Time to treatment failure following initiation of fingolimod versus teriflunomide for multiple sclerosis: a retrospective U.S. claims study.

Time to treatment failure following initiation of fingolimod versus teriflunomide for multiple sclerosis: a retrospective U.S. claims study.

Publication date: Nov 06, 2019

Objective: Disease modifying therapies (DMTs) for multiple sclerosis (MS) aim to delay progression and reduce relapses. Evidence is limited on the comparative effectiveness of the oral DMTs fingolimod and teriflunomide. This study evaluated time to treatment failure among patients with MS who initiated fingolimod versus teriflunomide in real-world settings. Methods: The retrospective cohort included 18-64 year old patients diagnosed with MS who initiated fingolimod or teriflunomide during 9/12/2012-9/30/2015 within MarketScan Commercial and Medicare Claims. Patients were followed from treatment initiation (index date) until first treatment failure or censoring. Treatment failure was defined as the first occurrence of MS relapse (identified using a validated algorithm) or treatment discontinuation (≥60-day supply gap). Treatment failure was examined through Kaplan-Meier analysis and multivariable Cox regression adjusting for 1-year baseline factors (age, gender, plan type, region, index year, prior DMT use, baseline relapses, Charlson comorbidity index [CCI], and MS symptoms). Results: On average, patients treated with fingolimod (n = 2,704) were younger (43.6 versus 49.8 years) with lower CCI (0.4 versus 0.7) and more relapses at baseline (0.46 versus 0.42) than those treated with teriflunomide (n = 1,859). Median time to treatment failure was 19.5 months with fingolimod versus 9.6 months with teriflunomide (p 

Vieira, M.C., Conway, D., Cox, G.M., Peeples, M., Bensimon, A.G., Macheca, M., and , Herrera. Time to treatment failure following initiation of fingolimod versus teriflunomide for multiple sclerosis: a retrospective U.S. claims study. 19433. 2019 Curr Med Res Opin.

Concepts Keywords
Algorithm Immunosuppressants
Cohort Medical specialties
Comorbidity Organic compounds
Cox Regression Immunology
DMT Teriflunomide
Fingolimod Fingolimod
Gender Multiple sclerosis
Median Relapse
Medicare
Multiple Sclerosis
Relapse
Type Region

Semantics

Type Source Name
disease MESH treatment failure
drug DRUGBANK Fingolimod
drug DRUGBANK Teriflunomide
disease MESH multiple sclerosis
disease DOID multiple sclerosis
gene UNIPROT CD69
gene UNIPROT DNMT1
disease MESH relapses
gene UNIPROT RASA1
gene UNIPROT CPOX
drug DRUGBANK Dimethyltryptamine
gene UNIPROT DMTN
disease MESH comorbidity

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