Treatment Patterns Among Patients with Multiple Sclerosis Initiating Second-Line Disease-Modifying Therapy

Area of Science:

• Neurology
• Clinical Research
• Real-World Evidence

Background:

• Disease-modifying therapies (DMTs) are crucial for managing multiple sclerosis (MS) relapse rates.
• Treatment effectiveness can vary among individuals with MS.
• Understanding real-world treatment patterns and their association with MS relapses is essential, particularly for patients switching therapies.

Purpose of the Study:

• To describe multiple sclerosis (MS) relapses in relation to treatment patterns among patients switching their first disease-modifying therapy (DMT).
• To analyze the persistence and relapse rates associated with different DMT switching patterns.

Main Methods:

• Utilized IBM MarketScan research databases to identify adult MS patients who switched DMTs after initial treatment.
• Defined non-persistence as DMT discontinuation (≥60 days) or switching.
• Employed a validated claims-based algorithm for MS relapse definition and multivariable analysis for persistence and relapse outcomes.

Main Results:

• Of 4121 MS patients, 49.6% switched to oral DMTs, 36.5% to injectables, and 13.9% to infusions.
• Switching DMTs reduced relapses by 32.4%; however, only 54.6% of patients remained persistent in the first year.
• Oral DMT switchers showed higher persistence (95% odds) and lower relapse odds (18%) versus injectable switchers; baseline relapses predicted post-index relapses.

Conclusions:

• Persistence with disease-modifying therapies (DMTs) remains consistently low among multiple sclerosis (MS) patients who switch treatments.
• Oral DMTs exhibited slightly higher persistence compared to injectable DMTs.
• There is a critical need to enhance long-term persistence with second-line DMTs in MS management.