MS Therapy Adherence and Relapse Risk (P01.193)

OBJECTIVE: To investigate the relationship between adherence to disease-modifying therapy (DMT) and multiple sclerosis (MS) relapses in the Therapy Optimization in MS (TOP MS) Study. BACKGROUND: Medication adherence is the extent that patients conform to recommendations about dosage and frequency of treatment. Evidence that therapy adherence is essential for patients to have fewer MS relapses is lacking. DESIGN/METHODS: Enrollees in TOP MS, a prospective, open-label study, were diagnosed with MS and being treated with glatiramer acetate or a beta interferon dispensed by a specialty pharmacy. Signed informed consents were returned to the pharmacies. Study enrollment produced log-on instructions for the study website. Responses were entered beginning at baseline, and at regular intervals. Adherence, measured by medication possession ratio (MPR), was derived from pharmacy shipment records. Logistic regression examined the association between physician confirmed relapses and DMT, therapy MPR ( 0.5 to 0.9), number of prior MS therapies, and time since first symptoms. RESULTS: Across all therapies, the mean MPR for the interim completer cohort of 1,309 was 0.9 (range: 0.1 to 1.0), with 63.8% reaching a two-year MPR >=0.9. Evaluated by categories of MPR, the proportion of participants remaining relapse-free for 24 months increased with increasing MPR, and the proportion with one or more relapses declined with increasing levels of MPR (p =0.9 MPR group was 0.5058, 50% of that of a patient in the MPR CONCLUSIONS: Better DMT adherence is associated with fewer MS relapses. Independent of adherence, one or more DMT changes increase the likelihood of relapses. Supported by: Teva Pharmaceuticals. Disclosure: Dr. Cohen has received personal compensation for activities with Astellis, Biogen Idec, EMD Serono, Genzyme Corporation, Sanofi-Aventis Pharmaceuticals, Inc., and Teva Neurscience. Dr. Cohen has received research support from Teva Neuroscience, the National Institutes of Health, Biogen Idec, EMD Serono, Novartis, and Roche. Dr. Leist has received personal compensation for activities with EMD Serono, Teva Neuroscience, Biogen, Bayer, and Pfizer as a consultant. Dr. Leist has received research support from EMD Serono, Teva Neuroscience, Bayer, ONO, Novartis Daishi, Acorda. Dr. Coyle has received personal compensation for activities with Acorda Therapeutics, Bayer, Biogen Idec, Genentech, Inc., Novartis, Pfizer Inc, Questcor, Roche Diagnostics Corporation, Sanofi-Aventis Pharmaceuticals Corporation, and Teva Neuroscience. Dr. Coyle has received personal compensation in an editorial capacity for NEURA. Dr. Coyle has received research support fromActelion, EMD Serono, and Novartis. Dr. Zwibel has received personal compensation for activities with Acorda Therapeutics, Bayer Pharmaceuticals Corporation, Biogen Idec, Serono, Inc., Genentech, Inc., and Teva Neuroscience as a consultant and/or member of speaker bureau. Dr. Markowitz has received personal compensation for activities with Bayer, Biogen-Idec, Eli Lilly, EMD-Serono, and Teva Neuroscience as a consultant. Dr. Tullman has received personal compensation for activities with Allergan, Inc., Acorda Therapeutics, Biogen Idec, EMD Serono, Novartis, Pfizer Inc, Questcor, Teva Neuroscience, and Sanofi-Aventis Pharmaceuticals, Inc.