The clinical and cost impact of switching to fingolimod versus other first line injectable disease-modifying therapies in patients with relapsing multiple sclerosis

被引:1
作者
Freedman, M. S. [1 ,2 ]
Duquette, P. [3 ]
Grand'Maison, F. [4 ]
Lee, L. [5 ]
Vorobeychik, G. [6 ]
Lara, N. [7 ]
Khurana, V [8 ]
Nakhaipour, H. R. [9 ]
Schecter, R. [9 ]
Haddad, P. [9 ]
机构
[1] Univ Ottawa, Ottawa Hosp Gen Campus,501 Smyth Rd, Ottawa, ON K1H 8L6, Canada
[2] Ottawa Hosp Res Inst, Ottawa Hosp Gen Campus,501 Smyth Rd, Ottawa, ON K1H 8L6, Canada
[3] Univ Montreal, Notre Dame Hosp, Montreal, PQ, Canada
[4] Neuro Rive Sud Clin, Greenfield Pk, PQ, Canada
[5] Univ Toronto, Sunnybrook Hlth Sci Ctr, Toronto, ON, Canada
[6] Burnaby Hosp, Fraser Hlth Multiple Sclerosis Clin, Burnaby, BC, Canada
[7] IQVIA, Barcelona, Spain
[8] Nevartis Healthcare Private Ltd, Hyderabad, Telangana, India
[9] Novartis Pharmaceut Canada Inc, Dorval, PQ, Canada
关键词
Multiple sclerosis; Fingolimod; disease-modifying therapy; switch; adherence; resource utilization; Canada; UNMET NEEDS TRIBUNE; TREATMENT OPTIMIZATION; TREATMENT EXPERIENCE; INTERFERON BETA-1A; NATURAL-HISTORY; MS; DISABILITY; INITIATION; ACETATE; BURDEN;
D O I
10.1080/03007995.2019.1565818
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: There is limited evidence on the effectiveness and healthcare costs of switching to fingolimod versus another first line injectable therapy (FLIT) in patients with relapsing multiple sclerosis (RMS) who have already been treated with FLIT. Objective: The objectives of the study were to assess the annualized relapse rate (ARR), socio-demographic and clinical characteristics, persistence and adherence rates, healthcare resource utilization and cost among patients with RMS who either switch to fingolimod or another FLIT in routine clinical practice. Methods: A multicenter, observational, retrospective chart review was conducted across eight clinics in Canada between 1 May 2011 and 30 June 2013. The data was collected from two cohorts: patients who switched to fingolimod and patients who switched to FLIT from a previous FLIT. Results and conclusions: A total of 124 patients were included in the study: 82 and 42 switched to fingolimod and FLIT, respectively. There were no significant differences in the patient characteristics at the date of switch except for number of previous disease-modifying therapies (DMTs) which was higher in the fingolimod cohort (fingolimod: 1.52; FLIT: 1.10, p < .001). The ARR during the first year of switching was numerically higher in the FLIT cohort compared to the fingolimod cohort (FLIT: 0.9 [95% CI 0.3-1.6]; fingolimod: 0.3 [95% CI 0.1-0.5]). The negative binomial model adjusted for the number of previous DMTs confirmed a statistically significant difference in ARR between the fingolimod and FLIT cohorts at 12 months of follow-up (p = .012). In the fingolimod cohort, 20.7% of patients experienced at least one relapse compared to 38.1% in the FLIT cohort. In both groups, a high proportion of patients (>90%) showed good treatment adherence (>= 80% of prescribed doses).
引用
收藏
页码:767 / 776
页数:10
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