BackgroundAvailability of oral disease-modifying therapy (DMT) for relapsing–remitting multiple sclerosis (RRMS) may affect injectable DMT (iDMT) treatment patterns.ObjectiveThe objective of this paper is to evaluate iDMT persistency, reasons for persistency lapses, and outcomes among newly diagnosed RRMS patients.MethodsMedical records of 300 RRMS patients initiated on iDMT between 2008 and 2013 were abstracted from 18 US-based neurology clinics. Eligible patients had ≥3 visits: pre-iDMT initiation, iDMT initiation (index), and ≥1 visit within 24 months post-index. MS-related symptoms, relapses, iDMT treatment patterns (i.e. persistency, discontinuation, switching, and restart), and reasons for non-persistency were tracked for 24 months.ResultsAt 24 months, iDMT persistency was 61.0%; 28.0% of patients switched to another DMT, 8.0% discontinued, and 3.0% stopped and restarted the same iDMT. The most commonly identified reasons for non-persistency were perceived lack of efficacy (22.2%), adverse events (18.8%), and fear of needles/self-injecting (9.4%). At 24 months, 38.0% of patients had experienced a relapse and 11.0% had changes in MRI lesion counts. Patients without MS-related symptoms at index reported increases in the incidence of these symptoms at 24 months.ConclusionsNon-persistency with iDMT remains an issue in the oral DMT age. Many patients still experienced relapses and disease progression, and should consider switching to more effective therapies.

BackgroundAxial spondyloarthritis (axSpA) is a chronic inflammatory disease affecting the sacroiliac joints and spine. Treatment primarily consists of first-line nonsteroidal anti-inflammatory drugs (NSAIDs) and/or biologic therapy when disease activity persists despite NSAID therapy. Although many studies have evaluated the efficacy of these treatments, there are few studies that have characterized NSAIDs and/or biologic therapy among patients with axSpA in the United States.ObjectivesTo characterize patients with axSpA treated with NSAIDs only, biologics only, or both NSAIDs and biologics at the time of enrollment in the US-based Corrona PsA/SpA Registry.MethodsThis study included all patients with axSpA diagnosed by the rheumatologist aged ≥18 years enrolled in the Corrona Registry between March 2013 and September 2016 who were treated with NSAIDs only, biologics only, or both NSAIDs and biologics at the time of enrollment (baseline). Patients fulfilled the Assessment of SpondyloArthritis international Society classification criteria.1 Demographics, clinical characteristics, disease activity measures and treatment history were collected at enrollment and described for each group.ResultsAs of September 2016, 359 patients with axSpA met the study inclusion criteria; at baseline, 224 patients (62.4%) were receiving NSAIDs (92 [25.6%] with NSAIDs only and 132 [36.8%] with both NSAIDs and biologics) and 135 patients (37.6%) were receiving biologics only. Baseline characteristics were similar across all treatment subgroups with regards to age, race and body mass index. Fewer females were treated with biologics (with/without NSAIDs) compared to the NSAIDs only group. At baseline, patients treated with NSAIDs or both NSAIDs and biologics were older, had longer duration of disease with worse disease activity (measured by ASDAS and BASDAI), functional impairment (BASFI and HAQ-DI) and had worse pain and fatigue compared to those treated with biologics only (Table 1). 88–96% of patients receiving biologics (with or without NSAIDs) had prior biologic use compared to only 25% of NSAIDs only group. Patients treated with biologics only reported decreased percentage of impairment while working, overall work impairment and activity impairment at baseline compared with patients treated with NSAIDs only and both NSAIDs and biologics.ConclusionsAbout two-thirds of patients with axSpA were treated with NSAIDs (with or without biologics) and about three-fourths of patients were treated with biologics (with or without NSAIDs) at enrollment. Patients that were already treated with biologics without NSAIDs at enrollment showed better measures of disease activity and PROs compared with the other treatment groups. Future research will assess changes in clinical and disease characteristics over time by treatment subgroup.References Rudwaleit M, et al. Ann Rheum Dis. 2009;68(6):777–783. AcknowledgementsCorrona, LLC, has been supported through contracted subscriptions in the last 2 years by AbbVie, Amgen, BMS, Crescendo, Eli Lilly and Compa...

s201were from all regions of the United States (Northeast, 19.3%; North Central, 15.7%; South, 44.7%; West, 16.1%; Puerto Rico/Virgin Islands, 0.4%); approximately 60% of patients were female and the mean (SD) age was 53.6 (12.0) years. Overall, 6.1% of patients were biologic naive, 41.9% received ≥ 1 prior biologic therapy, and 52.0% had missing information about prior biologic use. Among patients with prior biologic use, 38.6% had 1 reported biologic efficacy failure, 33.8% had 2 efficacy failures, and 27.7% had ≥ 3 efficacy failures; the most commonly reported biologic efficacy failures were adalimumab (67.4%) and etanercept (59.1%). For both initial and maintenance dosing, approximately half of patients were prescribed secukinumab 300 mg (51.1% and 51.6%, respectively). ConClusions: In this analysis of SRFs filled by patients with PsA and their health care providers, approximately half of patients were prescribed secukinumab 300 mg for both initial and maintenance dosing. These results provide early insights into the prescribing patterns of secukinumab for PsA in a US real-world setting. Future research is needed to better understand how clinical characteristics and treatment history may affect secukinumab usage in US patients with PsA.