Skip to main content
Top
Published in: CNS Drugs 6/2015

Open Access 01-06-2015 | Original Research Article

Platform Therapy Compared with Natalizumab for Multiple Sclerosis: Relapse Rates and Time to Relapse Among Propensity Score-Matched US Patients

Authors: Barbara H. Johnson, Machaon M. Bonafede, Crystal Watson

Published in: CNS Drugs | Issue 6/2015

Login to get access

Abstract

Background

Multiple sclerosis (MS) registry data, primarily from Europe, suggest that treatment with natalizumab delays time to relapse compared with platform therapy (interferon beta/glatiramer acetate).

Objective

This study uses US administrative claims data and propensity score matching (PSM) to compare relapse rates and time to relapse among patients with MS using either platform therapy or natalizumab.

Methods

Adults with MS receiving either platform therapy or natalizumab between January 1, 2009 and April 1, 2012 were identified in the Truven Health MarketScan® Research Databases. Patients were included if they had 12 months of continuous enrollment both before and after the index date (the first claim for either drug cohort) and had 12 months of claims data suggesting consistent treatment adherence during the follow-up period. Characteristics used in PSM included demographics, selected comorbidities and concomitant medications, MS severity, baseline relapse rates, and expenditures. A relapse was defined as an MS-related hospitalization or corticosteroid use.

Results

A total of 882 patients were matched. Relapse occurred among significantly fewer patients in the natalizumab group (26.5 %) than platform therapy (35.5 %, p < 0.001) (hazard ratio 0.69; 95 % CI 0.59–0.82). Relapses were also significantly later for those on natalizumab (308 vs 283 days without relapse, p < 0.001).

