|The following article is part of conference coverage from the 34th Congress of the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) in Berlin, Germany. Neurology Advisor’s staff will be reporting breaking news associated with research conducted by leading experts in neurology. Check back for the latest news from ECTRIMS 2018.|
Glatiramer acetate (GA) appears to be associated with long-term improvements in disability in patients with relapsing multiple sclerosis (RMS), according to a study presented at the 34th Congress of the European Committee for Treatment and Research in Multiple Sclerosis, held October 10-12, 2018, in Berlin, Germany.
“The UK Department of Health Multiple Sclerosis Risk Sharing Scheme (RSS) was established in 2002 to enable [people with] RMS access to the disease modifying drugs (DMDs) glatiramer acetate (GA) and beta interferon,” the investigators wrote. “The RSS included a 10-year observational study of 5602 [people with] RMS to assess the long-term clinical and cost effectiveness of the DMDs. The final, 10-year, aggregate results of this study demonstrated that, as a group, the DMDs were both clinically effective and cost effective when modelled over a 50-year time horizon (including a 50% waning effect applied at 10 years).”
The RSS was used to enroll a total of 755 people with RMS who met the 2001 Association of British Neurologist (ABN) guidelines and who were treated with patient- and physician-preferenced disease modifying therapy. During a 10-year period, patients’ per-year Expanded Disability Status Scale (EDSS) scores were recorded. Natural history data from a subset of patients from the British Columbia MS database between 1980 to 1996 were used to create a continuous Markov model to model the projected course of disease in untreated people with RMS (n=898). Disability progression during the 10-year period, as determined by EDSS, as well as utility loss for treated vs untreated people with RMS comprised the primary outcome. Additionally, the investigators calculated cost effectiveness of treatment in this cohort.
During a mean 7.12-year follow-up in people with RMS treated with GA, researchers found a 16.5% reduction in EDSS (implied hazard ratio [HR] 83.5%) as well as a 25.0% reduction in utility loss (implied HR 75.0%). When the researchers compared 6-year and 10-year outcomes data, they found no indication of a treatment waning effect. Only a 1.2% difference in EDSS progression was observed at 6 years (implied HR 84.7%). According to the 10-year data, the cost per quality-adjusted life years associated with GA treatment was £17,841, with ≤£30,000/QALY associated with cost effectiveness.
Disclosures: Multiple authors report relationships with industry. Please refer to the original abstract for a complete list of disclosures.
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Al-Izki CS, et al. Glatiramer acetate slows disability progression – final 10-year results from UK Risk Sharing Scheme. Presented at: 34th Congress of the European Committee for Treatment and Research in Multiple Sclerosis. October 10-12, 2018; Berlin, Germany. Abstract P1275.