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Relapse rates in patients with multiple sclerosis switching from interferon to fingolimod or glatiramer acetate: a US claims database study.
PLoS One 2014; 9(2):e88472Plos

Abstract

BACKGROUND

Approximately one-third of patients with multiple sclerosis (MS) are unresponsive to, or intolerant of, interferon (IFN) therapy, prompting a switch to other disease-modifying therapies. Clinical outcomes of switching therapy are unknown. This retrospective study assessed differences in relapse rates among patients with MS switching from IFN to fingolimod or glatiramer acetate (GA) in a real-world setting.

METHODS

US administrative claims data from the PharMetrics Plus™ database were used to identify patients with MS who switched from IFN to fingolimod or GA between October 1, 2010 and March 31, 2012. Patients were matched 1∶1 using propensity scores within strata (number of pre-index relapses) on demographic (e.g. age and gender) and disease (e.g. timing of pre-index relapse, comorbidities and symptoms) characteristics. A claims-based algorithm was used to identify relapses while patients were persistent with therapy over 360 days post-switch. Differences in both the probability of experiencing a relapse and the annualized relapse rate (ARR) while persistent with therapy were assessed.

RESULTS

The matched sample population contained 264 patients (n = 132 in each cohort). Before switching, 33.3% of patients in both cohorts had experienced at least one relapse. During the post-index persistence period, the proportion of patients with at least one relapse was lower in the fingolimod cohort (12.9%) than in the GA cohort (25.0%), and ARRs were lower with fingolimod (0.19) than with GA (0.51). Patients treated with fingolimod had a 59% lower probability of relapse (odds ratio, 0.41; 95% confidence interval [CI], 0.21-0.80; p = 0.0091) and 62% fewer relapses per year (rate ratio, 0.38; 95% CI, 0.21-0.68; p = 0.0013) compared with those treated with GA.

CONCLUSIONS

In a real-world setting, patients with MS who switched from IFNs to fingolimod were significantly less likely to experience relapses than those who switched to GA.

Authors+Show Affiliations

Novartis Pharma AG, Basel, Switzerland.IMS Health, Plymouth Meeting, Pennsylvania, United States of America.Novartis Pharma AG, Basel, Switzerland.Novartis Pharmaceuticals Corporation, East Hanover, New Jersey, United States of America.Novartis Pharmaceuticals Corporation, East Hanover, New Jersey, United States of America.Novartis Pharma AG, Basel, Switzerland.IMS Health, Plymouth Meeting, Pennsylvania, United States of America.IMS Health, Plymouth Meeting, Pennsylvania, United States of America.IMS Health, Plymouth Meeting, Pennsylvania, United States of America.IMS Health, Plymouth Meeting, Pennsylvania, United States of America.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

24516663

Citation

Bergvall, Niklas, et al. "Relapse Rates in Patients With Multiple Sclerosis Switching From Interferon to Fingolimod or Glatiramer Acetate: a US Claims Database Study." PloS One, vol. 9, no. 2, 2014, pp. e88472.
Bergvall N, Makin C, Lahoz R, et al. Relapse rates in patients with multiple sclerosis switching from interferon to fingolimod or glatiramer acetate: a US claims database study. PLoS ONE. 2014;9(2):e88472.
Bergvall, N., Makin, C., Lahoz, R., Agashivala, N., Pradhan, A., Capkun, G., ... Korn, J. R. (2014). Relapse rates in patients with multiple sclerosis switching from interferon to fingolimod or glatiramer acetate: a US claims database study. PloS One, 9(2), pp. e88472. doi:10.1371/journal.pone.0088472.
Bergvall N, et al. Relapse Rates in Patients With Multiple Sclerosis Switching From Interferon to Fingolimod or Glatiramer Acetate: a US Claims Database Study. PLoS ONE. 2014;9(2):e88472. PubMed PMID: 24516663.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Relapse rates in patients with multiple sclerosis switching from interferon to fingolimod or glatiramer acetate: a US claims database study. AU - Bergvall,Niklas, AU - Makin,Charles, AU - Lahoz,Raquel, AU - Agashivala,Neetu, AU - Pradhan,Ashish, AU - Capkun,Gorana, AU - Petrilla,Allison A, AU - Karkare,Swapna U, AU - McGuiness,Catherine Balderston, AU - Korn,Jonathan R, Y1 - 2014/02/06/ PY - 2013/08/29/received PY - 2014/01/04/accepted PY - 2014/2/12/entrez PY - 2014/2/12/pubmed PY - 2015/1/15/medline SP - e88472 EP - e88472 JF - PloS one JO - PLoS ONE VL - 9 IS - 2 N2 - BACKGROUND: Approximately one-third of patients with multiple sclerosis (MS) are unresponsive to, or intolerant of, interferon (IFN) therapy, prompting a switch to other disease-modifying therapies. Clinical outcomes of switching therapy are unknown. This retrospective study assessed differences in relapse rates among patients with MS switching from IFN to fingolimod or glatiramer acetate (GA) in a real-world setting. METHODS: US administrative claims data from the PharMetrics Plus™ database were used to identify patients with MS who switched from IFN to fingolimod or GA between October 1, 2010 and March 31, 2012. Patients were matched 1∶1 using propensity scores within strata (number of pre-index relapses) on demographic (e.g. age and gender) and disease (e.g. timing of pre-index relapse, comorbidities and symptoms) characteristics. A claims-based algorithm was used to identify relapses while patients were persistent with therapy over 360 days post-switch. Differences in both the probability of experiencing a relapse and the annualized relapse rate (ARR) while persistent with therapy were assessed. RESULTS: The matched sample population contained 264 patients (n = 132 in each cohort). Before switching, 33.3% of patients in both cohorts had experienced at least one relapse. During the post-index persistence period, the proportion of patients with at least one relapse was lower in the fingolimod cohort (12.9%) than in the GA cohort (25.0%), and ARRs were lower with fingolimod (0.19) than with GA (0.51). Patients treated with fingolimod had a 59% lower probability of relapse (odds ratio, 0.41; 95% confidence interval [CI], 0.21-0.80; p = 0.0091) and 62% fewer relapses per year (rate ratio, 0.38; 95% CI, 0.21-0.68; p = 0.0013) compared with those treated with GA. CONCLUSIONS: In a real-world setting, patients with MS who switched from IFNs to fingolimod were significantly less likely to experience relapses than those who switched to GA. SN - 1932-6203 UR - https://www.unboundmedicine.com/medline/citation/24516663/Relapse_rates_in_patients_with_multiple_sclerosis_switching_from_interferon_to_fingolimod_or_glatiramer_acetate:_a_US_claims_database_study_ L2 - http://dx.plos.org/10.1371/journal.pone.0088472 DB - PRIME DP - Unbound Medicine ER -