Drug-use patterns and severe adverse events with disease-modifying drugs in patients with multiple sclerosis: a cohort study based on German claims data

Alexandra Simbrich,1 Jasmine Thibaut,1 Laura Khil,1,2 Klaus Berger,1 Oliver Riedel,3 Niklas Schmedt3,41Institute of Epidemiology and Social Medicine, University of Münster, 48149 Münster, Germany; 2Cancer Registry North Rhine-Westphalia, 44801, Bochum, Germany; 3Department of Clini...

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Autores principales: Simbrich A, Thibaut J, Khil L, Berger K, Riedel O, Schmedt N
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Publicado: Dove Medical Press 2019
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spelling oai:doaj.org-article:963d319a905840299a92bfc98e4d48652021-12-02T10:43:41ZDrug-use patterns and severe adverse events with disease-modifying drugs in patients with multiple sclerosis: a cohort study based on German claims data1178-2021https://doaj.org/article/963d319a905840299a92bfc98e4d48652019-05-01T00:00:00Zhttps://www.dovepress.com/drug-use-patterns-and-severe-adverse-events-with-disease-modifying-dru-peer-reviewed-article-NDThttps://doaj.org/toc/1178-2021Alexandra Simbrich,1 Jasmine Thibaut,1 Laura Khil,1,2 Klaus Berger,1 Oliver Riedel,3 Niklas Schmedt3,41Institute of Epidemiology and Social Medicine, University of Münster, 48149 Münster, Germany; 2Cancer Registry North Rhine-Westphalia, 44801, Bochum, Germany; 3Department of Clinical Epidemiology, Leibniz Institute for Prevention Research and Epidemiology – BIPS, 28359 Bremen, Germany; 4InGef – Institute for Applied Health Research Berlin GmbH, 10117 Berlin, GermanyPurpose: To describe drug-use patterns in patients with multiple sclerosis (MS) using disease-modifying drugs (DMDs) and to estimate the incidence of severe adverse events (SAEs) of treatment.Methods: We conducted a cohort study within the German Pharmacoepidemiological Research Database between January 1, 2006 and December 31, 2013. MS patients on DMDs were described in terms of clinical characteristics and drug-use patterns. Next, we assessed the incidence of AEs in new users of fingolimod, natalizumab, glatiramer acetate, and IFNβ1a.Results: Among approximately 11 million insured members of German Statutory Health Insurance, the DMD-user cohort comprised 15,377 patients with MS, with a mean age of 39.6 years and 68% females. Nearly half of all DMD users had a diagnosis of depression, with prevalence ranging from 40.1% for IFNβ1a to 62.3% for immunoglobulins. The overall rate of MS relapses per patient and year was 0.34 (95% CI 0.33–0.34). During an average follow-up of 1,650 days, the majority (42.4%) of MS patients were adherent to DMD treatment (“continuous single users”), followed by patients interrupting treatment (39.5%, “interrupters”). Switch of DMD treatment (11.9%) was less frequent, and only 5.6% discontinued treatment. Treatment discontinuation was most common in users of natalizumab (7.5%) and IFNβ1b (7.0%). The most frequent SAE was hospitalization for depression, followed by any infectious disease and any malignancy. The incidence rate of all adverse events did not significantly differ across different DMDs.Conclusion: Treatment discontinuation with DMDs and treatment switch were rare. Causes of rather frequent DMD-treatment interruption have to be evaluated in further studies based on primary data collection. Active safety monitoring of new DMDs based on claims data requires large data sets to detect rare AEs and availability of up-to-date data.Keywords: multiple sclerosis, drug-use patterns, adverse events, claims data, disease-modifying drugsSimbrich AThibaut JKhil LBerger KRiedel OSchmedt NDove Medical Pressarticlemultiple sclerosisdrug use patternsadverse eventsclaims datadisease modifying drugsNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571Neurology. Diseases of the nervous systemRC346-429ENNeuropsychiatric Disease and Treatment, Vol Volume 15, Pp 1439-1457 (2019)
institution DOAJ
collection DOAJ
language EN
topic multiple sclerosis
drug use patterns
adverse events
claims data
disease modifying drugs
Neurosciences. Biological psychiatry. Neuropsychiatry
RC321-571
Neurology. Diseases of the nervous system
