Use of the new oral disease-modifying therapies for multiple sclerosis in British Columbia, Canada: the first five-years

• Published in: Multiple sclerosis and related disorders Vol. 25; pp. 57 - 60
• Main Authors: Setayeshgar, Solmaz, Kingwell, Elaine, Zhu, Feng, Zhang, Xinyu, Zhang, Tingting, Marrie, Ruth Ann, Carruthers, Robert, Tremlett, Helen
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.10.2018
• Subjects: Administration, Oral; Administrative health data; Adult; Antirheumatic Agents - administration & dosage; British Columbia - epidemiology; Cohort; Cohort Studies; Female; Humans; Immunologic Factors - administration & dosage; Male; Middle Aged; Multiple sclerosis; Multiple Sclerosis - drug therapy; Multiple Sclerosis - epidemiology; Neurology; Oral disease-modifying therapies; Sex Characteristics; Treatment Outcome; Use and uptake; Young Adult; British Columbia; Oral disease-modifying therapies; Use and uptake; Multiple sclerosis; Cohort; Administrative health data
• ISSN: 2211-0348; 2211-0356; 2211-0356
• DOI: 10.1016/j.msard.2018.07.012

•Little is known about the use of the new oral MS drugs in clinical practice.•Uptake for an oral MS drug was 16.6/1000 person-years over the five-year study period.•Uptake and use of the new oral DMTs increased substantially from 2011–2015.•Uptake and use of the oral MS drugs were similar for men and women.•However, subjects with a higher (vs. lower) socioeconomic status had a higher uptake. Background: Little is known about the use of the new oral disease-modifying therapies (DMTs: fingolimod, dimethyl fumarate, teriflunomide) for multiple sclerosis (MS) in clinical practice. We describe their rate of uptake, and their use as compared to the established first-generation (beta-interferon and glatiramer acetate) and second-generation (natalizumab and alemtuzumab) parenteral DMTs. Methods: Persons with MS (PwMS) were identified using health administrative data from British Columbia, Canada (2011-15). We described the uptake and use of the DMTs with Poisson and Log-Binomial regression, adjusting for sex, age, and socioeconomic status (SES). Results: Among 14,148 PwMS, 2,821 were exposed to any DMT over the study period. In total, 1,019 initiated an oral DMT, a rate of 16.6/1,000 person-year, and 83/1,000 PwMS filled at least one prescription for an oral DMT during the study period. The rate of uptake for oral DMTs, and the annual proportion of PwMS using an oral DMT or second-generation parenteral DMT increased over the 5 years, whereas use of the first-generation DMTs decreased by 30%. PwMS in the higher (vs. lower) SES group had a 19-44% higher rate of uptake for teriflunomide and fingolimod. Conclusion: The uptake and use of the oral DMTs increased substantially over the first 2 to 5 years after their introduction. These recent changes highlight the importance of monitoring the risks and benefits in the real world.