Abstract

Objective:
To compare relapse rates in multiple sclerosis (MS) patients switching from glatiramer acetate (GA) to fingolimod (FTY) versus those continuing treatment with GA.

Background:
Given the growing number of DMTs available for treatment of relapsing-remitting MS (RRMS), evidence generation to inform the use of individual agents and their treatment patterns is increasingly important.

Design/Methods:
A retrospective study was conducted using MarketScan Commercial Claims and Encounters and Medicare Supplemental and Coordination of Benefits Databases. MS patients (蠅1 claim ICD-9=340) treated with GA in the 12 months prior to their first prescription of the DMT of interest (pre-period) during 1/1/2010-9/30/2012 were identified and assigned to the treatment group is they switched to FTY or the control group if they remained on GA (GA→FTY versus GA only, respectively). Both groups were followed for twelve months (post-period). Demographics, clinical characteristics, and medication use were assessed in the pre-period. Analyses of trends and difference-in-differences (DD) were applied to evaluate relapse rates by group. Odds ratio of relapse between groups was estimated using logistic regression.

Results:
6,779 patients were included (GA only=6,416; GA→FTY=363). Significant differences were observed between groups in age, geographic region, non-DMT medication utilization, MS-related symptoms, and proportion of days covered. A decline in the percentage of relapses occurred in both groups in the post- versus pre-periods (GA→FTY=16.2[percnt]; GA only=2.5[percnt]). DD analyses indicated a 13.7[percnt] relapse rate reduction associated with GA→FTY versus GA only. Comparing the pre-period and the post-period, the odds of relapse was 2.63 and 1.22 respectively for GA→FTY versus GA only.

Conclusions:
Compared with patients remaining on GA, patients switching from GA to FTY demonstrated significant reductions in relapses over the 1-year timeframe. Characterization of key factors when considering a switch from GA to FTY is essential to informing appropriate treatment. Study Supported by: Novartis, KMK Consulting