HCC were analyzed.

Results

After 2:1 propensity score matching, 1090 FUM were compared to 545 S1P patients and 178 FUM to 89 CLAD patients. Mean age was 44–46 years, females comprising 74.5–77.5% between cohorts.

The mean [95% CI] population-level ARR in FUM vs. S1P were 0.06 [0.05–0.08] vs 0.06 [0.04–0.08] (p=0.63) and in FUM vs. CLAD were 0.04 [0.02–0.08] vs 0.07 [0.02–0.22] (p=0.367), respectively. At 24 months, relapse-free rates proportion [95% CI] were 90.3% [87.6–93.1] FUM vs 91.4% [88.5–94.4] S1P (p=0.94) and 95.3% [91.5–99.2] FUM vs 93.1% [87.0–99.6] CLAD (p=0.61). No significant differences in HCRU (all-cause or MS-related) were observed. MS-related HCC [95% CI] were $640.16 [603.77–678.74] FUM vs. S1P $720.06 [653.47–793.43] (p=0.044). FUM and CLAD HCCs were similar.

Conclusions In MS patients switching from platform therapies, FUM provides similar effectiveness and HCRU compared to S1Ps and CLAD.

Authors/Disclosures
Jose Avila-Ornelas, MD (Puerto Rico Multiple Sclerosis Center) PRESENTER	Dr. Avila-Ornelas has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Bristol Myers Squib. Dr. Avila-Ornelas has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen. Dr. Avila-Ornelas has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genentech. An immediate family member of Dr. Avila-Ornelas has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genentech. Dr. Avila-Ornelas has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Horizon. Dr. Avila-Ornelas has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. An immediate family member of Dr. Avila-Ornelas 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. Avila-Ornelas has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion. Dr. Avila-Ornelas has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for EMD Serono. An immediate family member of Dr. Avila-Ornelas has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for EMD Serono. An immediate family member of Dr. Avila-Ornelas has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Genzyme. Dr. Avila-Ornelas has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Biogen. An immediate family member of Dr. Avila-Ornelas has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Biogen. Dr. Avila-Ornelas has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Horizon. Dr. Avila-Ornelas has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Alexion. Dr. Avila-Ornelas has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Banner Pharmaceuticals.
Khaled Abdalla, MD (Winchester neurological consultants)	Dr. Abdalla has nothing to disclose.
Cortnee Roman, NP, DAAN (Rocky Mountain MS Clinic)	Ms. Roman has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Biogen. Ms. Roman has received personal compensation in the range of $500-$4,999 for serving as a Consultant for EMD Serono. Ms. Roman has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genentech. Ms. Roman has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genzyme. Ms. Roman has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Bristol Myers Squibb. Ms. Roman has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Ms. Roman has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Ms. Roman has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Bristol Myer Squibb. Ms. Roman has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genentech. Ms. Roman has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Novartis. Ms. Roman has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Genentech. Ms. Roman has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Genzyme. Ms. Roman has received personal compensation in the range of $50,000-$99,999 for serving on a Speakers Bureau for Biogen. Ms. Roman has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Bristol Myer Squibb/Celgene.
Yujie Wang, MD (UW Northwest)	Dr. Wang has received personal compensation in the range of $500-$4,999 for serving as a Consultant for TG Therapeutics. The institution of Dr. Wang has received research support from Genentech. The institution of Dr. Wang has received research support from uniQure. The institution of Dr. Wang has received research support from NIH/NINDS.
Marijean Buhse (Stony Brook University)	Marijean Buhse has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Biogen.
Boyang Bian	Boyang Bian has received personal compensation for serving as an employee of Biogen. Boyang Bian has stock in Biogen.
James B. Lewin, PharmD	Dr. Lewin has received personal compensation for serving as an employee of Biogen. Dr. Lewin has stock in Biogen.
Nicholas Belviso, PhD, PharmD	Dr. Belviso has received personal compensation for serving as an employee of Biogen.
Sai L. Shankar, PhD, FAAN (Biogen)	Dr. Shankar has received personal compensation for serving as an employee of Biogen. Dr. Shankar has stock in Biogen.

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