Persistence with multiple sclerosis disease-modifying therapies is highest when switching to fingolimod compared with other oral and injectable therapies: a retrospective US claims database analysis (P2.397)

Objective: Assess persistence with oral (fingolimod, dimethyl fumarate [DMF], teriflunomide) and injectable (interferons, glatiramer acetate [GA]) disease-modifying therapies (DMTs) among patients switching from interferon/GA. Background: Persistence, an indirect measure of treatment tolerability and effectiveness, may improve patient outcomes. Design/Methods: Patients switching from interferon to oral DMTs, GA or another interferon, or from GA to oral DMTs or interferons, between 09/22/2010 and 12/31/2013 were identified from the US PharMetrics Plus database. Patients aged ≥18 years at index date (date of treatment switch) with a multiple sclerosis diagnosis and continuous health plan enrolment in the 12-month pre-index and 24-month post-index periods were included. Persistence (mean number of consecutive days from index date to last supply of DMT, switch to another DMT or end of the study period [allowing for a ≥60-day gap], whichever occurred first) was assessed at 3, 6, 9, 12 and 24 months in this descriptive analysis. Results: In total, 2226 patients switched from interferon (n=653 to fingolimod, n=663 to DMF, n=108 to teriflunomide, n=513 to GA, n=289 to interferon); 1441 patients switched from GA (n=368 to fingolimod, n=531 to DMF, n=72 to teriflunomide, n=470 to interferon). When switching from interferon, 24-month persistence was highest among patients receiving fingolimod, then teriflunomide, DMF, GA and another interferon (persistent days [95% confidence interval]: 552 [533–572], 507 [454–561], 505 [484–527], 435 [411–459] and 403 [371–435] days, respectively). When switching from GA, 24-month persistence was highest among those switching to fingolimod, then teriflunomide, DMF and interferon (530 [503–556], 490 [424–557], 469 [445–494] and 385 [360–409] days, respectively). The pattern of persistence across DMTs over 3, 6, 9 and 12 months was consistent with that over 24 months. Conclusions: Persistence over 24 months was highest for patients switching from interferon/GA to fingolimod than to other DMTs. Study Supported by: Novartis Pharma AG Disclosure: Dr. Korn has received personal compensation for activities with QuintilesIMS. Dr. Medin has received personal compensation for activities with Novartis Pharma AG as an employee. Dr. Fang has received personal compensation for activities with Novartis Pharmaceuticals as an employee. Dr. Putzki has received personal compensation for activities with Novartis Pharma AG as an employee.