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Comparative effectiveness of fingolimod versus interferons or glatiramer acetate for relapse rates in multiple sclerosis: a retrospective US claims database analysis.
Curr Med Res Opin 2013; 29(12):1647-56CM

Abstract

OBJECTIVE

Disease-modifying therapies, such as fingolimod, interferon (IFN) and glatiramer acetate (GA), have differing effects on relapse rates in patients with multiple sclerosis (MS), but little is known about the real-world differences in relapse rates with these treatments. This retrospective study assessed relapse rates in patients with active MS initiating fingolimod, IFN or GA therapy in a real-world setting.

METHODS

Using administrative claims data from the US PharMetrics Plus database, we identified previously treated and untreated patients with MS who initiated fingolimod, IFN or GA treatment between 1 October 2010 and 31 March 2011 and had experienced a relapse in the previous year. A claims-based algorithm was used to identify relapses over the persistence period in patients with 540 days of post-index continuous enrolment. A logistic regression model assessed the probability of having at least one relapse and a generalized linear model estimated differences in annualized relapse rates (ARRs).

RESULTS

The study enrolled 525 patients (fingolimod, n = 128; combined IFN/GA cohort, n = 397) of the 31,041 initially identified. Similar findings for fingolimod and IFN/GA were observed for the unadjusted proportion of patients experiencing relapses (31.3% vs. 34.0%, respectively; p = 0.5653) and ARRs (0.50 vs. 0.55, respectively) while persistent to treatment. After adjusting for baseline differences, fingolimod was associated with a 52% reduction in the probability of having a relapse (odds ratio, 0.48; 95% confidence interval [CI], 0.28-0.84; p = 0.0097) and a 50% reduction in ARR (rate ratio, 0.50; 95% CI, 0.34-0.75; p = 0.0006) compared with IFN/GA.

LIMITATIONS

Identification of relapses is based on the claims in the database rather than on a clinical assessment.

CONCLUSIONS

In a real-world setting, fingolimod was shown to be associated with significantly lower relapse rates than IFN/GA in patients with MS who had a history of relapses.

Authors+Show Affiliations

Novartis Pharma AG , Basel , Switzerland.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Conference
Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

24059944

Citation

Bergvall, Niklas, et al. "Comparative Effectiveness of Fingolimod Versus Interferons or Glatiramer Acetate for Relapse Rates in Multiple Sclerosis: a Retrospective US Claims Database Analysis." Current Medical Research and Opinion, vol. 29, no. 12, 2013, pp. 1647-56.
Bergvall N, Makin C, Lahoz R, et al. Comparative effectiveness of fingolimod versus interferons or glatiramer acetate for relapse rates in multiple sclerosis: a retrospective US claims database analysis. Curr Med Res Opin. 2013;29(12):1647-56.
Bergvall, N., Makin, C., Lahoz, R., Agashivala, N., Pradhan, A., Capkun, G., ... Korn, J. R. (2013). Comparative effectiveness of fingolimod versus interferons or glatiramer acetate for relapse rates in multiple sclerosis: a retrospective US claims database analysis. Current Medical Research and Opinion, 29(12), pp. 1647-56. doi:10.1185/03007995.2013.847411.
Bergvall N, et al. Comparative Effectiveness of Fingolimod Versus Interferons or Glatiramer Acetate for Relapse Rates in Multiple Sclerosis: a Retrospective US Claims Database Analysis. Curr Med Res Opin. 2013;29(12):1647-56. PubMed PMID: 24059944.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparative effectiveness of fingolimod versus interferons or glatiramer acetate for relapse rates in multiple sclerosis: a retrospective US claims database analysis. AU - Bergvall,Niklas, AU - Makin,Charles, AU - Lahoz,Raquel, AU - Agashivala,Neetu, AU - Pradhan,Ashish, AU - Capkun,Gorana, AU - Petrilla,Allison, AU - Karkare,Swapna U, AU - Balderston McGuiness,Catherine, AU - Korn,Jonathan R, Y1 - 2013/10/01/ PY - 2013/9/25/entrez PY - 2013/9/26/pubmed PY - 2014/6/24/medline SP - 1647 EP - 56 JF - Current medical research and opinion JO - Curr Med Res Opin VL - 29 IS - 12 N2 - OBJECTIVE: Disease-modifying therapies, such as fingolimod, interferon (IFN) and glatiramer acetate (GA), have differing effects on relapse rates in patients with multiple sclerosis (MS), but little is known about the real-world differences in relapse rates with these treatments. This retrospective study assessed relapse rates in patients with active MS initiating fingolimod, IFN or GA therapy in a real-world setting. METHODS: Using administrative claims data from the US PharMetrics Plus database, we identified previously treated and untreated patients with MS who initiated fingolimod, IFN or GA treatment between 1 October 2010 and 31 March 2011 and had experienced a relapse in the previous year. A claims-based algorithm was used to identify relapses over the persistence period in patients with 540 days of post-index continuous enrolment. A logistic regression model assessed the probability of having at least one relapse and a generalized linear model estimated differences in annualized relapse rates (ARRs). RESULTS: The study enrolled 525 patients (fingolimod, n = 128; combined IFN/GA cohort, n = 397) of the 31,041 initially identified. Similar findings for fingolimod and IFN/GA were observed for the unadjusted proportion of patients experiencing relapses (31.3% vs. 34.0%, respectively; p = 0.5653) and ARRs (0.50 vs. 0.55, respectively) while persistent to treatment. After adjusting for baseline differences, fingolimod was associated with a 52% reduction in the probability of having a relapse (odds ratio, 0.48; 95% confidence interval [CI], 0.28-0.84; p = 0.0097) and a 50% reduction in ARR (rate ratio, 0.50; 95% CI, 0.34-0.75; p = 0.0006) compared with IFN/GA. LIMITATIONS: Identification of relapses is based on the claims in the database rather than on a clinical assessment. CONCLUSIONS: In a real-world setting, fingolimod was shown to be associated with significantly lower relapse rates than IFN/GA in patients with MS who had a history of relapses. SN - 1473-4877 UR - https://www.unboundmedicine.com/medline/citation/24059944/Comparative_effectiveness_of_fingolimod_versus_interferons_or_glatiramer_acetate_for_relapse_rates_in_multiple_sclerosis:_a_retrospective_US_claims_database_analysis_ L2 - http://www.tandfonline.com/doi/full/10.1185/03007995.2013.847411 DB - PRIME DP - Unbound Medicine ER -