PND67 IDENTIFICATION AND CHARACTERIZATION OF HIGH DISEASE ACTIVITY RELAPSING REMITTING MULTIPLE SCLEROSIS ADULT PATIENTS BASED ON THE SNIIRAM DATABASE

Abstract

The healthcare management of high disease activity relapsing remitting multiple sclerosis (HDA RRMS) patients is more complex and more expensive than overall MS patients, though extensive data at the national level are so far lacking. Thus, we consider using the Système National d’Information Interrégimes de l’Assurance Maladie (SNIIRAM) database to document at national level, the long-term treatment with disease modifying therapies (DMT) and management pattern of HA-RRMS patients (up to 8 years). Objectives will include characterization of these patients, prevalence, incidence and mortality of HA-RRMS, and describe long-term healthcare resources used, with corresponding economic impact. A retrospective cohort study was conducted based on the comprehensive French National Health Insurance (NHI) SNIIRAM database. The inclusion period was from 01 January 2010 to 31 December 2015. The follow-up period was from 01 January 2010 to 31 December 2017. This design allowed a minimum of 2 years of follow-up for each HA RRMS patient and up to 8 years for patients included in 2010. An algorithm has been set up to identify HA-RRMS patients in the database with three non- exclusive criteria based on different parameters involving reimbursement of second line DMTs, relapses and Magnetic Resonance Imaging of the central nervous system. For the period considered, 12,830 adult patients with HA-RRMS have been identified. 9,249 patients were identified through the reimbursement of at least one reimbursement of second line DMT, and 3,581 from relapses. Patients were mainly women (sex ratio = 2.8) and with a mean age of 39.9 years (SD = 10.5). There were 1,490 incident patients in 2015. These first analyses of the SNIIRAM database bring new insights on the demographic characteristics, prevalence, incidence and medical history of a rarely studied sub-population of RR-MS patients.