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2001 to 2020 Saw Shift in Rx for Disease-Modifying Therapy for Multiple Sclerosis

Oral disease-modifying therapies dominated new initiations by 2020 to 62.3 percent

By Lori Solomon HealthDay Reporter

THURSDAY, July 27, 2023 (HealthDay News) — Oral disease-modifying therapies (DMTs) predominated new initiations for treatment of multiple sclerosis (MS) in 2020, according to a study published online July 10 in JAMA Neurology.

Mackenzie Henderson, Pharm.D., from Rutgers University in New Brunswick, New Jersey, and colleagues examined real-world prescribing patterns of DMTs for MS. The analysis captured 153,846 DMT initiation episodes for adults and 583 DMT initiation episodes among children, of whom 113,583 patients (113,095 adults and 488 children) had initiation of at least one DMT, identified from MarketScan U.S. commercial claims data (2001 through 2020).

The researchers found that among adults, use of platform injectables showed an absolute decline of 73.8 percent during the study period, driven by a 61.2 percent decline in interferon β initiations. Initiation of oral DMTs increased as a share of all DMT initiations following their 2010 introduction (from 1.1 percent in 2010 to 62.3 percent in 2020). Over time, infusion therapy initiations remained relatively low, accounting for 3.2 percent of all initiations since their introduction in 2004, although there was a modest annual increase after ocrelizumab was introduced in 2017, reaching 8.2 percent of all initiations in 2020. Patterns were similar in children, except for oral therapy preference. In adults, dimethyl fumarate was the most commonly initiated DMT in 2019 to 2020 (23.3 to 27.2 percent of all initiations). In children, fingolimod was the most commonly initiated (34.8 to 68.8 percent) in 2019 to 2020.

“The increasing use of oral therapies may have been due to multiple factors, including convenience, insurance restrictions, or direct-to-consumer advertising,” the authors write.

Several authors disclosed ties to the pharmaceutical industry.

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