Conclusion

Treatment with natalizumab was associated with a significantly lower risk and rate of MS relapse and longer MS relapse-free time compared with platform therapies.
Literature
1.
2.
go back to reference Kantarci OH, Pirko I, Rodriguez M. Novel immunomodulatory approaches for the management of multiple sclerosis. Clin Pharmacol Ther. 2014;95:32–44.PubMedCrossRef Kantarci OH, Pirko I, Rodriguez M. Novel immunomodulatory approaches for the management of multiple sclerosis. Clin Pharmacol Ther. 2014;95:32–44.PubMedCrossRef
3.
4.
go back to reference Polman CH, O’Connor PW, Havrdova E, et al. A randomized, placebo-controlled trial of natalizumab for relapsing multiple sclerosis. N Engl J Med. 2006;354:899–910.PubMedCrossRef Polman CH, O’Connor PW, Havrdova E, et al. A randomized, placebo-controlled trial of natalizumab for relapsing multiple sclerosis. N Engl J Med. 2006;354:899–910.PubMedCrossRef
5.
go back to reference Goodin DS, Cohen BA, O’Connor P, Kappos L, Stevens JC. Assessment: the use of natalizumab (Tysabri) for the treatment of multiple sclerosis (an evidence-based review): report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology. 2008;71:766–73.PubMedCrossRef Goodin DS, Cohen BA, O’Connor P, Kappos L, Stevens JC. Assessment: the use of natalizumab (Tysabri) for the treatment of multiple sclerosis (an evidence-based review): report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology. 2008;71:766–73.PubMedCrossRef
6.
go back to reference Nicholas JA, Racke MK, Imitola J, Boster AL. First-line natalizumab in multiple sclerosis: rationale, patient selection, benefits and risks. Ther Adv Chronic Dis. 2014;5:62–8.PubMedCentralPubMedCrossRef Nicholas JA, Racke MK, Imitola J, Boster AL. First-line natalizumab in multiple sclerosis: rationale, patient selection, benefits and risks. Ther Adv Chronic Dis. 2014;5:62–8.PubMedCentralPubMedCrossRef
7.
go back to reference Goodin DS, Frohman EM, Garmany GP Jr, et al. Disease modifying therapies in multiple sclerosis: report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology and the MS Council for Clinical Practice Guidelines. Neurology. 2002;58:169–78.PubMedCrossRef Goodin DS, Frohman EM, Garmany GP Jr, et al. Disease modifying therapies in multiple sclerosis: report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology and the MS Council for Clinical Practice Guidelines. Neurology. 2002;58:169–78.PubMedCrossRef
8.
go back to reference Havrdova E, Galetta S, Hutchinson M, et al. Effect of natalizumab on clinical and radiological disease activity in multiple sclerosis: a retrospective analysis of the Natalizumab Safety and Efficacy in Relapsing-Remitting Multiple Sclerosis (AFFIRM) study. Lancet Neurol. 2009;8:254–60.PubMedCrossRef Havrdova E, Galetta S, Hutchinson M, et al. Effect of natalizumab on clinical and radiological disease activity in multiple sclerosis: a retrospective analysis of the Natalizumab Safety and Efficacy in Relapsing-Remitting Multiple Sclerosis (AFFIRM) study. Lancet Neurol. 2009;8:254–60.PubMedCrossRef
9.
go back to reference Bonafede MM, Johnson BH, Watson C. Health care-resource utilization before and after natalizumab initiation in multiple sclerosis patients in the US. Clinicoecon Outcomes Res CEOR. 2013;6:11–20.CrossRef Bonafede MM, Johnson BH, Watson C. Health care-resource utilization before and after natalizumab initiation in multiple sclerosis patients in the US. Clinicoecon Outcomes Res CEOR. 2013;6:11–20.CrossRef
10.
go back to reference Prosperini L, Gianni C, Leonardi L, et al. Escalation to natalizumab or switching among immunomodulators in relapsing multiple sclerosis. Mult Scler. 2012;18:64–71.PubMedCrossRef Prosperini L, Gianni C, Leonardi L, et al. Escalation to natalizumab or switching among immunomodulators in relapsing multiple sclerosis. Mult Scler. 2012;18:64–71.PubMedCrossRef
11.
go back to reference Lanzillo R, Bonavita S, Quarantelli M, et al. Natalizumab is effective in multiple sclerosis patients switching from other disease modifying therapies in clinical practice. Neurol Sci. 2013;34:521–8.PubMedCrossRef Lanzillo R, Bonavita S, Quarantelli M, et al. Natalizumab is effective in multiple sclerosis patients switching from other disease modifying therapies in clinical practice. Neurol Sci. 2013;34:521–8.PubMedCrossRef
12.
go back to reference Spelman T, Pellegrini F, Zhang A, et al. Comparison of patients treated with natalizumab and interferon beta/glatiramer using propensity-matched multiple sclerosis registry data. The 65th Annual Meeting of the American Academy of Neurology. San Diego, CA; 2013. Spelman T, Pellegrini F, Zhang A, et al. Comparison of patients treated with natalizumab and interferon beta/glatiramer using propensity-matched multiple sclerosis registry data. The 65th Annual Meeting of the American Academy of Neurology. San Diego, CA; 2013.
13.
go back to reference Clinical Coulthard-Morris L, Measures Rehabilitation. In: Burks JS, Johnson KP, editors. Multiple sclerosis diagnosis, medical management, and rehabilitation. New York: Demos Medical Publishing Inc; 2000. p. 221–90. Clinical Coulthard-Morris L, Measures Rehabilitation. In: Burks JS, Johnson KP, editors. Multiple sclerosis diagnosis, medical management, and rehabilitation. New York: Demos Medical Publishing Inc; 2000. p. 221–90.
14.
go back to reference Ho DE, Imai K, King G, Stuart EA. Matching as nonparametric preprocessing for reducing model dependence in parametric causal inference. Political Anal. 2007;15:199–236.CrossRef Ho DE, Imai K, King G, Stuart EA. Matching as nonparametric preprocessing for reducing model dependence in parametric causal inference. Political Anal. 2007;15:199–236.CrossRef
15.
go back to reference Ollendorf DA, Jilinskaia E, Oleen-Burkey M. Clinical and economic impact of glatiramer acetate versus beta interferon therapy among patients with multiple sclerosis in a managed care population. J Manag Care Pharm. 2002;8:469–76.PubMed Ollendorf DA, Jilinskaia E, Oleen-Burkey M. Clinical and economic impact of glatiramer acetate versus beta interferon therapy among patients with multiple sclerosis in a managed care population. J Manag Care Pharm. 2002;8:469–76.PubMed
16.
go back to reference Chastek BJ, Oleen-Burkey M, Lopez-Bresnahan MV. Medical chart validation of an algorithm for identifying multiple sclerosis relapse in healthcare claims. J Med Econ. 2010;13:618–25.PubMedCrossRef Chastek BJ, Oleen-Burkey M, Lopez-Bresnahan MV. Medical chart validation of an algorithm for identifying multiple sclerosis relapse in healthcare claims. J Med Econ. 2010;13:618–25.PubMedCrossRef
17.
go back to reference Butzkueven H, Kappos L, Pellegrini F, et al. Efficacy and safety of natalizumab in multiple sclerosis: interim observational programme results. J Neurol Neurosurg Psychiatry. 2014;85:1190–7.PubMedCentralPubMedCrossRef Butzkueven H, Kappos L, Pellegrini F, et al. Efficacy and safety of natalizumab in multiple sclerosis: interim observational programme results. J Neurol Neurosurg Psychiatry. 2014;85:1190–7.PubMedCentralPubMedCrossRef
Metadata
Title
Platform Therapy Compared with Natalizumab for Multiple Sclerosis: Relapse Rates and Time to Relapse Among Propensity Score-Matched US Patients
Authors
Barbara H. Johnson
Machaon M. Bonafede
Crystal Watson
Publication date
01-06-2015
Publisher
Springer International Publishing
Published in
CNS Drugs / Issue 6/2015
Print ISSN: 1172-7047
Electronic ISSN: 1179-1934
DOI
https://doi.org/10.1007/s40263-015-0251-1

Other articles of this Issue 6/2015

CNS Drugs 6/2015 Go to the issue