Real-world disease-modifying therapy usage in persons with relapsing-remitting multiple sclerosis: Cross-sectional data from the Swiss Multiple Sclerosis Registry

Bossart, Jonas; Kamm, Christian P.; Kaufmann, Marco; Stanikić, Mina; Puhan, Milo A.; Kesselring, Jürg; Zecca, Chiara; Gobbi, Claudio; Rapold, Irene; Kurmann, Roland; Ammann, Sabin; Wyl, Viktor von

doi:10.1016/j.msard.2022.103706

Cited by 11 publications

(12 citation statements)

References 23 publications

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“…Limitations of our study include the generalizability of our results, since we only included patients from a specific Italian region. However, our cohort had similar distribution (e.g., age, DMT use), when compared to other international studies [ 17 , 18 , 27 ], and, hence, may reflect the general MS population treated with ocrelizumab. Also, rates of disability progression, relapses and related healthcare resource utilization are expected to increase over the follow-up [ 28 ].…”

Section: Discussionsupporting

confidence: 60%

Persistence, adherence, healthcare resource utilization and costs for ocrelizumab in the real-world of the Campania Region of Italy

et al. 2022

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Aims We aim to provide real-world evidence on the use of ocrelizumab for treating multiple sclerosis (MS), with specific regard to prescription pattern, adherence, persistence, healthcare resource utilization and related costs, also in relation to other disease-modifying treatments (DMTs). Methods We included 2495 people with MS from the Campania Region (South Italy) who received first or switch DMT prescription from Jan 2018 to Dec 2020, and with at least 6-month follow-up. We collected hospital discharge records, drug prescriptions, and related costs, and calculated persistence (time from first prescription to discontinuation or switch to other DMT), adherence (proportion of days covered (PDC)), annualized hospitalization rate (AHR) for MS-related hospital admissions, and DMT costs. Results Ocrelizumab was the most commonly prescribed DMT (n = 399; age = 45.74 ± 10.98 years; females = 224), after dimethyl fumarate (n = 588) and fingolimod (n = 401); 26% patients treated with ocrelizumab were naïve. When compared with ocrelizumab, the risk of discontinuation was higher for other highly active DMTs (HR = 3.78; p = 0.01), and low/medium efficacy DMTs (HR = 7.59; p < 0.01). When compared with ocrelizumab, PDC was similar to other highly active DMTs (Coeff = 0.01; p = 0.31), but higher for low/medium efficacy DMTs (Coeff = 0.09; p < 0.01). When compared with ocrelizumab, AHR was similar to other highly active DMTs (Coeff = 0.01; p = 0.51), and low/medium efficacy DMTs (Coeff = 0.01; p = 0.55). When compared with ocrelizumab, DMT monthly costs were higher for other highly active DMTs (Coeff = 92.30; p < 0.01), but lower for low/medium efficacy DMTs (Coeff = − 1043.61; p < 0.01). Discussion Ocrelizumab was among the most frequently prescribed DMTs, with 26% prescriptions to treatment-naïve patients, suggesting its relevance in addressing unmet clinical needs (e.g., first approved treatment for primary progressive MS). Ocrelizumab was associated with the highest persistence, confirming its favorable benefit-risk profile. Costs for ocrelizumab were lower than those associated to similarly effective DMTs, in absence of changes in healthcare resource utilization.

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Section: Discussionsupporting

confidence: 60%

Persistence, adherence, healthcare resource utilization and costs for ocrelizumab in the real-world of the Campania Region of Italy

et al. 2022

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“…In addition to demonstrating favorable real-world effectiveness that appear to be consistent with clinical trial data, this SLR highlights other important aspects of realworld ocrelizumab use in RRMS and PPMS patients; three studies report stable or improving HRQoL following up to 1 year of ocrelizumab treatment, 9,20,44 five studies reported on the clinical effectiveness of switching to ocrelizumab from natalizumab, 8,25,36,39,58 and three further studies described the effective and safe transition to ocrelizumab from other DMTs, 16,18,27 highlighting ocrelizumab as a suitable option for previously treated patients that can mitigate the risk of disease reactivation.…”

Section: Discussionsupporting

confidence: 58%

“…Full text articles were available for 23 (44%) of the studies, while only conference abstracts were available for the remainder. Studies varied widely by geographical region; 33 reported real‐world outcomes in Europe, 7–39 seven in the United States, 40–46 two in the Middle East, 47,48 three in various geographical regions, 49–51 one in South America, 52 and six did not report the country in which the study was conducted 53–58 . The most frequently reported study populations included combined populations of RRMS, PPMS, and SPMS patients for which data were not stratified by type of MS ( n = 20).…”

