Author Of 1 Presentation
P0176 - Treatment and care management, clinical outcomes and mobility impairment in people with or without MS aged ≥ 50 years: observational 6-year analysis (ID 832)
Abstract
Background
Although multiple sclerosis (MS) is often described as a disease of young adults, a recent study conducted by the National Multiple Sclerosis Society showed that, in the US, people with MS have a median age of 52 years. Limited data are available in the older MS population.
Objectives
To characterize clinical outcomes, mobility impairment, treatment and care management patterns in people with MS ≥50 years of age (PwMS) compared with a cohort of adults ≥50 years of age without MS (AwoMS) from the general population.
Methods
Administrative US claims data from Truven Health MarketScan® Commercial and Medicare Databases 2011-2017 were analysed. PwMS included 3 claims with MS diagnoses (ICD9/10 340/G35) OR 1 MS diagnosis + 1 disease-modifying drug (DMD) within 1-year of each other, AND 1st diagnosis or DMD in 2012 as index; continuous enrollment 1-year pre-index (baseline), and ≥3 years follow-up; aged ≥50. AwoMS included those continuously enrolled from 2011 to minimum 2015, up to 2017, aged ≥50 and never diagnosed with MS, with July 1st 2012 used as index for baseline characteristics. A 1:1 matched cohort was created using propensity scores calculated from baseline covariates (age, sex, region, health plan and comorbidities). Multivariable models were used to compare infection and malignancy rates, treatment and care patterns including utilization of magnetic resonance imaging (MRI), skilled nursing facilities (SNF), and time to mobility aids (cane/walker or wheelchair use) between matched PwMS and AwoMS.
Results
Inclusion criteria were met by 10,746 PwMS and 3,521,326 AwoMS (10,746 matched to PwMS). Over the average 5-year follow-up, PwMS had a higher infection rate than AwoMS (0.738 vs. 0.247 per patient, respectively; rate ratio [RR]: 2.977 [with 95% confidence interval of [2.849-3.111]), a higher rate of MRI use (0.684 vs. 0.157 per patient, respectively; RR: 4.234 [4.016-4.464]), most being brain and spine MRIs, and a higher use of SNF (0.658 vs. 0.098 per patient, respectively; RR: 6.920 [6.487-7.385]). Having MS showed no significant association with the odds of developing a malignancy (odds ratio: 1.006 [0.940-1.076]). MS was associated with a shorter time to cane/walker or wheelchair use (hazard ratios: 2.374 [2.140-2.634] and 7.600 [6.516-8.863], respectively).
Conclusions
Compared with AwoMS, PwMS showed higher rates of infections, MRI utilization and SNF use, shorter time to cane/walker or wheelchair use, and similar rates of malignancies.