Abstract Details

Title Clinical Characteristics and Treatment Outcomes in Anti-CD20-treated Multiple Sclerosis Patients Who Switch to Natalizumab: A Komodo Health Sentinel Database Study

Topic Multiple Sclerosis

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

Poster/Presentation
Number 1-016

Objective To determine the clinical characteristics of patients with multiple sclerosis (MS) who switch from B-cell depleting therapies (anti-CD20s) to natalizumab (NTZ; TYSABRI^®); to estimate the annualized relapse rate (ARR), time to first relapse, and MS healthcare resource utilization (HRU) and healthcare costs (HCC).

Background NTZ and anti-CD20s are high-efficacy disease-modifying therapies (DMTs) approved to treat relapsing forms of MS. There is a paucity of published data on patients switching from anti-CD20s to NTZ.

Design/Methods Retrospective US claims data from 01Jan2016-15Apr2023 were used; index date was defined as the earliest date of the first NTZ claim following switch from anti-CD20. This analysis included adult patients with a diagnosis of MS (ICD-10-G35) who switched from any anti-CD20 to NTZ during the study period, with 12 months pre-index medical/pharmacy continuous enrolment.

Results Overall, 188 MS patients treated with anti-CD20 therapy (ocrelizumab, n=170; rituximab, n=18) met eligibility criteria; mean age: 43.5 years; 77% were female. The mean (SD) days on anti-CD20 was 489.6 (325.1). Most (120/188 [64%]) were treated with anti-CD20 for >360 days. Of the remaining 68 patients treated with anti-CD20 for <360, 19 received NTZ directly preceding anti-CD20. The mean (SD) duration (washout) from the last dose of anti-CD20 to NTZ initiation was 158.1 (68.7) days; duration of NTZ exposure was 440 (380) days. Overall, ARR (95% CI) was 0.21 (0.14, 0.32) while treated with anti-CD20, and 0.17 (0.11, 0.26) after switching to NTZ (rate ratio [95% CI]: 0.81 [0.48, 1.36]; p=0.42). The Kaplan Meier-estimated proportion of relapse-free patients at 12-months after switching from anti-CD20 to NTZ was 85.2% (79.4, 91.4). HRU and HCC were not statistically significant between the groups.

Conclusions Patients with MS who switched from anti-CD20 to NTZ in this claims database maintained similar ARR, percent of patients relapse-free, HCC, and HCRU. The long-term safety of this sequencing approach requires further research.

Authors/Disclosures
Jonathan C. Calkwood, MD (Minnesota Center for MS) PRESENTER	Dr. Calkwood has received personal compensation in the range of $500-$4,999 for serving as a Consultant for TG Therapeutics. Dr. Calkwood has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Octave Bio. Dr. Calkwood has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Biogen. Dr. Calkwood has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Genentech. Dr. Calkwood has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for TG Therapeutics. The institution of Dr. Calkwood has received research support from Sanofi. The institution of Dr. Calkwood has received research support from Novartis. The institution of Dr. Calkwood has received research support from Astra Zenica. The institution of Dr. Calkwood has received research support from TG Therapeutics. Dr. Calkwood has a non-compensated relationship as a Board of Trustees with National MS Society that is relevant to AAN interests or activities.
Jeffrey B. English, MD (Atlanta Neuroscience Institute)	Dr. English has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for biogen idec. Dr. English has received personal compensation in the range of $500-$4,999 for serving as a Consultant for bristol myer squibb. Dr. English has received personal compensation in the range of $500-$4,999 for serving as a Consultant for genentech. Dr. English has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for sanofi genzyme. Dr. English has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for biogen idec. Dr. English has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for genzyme. Dr. English has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for genentech. Dr. English has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for bristol myer squibb. Dr. English has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for TG Therpeutics. Dr. English has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for EMD Serono. Dr. English has received intellectual property interests from a discovery or technology relating to health care.
Harry Lay, NP (Raleigh Neurology Associates)	Mr. Lay has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for EMD/Serono. Mr. Lay has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Biogen. Mr. Lay has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Bristol Myers Squibb.
Daniel Long, DO (Neuroscience Group)	Dr. Long has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Alexion. Dr. Long has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Genzyme. Dr. Long has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Genetech. Dr. Long has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for BMS. Dr. Long has received personal compensation in the range of $50,000-$99,999 for serving as a Consultant for Biogen . Dr. Long has received personal compensation in the range of $100,000-$499,999 for serving as a Consultant for EMD.
Yang Mao-Draayer, MD (University of Michigan, Department of Neurology)	Dr. Mao-Draayer has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Biogen Idec. Dr. Mao-Draayer has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genzyme-Sanofi. Dr. Mao-Draayer has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genentech. Dr. Mao-Draayer has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genzyme-Sanofi. Dr. Mao-Draayer 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. Mao-Draayer has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Horizone. Dr. Mao-Draayer has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Biogen Idec. The institution of Dr. Mao-Draayer has received research support from NIH .
Claire Riley, MD, FAAN	Dr. Riley has received personal compensation for serving as an employee of AstraZeneca. Dr. Riley has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genentech. Dr. Riley has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for EMD Serono. Dr. Riley has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for TG Therapeutics. Dr. Riley has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Horizon. Dr. Riley has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Riley has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Amgen. Dr. Riley has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Immunic AG. Dr. Riley has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Cabaletta Bio. Dr. Riley 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. Riley 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. Riley has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for TG Therapeutics.
Thomas J. Shoemaker, MD (Rush University Medical Center)	Dr. Shoemaker has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Biogen. Dr. Shoemaker has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for AMGEN. Dr. Shoemaker has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for EMD Serono.
Lana Zhovtis Ryerson, MD, FAAN (Jersey Shore University Medical Center)	Dr. Zhovtis Ryerson has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Sanofi. Dr. Zhovtis Ryerson has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Sanofi.
Nicholas Belviso, PhD, PharmD	Dr. Belviso has received personal compensation for serving as an employee of Biogen.
Sarah England, PhD (Biogen)	Dr. England has received personal compensation for serving as an employee of Biogen. Dr. England has stock in Biogen.
Danette J. Rutledge, PhD	Ms. Rutledge has received personal compensation for serving as an employee of Biogen. Ms. Rutledge has stock in Biogen.

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