Journal
NEUROLOGY AND THERAPY
Volume 6, Issue 1, Pages 91-102Publisher
SPRINGER LONDON LTD
DOI: 10.1007/s40120-017-0064-x
Keywords
Comparative effectiveness; Dimethyl fumarate; Disease-modifying therapy; Fingolimod; Glatiramer acetate; Interferon beta; Multiple sclerosis; Teriflunomide
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Funding
- Biogen, Cambridge, MA, USA
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Limited data are available on the real-world effectiveness of newer oral disease-modifying therapies (DMTs) in multiple sclerosis. The purpose of this study was to retrospectively compare the real-world effectiveness of dimethyl fumarate (DMF), fingolimod, teriflunomide, and injectable DMTs in routine clinical practice based on US claims data. Patients newly-initiating DMF, interferon beta (IFN beta), glatiramer acetate (GA), teriflunomide, or fingolimod in 2013 were identified in the Truven MarketScan Commercial Claims Databases (N = 6372). Relapse episodes were identified based on a published claim-based algorithm and used to determine the annualized relapse rate (ARR) for the year before and after initiating therapy. Poisson and negative binomial regression was used to determine the adjusted incidence rate ratio (IRR) for each therapy relative to DMF. Significant ARR reductions in the year after initiating therapy were reported for DMF and fingolimod (P < 0.0001). Compared with DMF, the adjusted IRR (95% CI) for relapse in the year after initiating therapy was 1.27 (1.10-1.46) for IFN beta, 1.34 (1.17-1.53) for GA, 1.23 (1.05-1.45) for teriflunomide, and 1.03 (0.88-1.21) for fingolimod. Results were consistent across subgroup and sensitivity analyses. These real-world data suggest DMF and fingolimod have similar effectiveness and demonstrate superior effectiveness to IFN beta, GA, and teriflunomide. Funding: Biogen, Cambridge, MA, USA.
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