Abstract Details

Title Evolution of the Treatment Landscape for Patients Diagnosed with Amyotrophic Lateral Sclerosis in the United States

Topic General Neurology

Presentation(s) P9 - Poster Session 9 (11:45 AM-12:45 PM)

Poster/Presentation
Number 2-006

Objective Describe the evolution of the treatment landscape for patients diagnosed with amyotrophic lateral sclerosis (ALS).

Background Treatment options for ALS aim at modifying disease, alleviating symptoms, and improving quality of life. Over the past decade, United States Food and Drug Administration (FDA)-approved treatments for ALS have evolved.

Design/Methods Patients aged ≥12 years with incident ALS between January 2016 through December 2022 were identified using the Inovalon closed claims database sourced through HealthVerity. Patients were required to have continuous enrollment for 6 months before and after incident ALS diagnosis. FDA-approved ALS treatments, including riluzole, Mitsubishi Tanabe Pharma America (MTPA) IV (intravenous) and oral edaravone (Radicava® IV and Radicava ORS®), and sodium phenylbutyrate and taurursodiol (withdrawn from the US market following this analysis period), initiated within 6 months of ALS diagnosis and on/after the incident ALS diagnosis were examined by ALS diagnosis year.

Results

We observed an increase in the use of riluzole among patients with ALS diagnosed between 2016 and 2022, from 5.9% in 2016 to 24.8% in 2022. MTPA IV edaravone was introduced in 2017, and its use increased from 1% to 4.8% between 2017 and 2021. However, with the introduction of MTPA oral edaravone in 2022, use of MTPA IV edaravone decreased to 1%, while use of MTPA oral edaravone increased to 8.9%. Over the study period, a decrease was observed in untreated patients with ALS, from 87.1% in 2016 to 70.7% in 2022.

Conclusions During the 2016-2022 period, there was increased use of riluzole and a slow shift toward MTPA IV edaravone. With FDA approval of MTPA oral edaravonein 2022, there was a shift observed toward this newer option. Although many patients still had not received any FDA-approved treatments, that number has decreased, possibly due, in part, to the approval of MTPA oral edaravone.

Authors/Disclosures
Malgorzata Ciepielewska PRESENTER	Malgorzata Ciepielewska has received personal compensation for serving as an employee of Mitsubishi Tanable Pharma America, Inc..
Aastha Chandak, PhD	Dr. CHANDAK has received personal compensation for serving as an employee of Certara.
Artak Khachatryan, MD, PhD, MPH	Dr. Khachatryan has received personal compensation for serving as an employee of Certara.
Alekhya lavu, PhD, PharmD	Dr. lavu has nothing to disclose.
Polina Da Silva, Other (Mitsubishi Tanabe Pharma America)	Mrs. Da Silva has nothing to disclose.

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