Section: Resultsmentioning

confidence: 99%

“…44 No change in the Beck Depression Inventory-II (BDI-II) was observed. 44 In other studies, MFIS, BDI-II, and the EuroQol-5 Dimension Index (EQ-5D) measure acquired at baseline and at 6 months remained stable, 9 while the Multiple Sclerosis Quality of Life-54 (MSQoL-54) measure was found to remain stable from baseline to 1 year. 20…”

Section: Evidence Of Disease Activitymentioning

confidence: 93%

“…Regarding evidence of disease activity (EDA), significantly fewer patients exhibited EDA when switched from natalizumab to ocrelizumab (n = 5 [15%]) compared with patients switched to fingolimod (n = 24 [56%], P < 0.001). 8 Health-related quality of life Three of the studies included presented HRQoL outcomes, with patient numbers ranging from 93 to 355 9,20,44 (Table S11). In the only study that carried out statistical tests of differences in HRQoL in ocrelizumabtreated patients between baseline and subsequent time points, the Modified Fatigue Impact Scale (MFIS) suggested improvement with a mean change of À3.7 (p = 0.02) at 1 year.…”

Section: Evidence Of Disease Activitymentioning

confidence: 99%

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Real‐world evaluation of ocrelizumab in multiple sclerosis: A systematic review

Montalbán¹,

Matthews

Simpson

et al. 2023

Ann Clin Transl Neurol

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Across its clinical development program, ocrelizumab demonstrated efficacy in improving clinical outcomes in multiple sclerosis, including annualized relapse rates and confirmed disability progression. However, as with any new treatment, it was unclear how this efficacy would translate into real‐world clinical practice. The objective of this study was to systematically collate the published real‐world clinical effectiveness data for ocrelizumab in relapsing remitting multiple sclerosis and primary progressive multiple sclerosis. A search strategy was developed in MEDLINE and Embase to identify articles reporting real‐world evidence in people with relapsing remitting multiple sclerosis or primary progressive multiple sclerosis receiving treatment with ocrelizumab. The search focused on English language articles only but was not limited by the country in which the study was conducted or the time frame of the study. Additional manual searches of relevant websites were also performed. Fifty‐two studies were identified reporting relevant evidence. Real‐world effectiveness data for ocrelizumab were consistently favorable, with reductions in relapse rate and disease progression rates similar to those reported in the OPERA I/OPERA II and ORATORIO clinical trials, including in studies with more diverse patient populations not well represented in the pivotal trials. Although direct comparisons are confounded by lack of randomization of treatments, outcomes reported suggest that ocrelizumab has a similar or greater efficacy than other therapy options. Initial real‐world effectiveness data for ocrelizumab appear favorable and consistent with results reported in clinical trials, providing clinicians with an efficacious option to treat patients with multiple sclerosis.

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Male sexual and reproductive health in multiple sclerosis: a scoping review

Toljan,

Briggs

2024

J Neurol

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Background Multiple sclerosis (MS) is a chronic neuroinflammatory disease with highest incidence during the period of optimal reproductive health. This scoping review aimed to identify and summarize available data on sexual/reproductive health in males with MS (MwMS). Methods This review was based on PRISMA extension for Scoping Review. PubMed database was searched for keyword “multiple sclerosis” alongside keywords “sexual health”, “reproductive health”, “family planning”, “male fertility”, “male infertility”, “sexual dysfunction”, and “erectile dysfunction”, iteratively using the “AND” logical operator. Descriptive analysis was performed on the included articles. Results Thirty-four studies were included, and four topics emerged: sexual dysfunction, erectile dysfunction, fertility, and family planning. Sexual dysfunction is common in MwMS (35–72%), yet only a minority of MwMS discuss their sexual health with their treatment teams. Both MS disability and depression were associated with sexual dysfunction in MwMS, with erectile dysfunction and decreased libido as the most prevalent aspects of sexual dysfunction. Positively, phosphodiesterase-5 inhibitors appear effective for treating erectile dysfunction and improving sexual quality of life in MwMS. There may also be a relationship between MS and male infertility, though changes in sexual behavior may underlie this association. Finally, a prominent knowledge gap was observed for disease-modifying therapy use and family planning in MwMS. Conclusion Sexual dysfunction is common, impacted by MS severity, and associates with decreased quality of life in MwMS. Communication barriers regarding sexual and reproductive health appear to exist between MwMS and providers, as do literature gaps related to MS therapeutics and sexual/reproductive health.

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Real-world disease-modifying therapy usage in persons with relapsing-remitting multiple sclerosis: Cross-sectional data from the Swiss Multiple Sclerosis Registry

Cited by 11 publications

References 23 publications

Persistence, adherence, healthcare resource utilization and costs for ocrelizumab in the real-world of the Campania Region of Italy

Persistence, adherence, healthcare resource utilization and costs for ocrelizumab in the real-world of the Campania Region of Italy

Real‐world evaluation of ocrelizumab in multiple sclerosis: A systematic review

Male sexual and reproductive health in multiple sclerosis: a scoping review

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