Peginterferon Beta-1a Tied to High Adherence and Persistence in Multiple Sclerosis

Treatment adherence and persistence is higher for peginterferon beta-1a (PEG) injection vs once daily glatiramer acetate in patients with multiple sclerosis (MS), according to research presented at the 2021 Annual Meeting of the Consortium of Multiple Sclerosis Centers (CMSC), held October 25 to 28, 2021, in Orlando, Florida.

The efficacy of disease-modifying therapies (DMTs) for patients with MS requires adherence and persistence. Dosing schedule and adverse events are just some of the factors that can affect this. The objective of the current study was to compare both adherence and persistence levels in patients with MS who are receiving DMTs.

Researchers analyzed MarketScan data from May 2014 to September 2019, with a focus placed on patients with MS in commercial healthcare plans who started an injectable DMT and had ≥12 months’ worth of follow-up. Specifically, they included patients with MS who received subcutaneous PEG once every 2 weeks (n=275), intramuscular interferon (IFN) beta-1a once per week (n=314), subcutaneous IFN beta-1a 3 times per week (n=463), subcutaneous IFN beta-1b every other day (n=236), subcutaneous glatiramer acetate once daily (n=361), and subcutaneous glatiramer acetate 3 times per week (n=2198).

Adherence to treatment was assessed using the proportion of days covered ≥80%, evaluated by DMT schedule and index year. Persistence, or the time to discontinuation or treatment switch, was also evaluated. Logistic regression and Cox regression models used in the adherence and persistence analyses, respectively, were adjusted for age, sex, Charlson Comorbidity Index, comorbidities, MS-related symptoms, and disease severity.

Overall, the proportion of patients adherent to therapy was lower for PEG (40.7%) than it was for IFN beta-1a once per week (46.2%), IFN beta-1a 3 times per week (43.2%), IFN beta-1b every other day (44.1%), or glatiramer acetate 3 times per week (50.5%). The lowest proportion of adherent patients was reported with glatiramer acetate once daily (24.7%). Patients treated with glatiramer acetate once daily had lower odds of adherence (odds ratio [OR], 0.44; P <.0001), while those treated with glatiramer acetate 3 times per week had higher odds of adherence (OR, 1.50; P =.0021) compared with patients who received PEG.

The mean proportion of days covered for patients treated with PEG increased from 48.9% to 73.8% from 2014 to 2018, respectively. Patients treated with glatiramer acetate once daily were more likely to either discontinue or switch treatment compared with those treated with PEG (hazard ratio [HR], 1.68; P <.0001). In contrast, patients were less likely to discontinue or switch if they were treated with IFN beta-1a once per week (HR, 0.74; P =.0276) and glatiramer acetate 3 times per week (HR, 0.60; P <.0001).

According to the researchers, the main findings from this study “cannot be explained solely by the dosing schedule and may relate to the higher incidence of flu-like symptoms with IFNs than with” glatiramer acetate. They added that the findings “highlight an increase in PEG adherence that may reflect the increase in education and training on setting expectations for potential” adverse events.

Disclosure: Multiple authors declared affiliations with the pharmaceutical industry. Please refer to the original article for a full list of disclosures.

Reference

Tsao N, Dong S, Naylor ML, et al. Adherence and persistence to injectable disease-modifying therapies among patients with multiple sclerosis enrolled in US commercial plans. Presented at: CMSC 2021; October 25-28, 2021; Orlando, Florida. Abstract DMT52.