Allignol Arthur, Boutmy Emmanuelle, Sabidó Espin Meritxell, Marhardt Kurt, Vermersch Patrick
Merck Healthcare KGaA, Darmstadt, Germany.
Merck Gesellschaft mbH (an affiliate of Merck KGaA), Vienna, Austria.
Front Neurol. 2021 Jul 22;12:676585. doi: 10.3389/fneur.2021.676585. eCollection 2021.
It is thought that older patients with multiple sclerosis (MS) may present with a different clinical disease phenotype, and therefore respond to subcutaneous interferon beta-1a (sc IFN β-1a) differently to younger patients. However, few real-world data are available concerning the effectiveness of sc IFN β-1a according to age. Using data from US claims databases, this cohort analysis aimed to determine the differences in relapse rates, healthcare utilization, treatment adherence, and discontinuation according to pre-defined age groups. Patient data were pooled from the IBM® MarketScan® Commercial Claims Database and Medicare Supplemental Database. Patients with a confirmed MS diagnosis who initiated treatment with sc IFN β-1a between July 01, 2010 and December 31, 2015, along with at least 6 months continuous enrolment in a healthcare plan, were followed from first prescription (index date) until date of discontinuation, treatment switch, or end of observation period (1 year after index date). Of the 5,340 patients included in the analysis, there was a high proportion of patients free from relapse across all age groups (range: 94.1-95.4%), with a numerical decrease in the number of MRI performed by age (mean: 0.25, 18-30 years; 0.20, 31-40 years; 0.16, 41-50 years; 0.14, ≥51 years). Adherence (≥80%) was seen to increase with age (77.6%, 18-30 years; 79.6%, 31-40 years; 81.3%, 41-50 years; 84.0%, ≥51 years), at the same time as a non-significant decrease in discontinuation (incidence rate: 79.91, 73.01, 71.75, 68.71%). The effectiveness of sc IFN β-1a does not appear reduced as a consequence of age in this real-world setting. Older patients had lower discontinuation rates and reduced disease activity, reflected in lower relapse rates and fewer MRI scans compared with younger patients.
人们认为,老年多发性硬化症(MS)患者可能呈现出不同的临床疾病表型,因此与年轻患者相比,他们对皮下注射干扰素β-1a(sc IFN β-1a)的反应也有所不同。然而,关于sc IFN β-1a根据年龄划分的有效性,几乎没有真实世界的数据。利用美国索赔数据库的数据,这项队列分析旨在确定根据预先定义的年龄组在复发率、医疗保健利用率、治疗依从性和停药方面的差异。患者数据来自IBM® MarketScan®商业索赔数据库和医疗保险补充数据库。对2010年7月1日至2015年12月31日期间开始使用sc IFN β-1a治疗且在医疗保健计划中连续登记至少6个月的确诊MS患者,从首次处方(索引日期)开始随访,直至停药、治疗转换或观察期结束(索引日期后1年)。在纳入分析的5340名患者中,所有年龄组中无复发的患者比例都很高(范围:94.1-95.4%),MRI检查次数随年龄增长呈数值下降(平均值:18-30岁为0.25次;31-40岁为0.20次;41-50岁为0.16次;≥51岁为0.14次)。依从性(≥80%)随年龄增长而增加(18-30岁为77.6%;31-40岁为79.6%;41-50岁为81.3%;≥51岁为84.0%),同时停药率有非显著性下降(发病率:79.91、73.01、71.75、68.71)。在这个真实世界的环境中,sc IFN β-1a的有效性似乎不会因年龄而降低。与年轻患者相比,老年患者停药率较低,疾病活动度降低,这体现在复发率较低和MRI扫描次数较少上。