Medical and Pharmacy Claims Analysis Comparing Outcomes with Extended-Release Topiramate (Trokendi XR®) and Immediate-Release Topiramate (P2.169)

Objective: Use large national pharmacy and medical claims database to compare outcomes with extended-release topiramate (Trokendi-XR®, Supernus Pharmaceuticals) and immediate-release topiramate (TPM-IR) in migraine and epilepsy. Background: Trokendi XR: novel QD formulation bioequivalent with BID TPM-IR while producing more constant steady-state TPM plasma concentration-time profiles. Retrospective multisite medical record review suggested more favorable outcomes with Trokendi XR in epilepsy and migraine populations. National claims database provides larger dataset for outcome analysis. Design/Methods: Data source: medical and pharmacy claims data from HealthCore Integrated Research Database. Intake period [index claim for Trokendi XR or TPM-IR]: 8/1/2013 – 10/31/2014. Assessment period: 8/1/2012 – 4/30/2015. Other criteria: ≥6 yrs of age; continuous health plan enrollment ≥12 months pre-index and ≥6 months post-index. Continuous TPM therapy defined as Results: Analysis populations: 9064 migraineurs (Trokendi XR, 468; TPM-IR, 8596); 1463 epilepsy patients (Trokendi XR, 99; TPM-IR, 1364). Migraineurs were significantly (p 50% greater increase in cognitive dysfunction and dizziness were associated with initiation of TPM-IR vs. Trokendi XR. Similar patterns favoring Trokendi XR over TPM-IR in persistence and adherence were observed in epilepsy patients. Conclusions: In this retrospective claims-based study, Trokendi XR was associated with better outcomes vs. TPM-IR in migraineurs and epilepsy patients, including potential for fewer CNS (eg, cognitive) AEs in migraineurs. Analyses of larger datasets and prospective studies are needed to confirm these observations. Study Supported by: Supernus Pharmaceuticals, Inc. Disclosure: Dr. O9Neal has received personal compensation for activities with Supernus Pharmaceuticals, Inc. as an employee. Dr. Hur has received personal compensation for activities with Supernus Pharmaceuticals, Inc. as an employee. Dr. Liranso has received personal compensation for activities with Supernus Pharmaceuticals, Inc. as an employee. Dr. Chung has received personal compensation for activities with HealthCore, Inc. as an employee. Dr. Gu has received personal compensation for activities with HealthCore, Inc. as an employee. Dr. Turner has received personal compensation for activities with HealthCore, Inc. as an employee.