Multiple Sclerosis Patients Treated With Diroximel Fumarate in the Real-World Setting Have High Rates of Persistence and Adherence

• DOI: 10.1007/s40120-021-00242-7
• Publication Date: 2021-04-12T16:03:33Z
• Authors: Jacob Liseno; Brittney Lager; Catherine Miller; Sai L. Shankar; Jason P. Mendoza; James B. Lewin
• Keywords: Dimethyl fumarate; Discontinuation; Tolerability; Persistence (discontinuity)

Persistence to multiple sclerosis (MS) disease-modifying therapy is fundamental for maximal treatment outcomes. Diroximel fumarate (DRF) approved in the USA relapsing MS. Following oral administration, DRF metabolized monomethyl fumarate, active metabolite of dimethyl (DMF). showed clinically significant improvements gastrointestinal (GI) tolerability versus DMF a head-to-head clinical trial; however, real-world persistence/adherence has not been assessed. We evaluated DRF-treated patients practice. This retrospective analysis AcariaHealth Specialty Pharmacy Program included initiating from 4 December 2019 through 3 April 2020 and followed until data extraction (31 August 2020). Exclusion criteria undetermined status (e.g., prescription transfer different pharmacy). Endpoints persistence (overall proportion remaining on DRF), discontinuation rate due GI adverse events (AEs), adherence (proportion days covered [PDC]). AEs GI-related occurring at any time, or unknown AE without details about nature event if occurred ≤ 90 after initiation. Overall, 160 with MS were included. Median (range) patient age was 51 (20−79) years, 80.6% (129/160) female, 16.3% (26/160) had prior treatment. duration 7.6 (0.1−10.4) months. Estimated persistent 8 months 88.6% (95% confidence interval [CI] 82.5–2.7). 3.8% (6/160) discontinued AEs. Mean PDC 91.4% CI 89.1−93.7). In DMF-to-DRF switch subgroup, 92.3% (24/26) remained DRF, (1/26) high overall persistence, low AEs, therapy, aligning expectations based trials. Data consistent subgroup.