Comparison of Adherence and Persistence to Glatiramer Acetate 40 mg/mL Three-Times Weekly Subcutaneous Injections Versus Oral Therapies in Multiple Sclerosis (P6.366)

Objective: To compare adherence and persistence in multiple sclerosis (MS) patients initiating disease-modifying therapies (DMTs) with either glatiramer acetate 40 mg/mL three-times weekly subcutaneous injections (GA40) or oral therapies. Background: Treatment adherence critically impacts the effectiveness of DMTs and clinical outcomes in MS. Recent analyses showing better adherence and persistence to GA40 than to oral DMTs require validation with evaluation of larger samples. Design/Methods: This retrospective study used medical and pharmacy claims data from a large national US health plan. Analyses included commercially insured adults initiating DMTs (GA40 or oral therapies [fingolimod, teriflunomide, and dimethyl fumarate]) between 02/01/2014 and 07/31/2015, with continuous health plan enrollment and ≥1 MS diagnosis during 6-month pre- or post-index periods. The first DMT claim determined the index date and assignment to GA40 or oral DMT cohort. Outcomes examined in the follow-up period included adherence (medication possession ratio [MPR] and proportion of days covered [PDC]) and persistence (time to first ≥30-day gap in index DMT). All variables were analyzed descriptively. Additionally, logistic regressions modeling MPR≥0.80 or PDC≥0.80 were estimated, controlling for index DMT and demographic and clinical characteristics. Results: In 6-month follow-up, cohorts (GA40, n=358; oral DMT, n=1170) had similar pre-index DMT exposure and relapse rates; GA40-treated patients were younger, on average (42.1 vs 44.4 years; P P =0.005) and PDC (0.80 vs 0.75; P =0.004); adjusted analyses showed that GA40-treated patients had higher odds of MPR≥0.80 (OR: 1.60; P P =0.008). Conclusions: Consistent with earlier evaluations, there is evidence of better adherence to GA40 than to oral DMTs in the 6 months following initiation, potentially conferring clinical benefit. Disclosure: Dr. Trenz has received personal compensation for activities with Optum as an employee. Dr. Liassou has received personal compensation for activities with Optum as an employee. Dr. Wolbeck has received personal compensation for activities with Optum as an employee. Dr. Iyer has received personal compensation for activities with Teva Pharmaceutical Industries as an employee. Dr. Wu has received personal compensation for activities with Teva Neuroscience as an employee.