Background and Importance Therapeutic efficacy of disease modifying therapies (DMTs) for multiple sclerosis (MS) is often hindered by poor persistence and adherence, impacted by patient-perceived efficacy concerns, adverse effects and forgetfulness. Real-world studies have shown that nonpersistence and nonadherence to DMTs can lead to negative clinical outcomes, including higher rates of relapse and disease progression.

Aim and Objectives This study measured persistence, adherence, and time to switching to other therapy among patients with MS initiating teriflunomide or dimethyl fumarate treatment.

Material and Methods This retrospective study used data from patients with MS newly initiated oral DMTs teriflunomide, dimethyl fumarate within the qualifying time period (January 1, 2019 through December 31, 2019). Patient demographics were collected for each patient and included age, sex, and treatment history. Patients were followed from the start of the initial treatment until December 2021. Persistence was defined as the duration a patient continued their medication. Kaplan-Meier curves assessed persistence. Adherence was measured using medication possession ratio (MPR); patients with MPR>80% were considered adherent. Switching was measured by comparing number of patients switching and mean time to switch to other therapies.

Results The baseline characteristics of the 201 patients included in this study were collected. The majority of patients were on dimethyl fumarate (72,6%; n = 146), followed by teriflunomide (27,3%; n = 55). The majority of patients were female (75,1%).Teriflunomide and dimethyl fumarate patients had a high persistence rates, 74,5% and 68,4%, respectively, after 12 months. The proportion of patients adherent (MPR> 80%) to teriflunomide and dimethyl fumarate were 90% and 72%, respectively. Patients newly initiated on dimethyl fumarate had the highest rate of switching to other therapy (32,1%; n = 47), followed by patients on teriflunomide (21,8%; n = 12). The mean time to switching ranged from 277 days for teriflunomide to 342 days for dimethyl fumarate.

Conclusion and Relevance This real-world claims data study demonstrates that patients with MS newly initiated on teriflunomide and dimethyl fumarate had high persistence and adherence at 12 months.

Given the importance of treatment persistence, adherence, and time to switching on clinical outcomes for patients with MS, our findings can be used to inform treatment decision-making by healthcare providers.

Conflict of Interest No conflict of interest.