MS Speaks

[P3.269] Risk of Disease Progression after Starting Dimethyl Fumurate (DMF): Data from the Providence Multiple Sclerosis Center’s DMF Registry

Kyle Smoot, Kiren Kresa-Reahl, Chiayi Chen, Tamela Stuchiner, Bobbie Lee Roth, Stanley Cohan

Portland, OR, USA.

OBJECTIVE:

To determine the risk of clinical relapses and MRI progression in patients treated with DMF [dimethyl fumarate = Tecfidera].

BACKGROUND:

Given the results of two Phase III trials and the greater convenience of an oral medication, we anticipated a strong interest in DMF. Because data concerning transition from prior disease modifying therapy to DMF is limited, a registry was established to monitor the utilization of DMF and the treatment outcomes.

DESIGN/METHODS:

Subjects prescribed DMF from March 2013 to September 2014 were identified. Charts are reviewed at the time of starting DMF and then every 6 months.

RESULTS:

321 identified patients have been followed for a mean of 9.3 months; 103 (32.1%) were previously treated with interferon beta (INFβ), 52 (16.2%) with glatiramer acetate (GA), 13 (4.0%) with fingolimod, 54 (16.8%) with natalizumab, 17 (5.3%) with other agents. 30 patients (9.3%) were newly diagnosed , and 52 (16.2%) had been off prior treatment for at least 6 months before starting DMF.

Clinical relapses occurred in 44 (13.7%) patients. Of those, 18 (40.9%) of the relapses occurred within the first 3 months, 10 ( 22.7%) between month 3 and 6, and 16 (36.4%) between month 6 and 12 after starting DMF.

MRI results are available from 171 (53.3%) patients, 143 (83.6%) of which were stable.

To date, 81 (25.2%) patients have stopped DMF including 27 (8.4%) secondary to clinical or radiographic progression and 58 (18.0%) secondary to side effects.

CONCLUSIONS:

The majority of relapses on DMF occurred within the first 3 months after starting therapy. The risk of relapse was high in patients who were newly diagnosed (26.7%) and transitioning from natalizumab (18.5%). Mean washout period was 8 weeks for those who relapsed.

Patients who previously were on fingolimod had a high rate of relapse; however, the number was relatively small, 4 (30.8%).

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Category - MS and CNS Inflammatory Disease: Health Services/Outcomes Research

Session: P3: Poster Session III: MS and CNS Inflammatory Diseases: Treatment Efficacy, Safety and Tolerability (2:00 PM-6:30 PM)
Date/Time: Tuesday, April 21, 2015 - 2:00 pm