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Published on: December 9, 2015
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Increased relapse activity for multiple sclerosis natalizumab users who become nonpersistent: a retrospective study
R Brett McQueen1, Terrie Livingston, Timothy Vollmer
1University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Anschutz Medical Campus, Mail Stop C238, 12850 E. Montview Blvd., Aurora, CO 80045. Tel.: 303.709.9264; FAX: 303.724.0979. Robert.mcqueen@ucdenver.edu.
Journal of Managed Care & Specialty Pharmacy
|March 2, 2015
Summary
Consistent natalizumab use in relapsing-remitting multiple sclerosis (MS) is linked to better outcomes. Patients who switch from consistent to inconsistent natalizumab therapy experience more relapses and higher costs.
Area of Science:
- Neurology
- Pharmacology
- Health Services Research
Background:
- Natalizumab is an effective disease-modifying therapy for relapsing-remitting multiple sclerosis (MS).
- Real-world data on natalizumab persistence and its impact on relapse-related outcomes are limited.
Purpose of the Study:
- To assess the effect of consistent (persistent) versus inconsistent (nonpersistent) natalizumab use on relapse-related outcomes in MS patients.
- To evaluate other treatment patterns' impact on relapse-related outcomes for natalizumab initiators.
Main Methods:
- Utilized the IMS PharMetrics Plus claims database (2006-2012) for MS patients initiating natalizumab.
- Defined persistence as no 90-day gap in therapy; relapse as MS-related hospitalization or steroid burst claim.
- Analyzed changes in persistence status year-to-year, comparing mean annual relapses and costs.
Main Results:
- Persistent to nonpersistent transitions showed a significant increase in mean annual relapses (+0.23) and costs (+$1,346).
- Nonpersistent to persistent transitions indicated a nonsignificant decrease in mean annual relapses (-0.15) and costs (-$1,369).
Conclusions:
- Real-world data indicate that decreased natalizumab persistence is associated with increased relapses and costs in MS.
- Transitioning to consistent natalizumab therapy may offer benefits, though not statistically significant in this analysis.