RC346-429
spellingShingle multiple sclerosis
drug use patterns
adverse events
claims data
disease modifying drugs
Neurosciences. Biological psychiatry. Neuropsychiatry
RC321-571
Neurology. Diseases of the nervous system
RC346-429
Simbrich A
Thibaut J
Khil L
Berger K
Riedel O
Schmedt N
Drug-use patterns and severe adverse events with disease-modifying drugs in patients with multiple sclerosis: a cohort study based on German claims data
description Alexandra Simbrich,1 Jasmine Thibaut,1 Laura Khil,1,2 Klaus Berger,1 Oliver Riedel,3 Niklas Schmedt3,41Institute of Epidemiology and Social Medicine, University of Münster, 48149 Münster, Germany; 2Cancer Registry North Rhine-Westphalia, 44801, Bochum, Germany; 3Department of Clinical Epidemiology, Leibniz Institute for Prevention Research and Epidemiology – BIPS, 28359 Bremen, Germany; 4InGef – Institute for Applied Health Research Berlin GmbH, 10117 Berlin, GermanyPurpose: To describe drug-use patterns in patients with multiple sclerosis (MS) using disease-modifying drugs (DMDs) and to estimate the incidence of severe adverse events (SAEs) of treatment.Methods: We conducted a cohort study within the German Pharmacoepidemiological Research Database between January 1, 2006 and December 31, 2013. MS patients on DMDs were described in terms of clinical characteristics and drug-use patterns. Next, we assessed the incidence of AEs in new users of fingolimod, natalizumab, glatiramer acetate, and IFNβ1a.Results: Among approximately 11 million insured members of German Statutory Health Insurance, the DMD-user cohort comprised 15,377 patients with MS, with a mean age of 39.6 years and 68% females. Nearly half of all DMD users had a diagnosis of depression, with prevalence ranging from 40.1% for IFNβ1a to 62.3% for immunoglobulins. The overall rate of MS relapses per patient and year was 0.34 (95% CI 0.33–0.34). During an average follow-up of 1,650 days, the majority (42.4%) of MS patients were adherent to DMD treatment (“continuous single users”), followed by patients interrupting treatment (39.5%, “interrupters”). Switch of DMD treatment (11.9%) was less frequent, and only 5.6% discontinued treatment. Treatment discontinuation was most common in users of natalizumab (7.5%) and IFNβ1b (7.0%). The most frequent SAE was hospitalization for depression, followed by any infectious disease and any malignancy. The incidence rate of all adverse events did not significantly differ across different DMDs.Conclusion: Treatment discontinuation with DMDs and treatment switch were rare. Causes of rather frequent DMD-treatment interruption have to be evaluated in further studies based on primary data collection. Active safety monitoring of new DMDs based on claims data requires large data sets to detect rare AEs and availability of up-to-date data.Keywords: multiple sclerosis, drug-use patterns, adverse events, claims data, disease-modifying drugs
format article
author Simbrich A
Thibaut J
Khil L
Berger K
Riedel O
Schmedt N
author_facet Simbrich A
Thibaut J
Khil L
Berger K
Riedel O
Schmedt N
author_sort Simbrich A
title Drug-use patterns and severe adverse events with disease-modifying drugs in patients with multiple sclerosis: a cohort study based on German claims data
title_short Drug-use patterns and severe adverse events with disease-modifying drugs in patients with multiple sclerosis: a cohort study based on German claims data
title_full Drug-use patterns and severe adverse events with disease-modifying drugs in patients with multiple sclerosis: a cohort study based on German claims data
title_fullStr Drug-use patterns and severe adverse events with disease-modifying drugs in patients with multiple sclerosis: a cohort study based on German claims data
title_full_unstemmed Drug-use patterns and severe adverse events with disease-modifying drugs in patients with multiple sclerosis: a cohort study based on German claims data
title_sort drug-use patterns and severe adverse events with disease-modifying drugs in patients with multiple sclerosis: a cohort study based on german claims data
publisher Dove Medical Press
publishDate 2019
url https://doaj.org/article/963d319a905840299a92bfc98e4d4865
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