Background

In clinical trials, the probability of confirmed disability worsening (CDW) is significantly lower with intramuscular (IM) interferon beta-1a (IFNβ1a) and peginterferon beta-1a (PEG) treatment than with placebo in patients with relapsing forms of multiple sclerosis (RMS). Registry data provides information on disability outcomes with long-term treatment.

Objectives

To examine the long-term effects of IM IFNβ1a and PEG on real-world effectiveness in participants with RMS from the North American Research Committee on Multiple Sclerosis (NARCOMS) registry.

Methods

This analysis included NARCOMS participants diagnosed with RMS who initiated IM IFNβ1a treatment between April 2004 and October 2019 (N=760) or PEG between October 2014 and October 2019 (N=116). Patient-reported outcomes were collected every 6 months. The primary endpoint was 6-month CDW, defined as a ≥1-point increase in Patient Determined Disease Steps (PDDS) score sustained for ≥6 months. Separate analyses were conducted in the IM IFNβ1a and PEG cohorts. A Kaplan-Meier analysis assessed the cumulative probability of CDW; participants were censored if they discontinued treatment or had no additional follow-up. Only participants who completed ≥2 surveys with treatment history and ≥3 surveys with PDDS history were included in the CDW analysis (IM IFNβ1a: N=760; PEG: n=81). Progression to secondary progressive multiple sclerosis (SPMS) was analysed in IM IFNβ1a participants who completed ≥50% of their surveys (n=630) and in PEG participants (n=102).

Results

At the first survey on treatment in IM IFNβ1a and PEG participants, the mean age was 49.7 and 53.0 years, respectively, the mean (standard deviation [SD]) disease duration was 11.1 (8.6) and 15.8 (7.9) years, respectively, and 8.4% and 91.2% had prior disease modifying therapy (DMT) use, respectively. The median PDDS score at the first survey was 2.0 for both populations, indicating moderate disability. The cumulative probability of remaining free of CDW was 77.6% and 43.6% at 2 and 11 years of IM IFNβ1a treatment, respectively, and 84.4% at 2 years of PEG treatment. The cumulative probability of participant-reported progression to SPMS was 1.2% and 12.0% at 2.5 and 11 years in IM IFNβ1a participants, respectively, and 3.3% at 2.5 years in PEG participants.

Conclusions

These results support clinical trial data showing the effectiveness of IM IFNβ1a and PEG in preventing CDW and demonstrate their long-term effectiveness in RMS patients.

This study is funded by Biogen. Biogen funded the analyses and writing support for this abstract. Writing support was provided by Ashfield Healthcare Communications (Middletown, CT, USA).

Background

Studies have shown that patients with multiple sclerosis (MS) treated with disease-modifying therapies (DMTs) such as peginterferon beta-1a and intramuscular (IM) interferon (IFN) beta-1a in real-world clinical practice tend to be older than patients in randomized clinical trials. However, data on the use of DMTs in real-world patients with MS who are on average older than those in clinical trials are limited.

Objectives

Describe the characteristics of patients aged ≥55 years treated with peginterferon beta-1a or IM IFN beta-1a in real-world clinical practice.

Methods

Truven MarketScan^® Commercial Claims and Medicare Supplemental database records from October 2013 through March 2018 were used to identify patients with ≥1 diagnosis of MS, ≥1 claim for peginterferon beta-1a or IM IFN beta-1a during the study period (date of first claim=index date), age ≥55 years as of the index date, and ≥1 year of continuous medical and pharmacy coverage prior to the index date.

Results

This study included 2479 patients aged ≥55 years. Of these, 253 (10.2%) were treated with peginterferon beta-1a (mean age: 61.7 years) and 2226 (89.8%) with IM IFN beta-1a (mean age, 60.6 years). In both groups, most patients were aged 55–64 years (peginterferon beta-1a, 84.2%; IM IFN beta-1a, 76.5%). In the year prior to index, 180 peginterferon beta-1a patients (71.2%) had prior DMT use; of these, 52.2% switched from a different injectable, 43.3% from an oral DMT, and 4.4% from an infusible DMT. Over the study period, the mean (SD) number of relapses was low (peginterferon beta-1a, 0.26 [0.64]; IM IFN beta-1a, 0.13 [0.54]), and most patients in both groups were free from relapse (peginterferon beta-1a, 81.8%; IM IFN beta-1a, 91.2%). Additional patient characteristics, including comorbidity data, and effectiveness outcomes will be presented.

Conclusions

This retrospective claims database study provides real-world data on the usage of peginterferon beta-1a and IM IFN beta-1a in patients aged ≥55 years. Of the patients initiating peginterferon beta-1a, a majority switched from a different injectable DMT in the year prior to the index date, though >40% switched from an oral DMT. Overall, most peginterferon beta-1a and IM IFN beta-1a patients aged ≥55 years remained free from relapse.

This study was supported by Biogen.

Background

Studies have shown that patients with multiple sclerosis (MS) treated with disease-modifying therapies (DMTs) such as peginterferon beta-1a and intramuscular (IM) interferon (IFN) beta-1a in real-world clinical practice tend to be older than patients in randomized clinical trials. However, data on the use of DMTs in real-world patients with MS who are on average older than those in clinical trials are limited.

Objectives

Describe the characteristics of patients aged ≥55 years treated with peginterferon beta-1a or IM IFN beta-1a in real-world clinical practice.

Methods

Truven MarketScan^® Commercial Claims and Medicare Supplemental database records from October 2013 through March 2018 were used to identify patients with ≥1 diagnosis of MS, ≥1 claim for peginterferon beta-1a or IM IFN beta-1a during the study period (date of first claim=index date), age ≥55 years as of the index date, and ≥1 year of continuous medical and pharmacy coverage prior to the index date.

Results

This study included 2479 patients aged ≥55 years. Of these, 253 (10.2%) were treated with peginterferon beta-1a (mean age: 61.7 years) and 2226 (89.8%) with IM IFN beta-1a (mean age, 60.6 years). In both groups, most patients were aged 55–64 years (peginterferon beta-1a, 84.2%; IM IFN beta-1a, 76.5%). In the year prior to index, 180 peginterferon beta-1a patients (71.2%) had prior DMT use; of these, 52.2% switched from a different injectable, 43.3% from an oral DMT, and 4.4% from an infusible DMT. Over the study period, the mean (SD) number of relapses was low (peginterferon beta-1a, 0.26 [0.64]; IM IFN beta-1a, 0.13 [0.54]), and most patients in both groups were free from relapse (peginterferon beta-1a, 81.8%; IM IFN beta-1a, 91.2%). Additional patient characteristics, including comorbidity data, and effectiveness outcomes will be presented.

Conclusions

This retrospective claims database study provides real-world data on the usage of peginterferon beta-1a and IM IFN beta-1a in patients aged ≥55 years. Of the patients initiating peginterferon beta-1a, a majority switched from a different injectable DMT in the year prior to the index date, though >40% switched from an oral DMT. Overall, most peginterferon beta-1a and IM IFN beta-1a patients aged ≥55 years remained free from relapse.

This study was supported by Biogen.