Objective:

To evaluate patient characteristics and 1-year treatment persistence among patients with multiple sclerosis (MS) initiating cladribine tablets (CladT).

Background:

Real-world evidence for CladT in patients with MS is emerging.

Design/Methods:

Patients with ≥1 CladT claim (4/1/2019–12/31/2020; first CladT claim=index date), ≥2 MS diagnoses ≥30 days apart (1/1/2012–12/31/2021), continuous insurance 1 year before (baseline period) and after (follow-up period) the month of the index date, and age 18–64 from the IQVIA PharMetrics^® Plus database were included. Patient characteristics evaluated were age, sex, geographic region, Charlson Comorbidity Index (CCI) score, select comorbidities, and prior disease-modifying therapies (DMTs). Patients were considered persistent if they had 2 CladT claims during follow-up without ≥1 non-CladT DMT claim (ie, switch).

Results:

Among 830 patients with ≥1 CladT claim, 200 met inclusion criteria (mean [SD] age 45.3 [10.0] years; 76.0% female; 40.5% South, 28% Midwest, 23.5% Northeast, 7.5% West). Mean (SD) CCI score was 0.54 (1.02). Top comorbidities included depression/anxiety (41.0%), mild liver disease (8.5%), and chronic lung disease (9.5%). A non-CladT DMT claim was present in 66.5% of patients during the baseline period. Of those on DMTs in the 1-year baseline period, patients switched from dimethyl fumarate (10.5%), fingolimod (10.5%), natalizumab (10.5%), ocrelizumab (10.5%), teriflunomide (8%), glatiramer acetate (7.5%), and subcutaneous interferon beta-1a (5.5%). Of the 200 patients, 189 (94.5%) had 2 claims for CladT during follow-up, and of these, 3 switched to another DMT. Of the 11 (5.5%) who had only 1 CladT claim during follow-up, 4 switched to another DMT. Overall, 7 (3.5%) switched to other DMTs (siponimod, dimethyl fumarate, glatiramer acetate, and ocrelizumab). Overall persistence was 93.0%, and mean (SE) survival time until first evidence of nonpersistence was 215.2 (3.2) days.

Conclusions: