PSY132 - Patterns of Use of Disease Modifying Treatments Among Patients with Relapsing Remitting Multiple Sclerosis in Europe Between 2012 and 2016

Abstract

To assess the patterns of use of Disease Modifying Treatments (DMTs) between 2012 and 2016 among Relapsing Remitting Multiple Sclerosis (RRMS) patients in Europe (EU). Data are from an ongoing multi-center retrospective chart-review study of RRMS patients in 5-EU (5EU: UK/Germany/France/Italy/Spain). Data on diagnosis, clinical status, and treatment patterns are collected from health care providers (HCPs) with practice duration (≥3yrs) and patient volume (≥15 MS patients/month). Each HCP collects de-identified data from next 10 consecutive MS patients within the respective study windows. RRMS patients taking injectable (INJ), ORAL, or infusible (INF) DMTs were analyzed across five time-periods since 2012: Q42012/Q42013/Q42014/Q42015/Q42016. In total, 1395(Q42012)/1465(Q42013)/1601(Q42014)/1586(Q4015)/1591(Q416) eligible RRMS patient charts were included in the analyses. Over the 2012-2016 time period, top-4 reasons for choosing DMTs were: efficacy factors (74.2%/55.6%), convenience factors (8.0%/13.6%), benefit vs risk profile (2.6%/10.5%) and patient decision (5.5%/5.9%). Overall % patients on INJ decreased from 73.5% (Q42012) to 38.8% (Q42016), and those on ORAL increased from 11.3% (Q42012) to 43.2% (Q42016). INF use showed only slight increase (14.6%/17.5% in Q42012/Q42016). Within 1st-line, changes in drug utilization from Q42012/Q42016 were: INJ:93.5%/53.5%, ORAL:2.0%/35.7%, INF:4.2%/10.3%; within 2nd-line, INJ:51.8%/23.7%, ORAL:18.9%/53.5%, INF:28.6%/22.7%; within 3rd and later lines, INJ:17.8%/9.4%, ORAL:44.1%/51.1%, INF:36.2%/37.8%. Among the overall cohort, mean EDSS scores at the time of study data collection remained stable from Q42012/Q42016 for INJ (2.08/1.99) & INF (3.63/3.26), while EDSS scores decreased for ORAL (3.18/2.16). In this study cohort, adoption of oral DMTs increased dramatically; displacing the use of injectables as preferred treatment and corresponding to a shift in prescription driver trends. Most recent EDSS scores indicated lower disease severity among users of oral DMTs, a likely consequence of their 1st line penetration. Impact of observed treatment patterns and treatment sequencing strategies on patient outcomes warrant further scrutiny.