049 Real world evidence (RWE) on impact of age on long-term persistence to disease modifying therapies (DMTS) in relapsing-remitting multiple sclerosis (RRMS) in australia. (29th July 2019)

• Record Type: Journal Article
• Authors: Kornberg, Andrew; Spelman, Tim; Schulz, Mark; Arora, Birendra; Chung, Eric; Juneja, Prabjot; Walker, Robert; Walt, Anneke van der; Butzkueven, Helmut
• Is Part Of: Journal of neurology, neurosurgery and psychiatry. Volume 90(2019)e7
• Page Start: A16
• Page End: A17
• Publication Date: 2019-07-29
• Subjects: Neurology -- Periodicals; Nervous system -- Surgery -- Periodicals; Psychiatry -- Periodicals; 616.8
• DOI: 10.1136/jnnp-2019-anzan.44
• Languages: English
• ISSNs: 0022-3050

Abstract

Abstract : Background: Age has been independently associated with higher rates of treatment discontinuation in multiple sclerosis. Objective: The current study examines the impact of age on persistence for all reimbursed DMTs for RRMS in Australia. Methods: The Pharmaceutical Benefits Scheme (PBS) 10% sample supplied by the Department of Human Services was used in this study. Eligible patients must have received a script for a reimbursed DMT for RRMS between September 2011 and February 2016. Patients were classified into five age-groups (ages 18–30; 31–40; 41–50; 51–60; 61+) and defined as persistent if their DMT script was filled within 4 months. Persistence was derived using the Kaplan-Meier method and hazard ratios (HR) to represent the relative rate of drop-off of different age groups. Results: Patients aged 18–30 (n=250) had a 44% increased risk of discontinuation (HR 1.44 (95%CI: 1.22–1.72) compared to the 'all ages' cohort (n=1, 866); no significant difference was observed for any other age group (HRs between 1.08 and 0.92). Patients in this 18–30 age-group had a significantly higher risk of discontinuation on injectable therapy (glatiramer acetate, interferon beta-1a, interferon beta-1b) compared to those on non-injectable therapy (dimethyl fumarate, fingolimod, natalizumab, teriflunomide) (HR 2.42 (95% CI: 1.63–3.61). Conclusions: Patients aged 18–30 were the least persistent age group in this study. Patients aged 18–30 were less persistent on injectable than non-injectable DMTs.