Relapse outcomes, safety, and treatment patterns in patients diagnosed with relapsing-remitting multiple sclerosis and initiated on subcutaneous interferon β-1a or dimethyl fumarate: a real-world study. (2nd December 2017)

• Record Type: Journal Article
• Authors: Ernst, Frank R.; Barr, Peri; Elmor, Riad; Wong, Schiffon L.
• Is Part Of: Current medical research and opinion. Volume 33:Number 12(2017)
• Page Start: 2099
• Page End: 2106
• Publication Date: 2017-12-02
• Subjects: Multiple sclerosis -- relapsing-remitting -- interferon β-1a -- dimethyl fumarate -- observational study; Clinical medicine -- Periodicals; Therapeutics -- Periodicals; 615.5
• DOI: 10.1080/03007995.2017.1380616
• Languages: English
• ISSNs: 0300-7995

Abstract

Abstract: Objective: To estimate real-world treatment patterns, safety, and relapse outcomes of subcutaneous (sc) interferon (IFN) β -1a (Rebif) vs dimethyl fumarate (DMF; Tecfidera), to treat relapsing-remitting multiple sclerosis (RRMS). Methods: A US retrospective chart review of 450 randomly selected adults newly diagnosed with RRMS who received sc IFN β -1a ( n = 143) or DMF ( n = 307) was conducted. Patients were either (a) treatment-naïve, initiating first-line treatment with sc IFN β -1a or DMF, or (b) previously treated, switching to sc IFN β -1a or DMF. Two years' follow-up data were captured. Patient characteristics, persistence, and adverse events between treatment groups were compared using t -tests or Chi-square tests. Kaplan-Meier curves with log-rank tests and Cox proportional hazards models were used to compare time to, and risk of non-persistence. Annualized Relapse Rates (ARR) were calculated using a robust variance Poisson model adjusting for covariates. Propensity scores were used to address possible selection bias. Results: One hundred and twelve patients became non-persistent, most commonly due to an adverse event ( n = 37). No difference was observed in time to overall non-persistence between sc IFN β -1a and DMF patients. Among treatment-naïve patients, those receiving DMF had 2.4-times the risk (HR = 2.439, 95% CI = 1.007–5.917, p = .0483) of experiencing a discontinuation than patients receiving sc IFN β -1a. Non-persistent patients receiving DMF had 2.3-times the risk (HR = 2.311, 95% CI = 1.350–3.958, p = .0023) of experiencing an adverse event at a given time point than patients prescribed sc IFN β -1a. No differences in relapse risk or ARR between sc IFN β -1a- and DMF-treated patients were observed. Conclusions: sc IFN β -1a-treated patients had comparable persistence and relapse outcomes, and better safety outcomes vs DMF-treated patients across 2 years.