Adherence to and Persistence with Disease-Modifying Therapies for Multiple Sclerosis Over 24 Months: A Retrospective Claims Analysis.

Content Provider	Europe PMC
Author	Pardo, Gabriel Pineda, Elmor D. Ng, Carmen D. Bawa, Komal K. Sheinson, Daniel Bonine, Nicole G.
Abstract	IntroductionWe sought to assess adherence to and persistence with ocrelizumab (OCR) compared with other disease-modifying treatments (DMTs), by route of administration (RoA), for multiple sclerosis (MS) after 24 months in the United States.MethodsThis retrospective claims analysis of MS patients initiating a new DMT was conducted using the IBM MarketScan Commercial and Medicare Supplemental databases between April 2016 and December 2019. Continuous enrollment of ≥ 12 months before and up to 24 months after initiating the index DMT was required. Adherence was assessed based on proportion of days covered (PDC) in the follow-up period with values ≥ 80% considered adherent. Persistence was defined as no evidence of switching to another DMT or no gap ≥ 60 days in DMT coverage.ResultsA total of 1710 patients with ≥ 24 months of follow-up (OCR, n = 524; oral, n = 701; injectable, n = 365; other intravenous [IV], n = 120) were included. Patients initiating OCR had higher adherence (80% vs. 55%, 35%, and 54% for oral, injectable, and other IV, respectively) and persistence (75% vs. 54%, 33%, and 55%, respectively) at 24 months. Relative risks (RRs) of 24-month non-adherence for those initiating orals, injectables, and other IVs were 2.2 (95% CI, 1.7–2.9), 3.0 (95% CI, 2.2–4.0), and 2.2 (95% CI, 1.5–3.3), respectively, compared to those initiating OCR. Similarly, patients receiving orals, injectables, and other IVs had RR of 1.9 (95% CI, 1.4–2.4), 2.5 (95% CI, 1.9–3.4), and 1.8 (95% CI, 1.2–2.6) for 24-month discontinuation, respectively. Similar patterns were observed at 12 and 18 months.ConclusionsPatients initiating OCR in a real-world setting achieved higher rates of adherence and persistence at 24 months compared with those initiating other DMTs, consistent with published literature showing similar results at 12 and 18 months. Optimizing medication adherence and persistence is fundamental to MS care, so clinicians should consider all elements of DMTs that may improve compliance.Supplementary InformationThe online version contains supplementary material available at 10.1007/s40120-021-00319-3.
Related Links	https://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC8857349&blobtype=pdf
ISSN	21938253
Journal	Neurology and Therapy [Neurol Ther]
Volume Number	11
DOI	10.1007/s40120-021-00319-3
PubMed Central reference number	PMC8857349
Issue Number	1
PubMed reference number	35020156
e-ISSN	21936536
Language	English
Publisher	Springer Healthcare
Publisher Date	2022-01-12
Publisher Place	Cheshire
Access Restriction	Open
Rights License	Open AccessThis article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, which permits any non-commercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc/4.0/. © The Author(s) 2022
Subject Keyword	Multiple sclerosis MS Adherence Persistence Ocrelizumab
Content Type	Text
Resource Type	Article
Subject	Neurology Neurology (clinical)