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SEATTLE – The proportion of patients with multiple sclerosis (MS) who start a disease-modifying therapy (DMT) within 1 year of MS onset has increased in Southern Alberta, researchers reported at the annual meeting of the Consortium of Multiple Sclerosis Centers. , said Jamie Greenfield, MPH, an epidemiologist at the University of Calgary, Alta., and colleagues.
Studies suggest that early initiation of DMT may change the course of MS, but diagnostic delays and barriers to treatment “often impede this opportunity,” the investigators said at the annual meeting of the Consortium of Multiple Sclerosis Centers. To assess time to treatment initiation among patients with relapsing-remitting MS, the researchers analyzed administrative data from the Calgary MS Clinic. They determined the time to initiation of an approved first-line DMT from MS onset, first MS clinic appointment, MS diagnosis, and most recent prior MS clinic appointment. They excluded patients who started a second-line DMT, started a DMT before an MS clinic appointment, or started a DMT during a clinical trial. In addition, they excluded patients with MS onset before 1999, when government reimbursements for DMTs became available.
In all, 1,462 eligible patients started DMTs during August 1999–March 2018; 57.2% started glatiramer acetate, 28.2% interferon-beta, 12.5% dimethyl fumarate, and 2.1% teriflunomide. Average age at treatment initiation was 36 years, and 71.3% were women. Median Expanded Disability Status Scale (EDSS) score was 2.0, and about 90% were urban residents. Approximately 23% had MS diagnosed before their first visit, 37% at their first visit, and 40% after their first visit.
Median time to DMT initiations was 20.3 months from MS onset, 5.4 months from first appointment, 4.1 months from MS diagnosis, and 1.6 months from most recent prior appointment. During 2015-2017, a greater percentage of patients started a DMT within 1 year of MS onset, compared with 1999-2004 (60.9% vs. 20.4%). During 2015-2017, patients also were more likely to start DMTs within 1 year of their first appointment (88.4% vs. 65.7%), within 1 year of MS diagnosis (92.8% vs. 81.3%), and within 3 months of their most recent prior appointment (89.2% vs. 59.5%), compared with 1999-2004.
The investigators used Spearman rank correlations or Kruskal-Wallis tests to evaluate associations between baseline characteristics and time to DMT initiation. A diagnosis of MS or a relapsing-remitting MS course at the first appointment, older age at MS onset, longer MS duration at the first appointment, higher EDSS scores at the first or most recent prior appointment, and shorter time between diagnosis and first appointment, regardless of whether diagnosis occurred before or after the appointment, were associated with earlier DMT initiation.
“Treatment delays are improving. Better understanding of these delays will guide development of additional early-initiation strategies,” the authors concluded.
Ms. Greenfield had no disclosures. A coauthor reported consulting fees from Biogen, Roche, Sanofi Genzyme, and Serono.
SOURCE: Greenfield J et al. CMSC 2019, Abstract DXT25.
SEATTLE – The proportion of patients with multiple sclerosis (MS) who start a disease-modifying therapy (DMT) within 1 year of MS onset has increased in Southern Alberta, researchers reported at the annual meeting of the Consortium of Multiple Sclerosis Centers. , said Jamie Greenfield, MPH, an epidemiologist at the University of Calgary, Alta., and colleagues.
Studies suggest that early initiation of DMT may change the course of MS, but diagnostic delays and barriers to treatment “often impede this opportunity,” the investigators said at the annual meeting of the Consortium of Multiple Sclerosis Centers. To assess time to treatment initiation among patients with relapsing-remitting MS, the researchers analyzed administrative data from the Calgary MS Clinic. They determined the time to initiation of an approved first-line DMT from MS onset, first MS clinic appointment, MS diagnosis, and most recent prior MS clinic appointment. They excluded patients who started a second-line DMT, started a DMT before an MS clinic appointment, or started a DMT during a clinical trial. In addition, they excluded patients with MS onset before 1999, when government reimbursements for DMTs became available.
In all, 1,462 eligible patients started DMTs during August 1999–March 2018; 57.2% started glatiramer acetate, 28.2% interferon-beta, 12.5% dimethyl fumarate, and 2.1% teriflunomide. Average age at treatment initiation was 36 years, and 71.3% were women. Median Expanded Disability Status Scale (EDSS) score was 2.0, and about 90% were urban residents. Approximately 23% had MS diagnosed before their first visit, 37% at their first visit, and 40% after their first visit.
