Comparative Effectiveness Research of Disease-Modifying Therapies for the Management of Multiple Sclerosis: Analysis of a Large Health Insurance Claims DatabaseReport as inadecuate




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Neurology and Therapy

, Volume 6, Issue 1, pp 91–102

First Online: 16 February 2017Received: 14 September 2016DOI: 10.1007-s40120-017-0064-x

Cite this article as: Boster, A., Nicholas, J., Wu, N. et al. Neurol Ther 2017 6: 91. doi:10.1007-s40120-017-0064-x

Abstract

IntroductionLimited 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.

MethodsPatients newly-initiating DMF, interferon beta IFNβ, 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.

ResultsSignificant 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 IFNβ, 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.

ConclusionThese real-world data suggest DMF and fingolimod have similar effectiveness and demonstrate superior effectiveness to IFNβ, GA, and teriflunomide.

Funding : Biogen, Cambridge, MA, USA.

KeywordsComparative effectiveness Dimethyl fumarate Disease-modifying therapy Fingolimod Glatiramer acetate Interferon beta Multiple sclerosis Teriflunomide Enhanced contentTo view enhanced content for this article go to.

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Electronic supplementary materialThe online version of this article doi:10.1007-s40120-017-0064-x contains supplementary material, which is available to authorized users.





Author: Aaron Boster - Jacqueline Nicholas - Ning Wu - Wei-Shi Yeh - Monica Fay - Michael Edwards - Ming-Yi Huang - Andrew Lee

Source: https://link.springer.com/



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