Median time to DMT initiations was 20.3 months from MS onset, 5.4 months from first appointment, 4.1 months from MS diagnosis, and 1.6 months from most recent prior appointment. During 2015-2017, a greater percentage of patients started a DMT within 1 year of MS onset, compared with 1999-2004 (60.9% vs. 20.4%). During 2015-2017, patients also were more likely to start DMTs within 1 year of their first appointment (88.4% vs. 65.7%), within 1 year of MS diagnosis (92.8% vs. 81.3%), and within 3 months of their most recent prior appointment (89.2% vs. 59.5%), compared with 1999-2004.
The investigators used Spearman rank correlations or Kruskal-Wallis tests to evaluate associations between baseline characteristics and time to DMT initiation. A diagnosis of MS or a relapsing-remitting MS course at the first appointment, older age at MS onset, longer MS duration at the first appointment, higher EDSS scores at the first or most recent prior appointment, and shorter time between diagnosis and first appointment, regardless of whether diagnosis occurred before or after the appointment, were associated with earlier DMT initiation.
“Treatment delays are improving. Better understanding of these delays will guide development of additional early-initiation strategies,” the authors concluded.
Ms. Greenfield had no disclosures. A coauthor reported consulting fees from Biogen, Roche, Sanofi Genzyme, and Serono.
SOURCE: Greenfield J et al. CMSC 2019, Abstract DXT25.
SEATTLE – The proportion of patients with multiple sclerosis (MS) who start a disease-modifying therapy (DMT) within 1 year of MS onset has increased in Southern Alberta, researchers reported at the annual meeting of the Consortium of Multiple Sclerosis Centers. , said Jamie Greenfield, MPH, an epidemiologist at the University of Calgary, Alta., and colleagues.
Studies suggest that early initiation of DMT may change the course of MS, but diagnostic delays and barriers to treatment “often impede this opportunity,” the investigators said at the annual meeting of the Consortium of Multiple Sclerosis Centers. To assess time to treatment initiation among patients with relapsing-remitting MS, the researchers analyzed administrative data from the Calgary MS Clinic. They determined the time to initiation of an approved first-line DMT from MS onset, first MS clinic appointment, MS diagnosis, and most recent prior MS clinic appointment. They excluded patients who started a second-line DMT, started a DMT before an MS clinic appointment, or started a DMT during a clinical trial. In addition, they excluded patients with MS onset before 1999, when government reimbursements for DMTs became available.
In all, 1,462 eligible patients started DMTs during August 1999–March 2018; 57.2% started glatiramer acetate, 28.2% interferon-beta, 12.5% dimethyl fumarate, and 2.1% teriflunomide. Average age at treatment initiation was 36 years, and 71.3% were women. Median Expanded Disability Status Scale (EDSS) score was 2.0, and about 90% were urban residents. Approximately 23% had MS diagnosed before their first visit, 37% at their first visit, and 40% after their first visit.
Median time to DMT initiations was 20.3 months from MS onset, 5.4 months from first appointment, 4.1 months from MS diagnosis, and 1.6 months from most recent prior appointment. During 2015-2017, a greater percentage of patients started a DMT within 1 year of MS onset, compared with 1999-2004 (60.9% vs. 20.4%). During 2015-2017, patients also were more likely to start DMTs within 1 year of their first appointment (88.4% vs. 65.7%), within 1 year of MS diagnosis (92.8% vs. 81.3%), and within 3 months of their most recent prior appointment (89.2% vs. 59.5%), compared with 1999-2004.
The investigators used Spearman rank correlations or Kruskal-Wallis tests to evaluate associations between baseline characteristics and time to DMT initiation. A diagnosis of MS or a relapsing-remitting MS course at the first appointment, older age at MS onset, longer MS duration at the first appointment, higher EDSS scores at the first or most recent prior appointment, and shorter time between diagnosis and first appointment, regardless of whether diagnosis occurred before or after the appointment, were associated with earlier DMT initiation.
“Treatment delays are improving. Better understanding of these delays will guide development of additional early-initiation strategies,” the authors concluded.
Ms. Greenfield had no disclosures. A coauthor reported consulting fees from Biogen, Roche, Sanofi Genzyme, and Serono.
SOURCE: Greenfield J et al. CMSC 2019, Abstract DXT25.
REPORTING FROM CMSC 2019
Key clinical point: The proportion of patients with multiple sclerosis who start disease-modifying therapies within 1 year of disease onset may be increasing.
Major finding: During 1999-2004, about 20% of patients with MS started treatment within 1 year of disease onset, compared with 60% of patients during 2015-2017, at a center in Southern Alberta.
Study details: An analysis of administrative data from 1,462 patients from the Calgary MS Clinic between 1999 and 2018.
Disclosures: Ms. Greenfield had no disclosures. A coauthor reported consulting fees from Biogen, Roche, Sanofi Genzyme, and Serono.
Source: Greenfield J et al. CMSC 2019, Abstract DXT25.