May 04, 2019
Influence of Gender and Age in Use of Ocrelizumab for PPMS Patients Among US Neurologists
Authors: Robert T. Naismith; Patricia K. Coyle; Shiv Saidha; Jennifer Robinson; Virginia R. Schobel
To evaluate current use of ocrelizumab in primary progressive multiple sclerosis (PPMS) patients. We hypothesized that ocrelizumab would be predominantly used in younger, male patients.
In the phase 3 ORATORIO PPMS trial of ocrelizumab versus placebo, there was no disability progression benefit in women. In addition, patients over age 55 were excluded.
In 2018, 146 United States (US) neurologists completed an online survey on optimal ocrelizumab use. They submitted online chart audits for 324 recently evaluated PPMS patients treated with a disease-modifying therapy (DMT).
Treated PPMS patients were predominantly female (52%) and 55 years old or younger (75%; Fig. 1). 49% were treated with ocrelizumab; other DMTs were orals (19%), other monoclonal antibodies (15%), glatiramer acetate (10%), and interferons (7%; Fig. 2). Ocrelizumab usage patterns did not differ by treating neurologist demographics (Fig. 3 ). Ocrelizumab-treated versus other DMT-treated PPMS patients were more likely to be male (56% vs. 40%, p <0.05), but were not more likely to be younger (mean age 46.9 vs. 48.0 years, p =0.415; Fig. 4). Proportion of patients aged 55 years or less was 73% in the ocrelizumab arm vs. 77% in the other DMT arm (p >0.05; Fig. 5). Ocrelizumab use was greater among those neurologists who reported that age was not a constraint to use (66% vs. 30%, p <0.05); no correlation was found based upon neurologists’ self-reported attitude toward ocrelizumab being more effective in males (Fig. 6).
18 months post launch, ocrelizumab is the most commonly used DMT to treat PPMS. The ocrelizumab-treated PPMS patient is more likely to be male, but not more likely to be age 55 or less, compared to non-ocrelizumab-treated PPMS patients. Sex appears to be a more impactful consideration than age when US neurologists choose to use ocrelizumab in PPMS.
Patricia K. Coyle received consulting fees from Accordant, Alexion, Bayer, Biogen, Celgene, Genentech/Roche, Novartis, Sanofi Genzyme, Serono, and TG Therapeutics. She has received research support from Actelion, Alkermes, Genentech/Roche, MedDay, NINDS, and Novartis.
Robert T. Naismith consults for Acorda, Alkermes, Biogen, EMD Serono, Genentech, Genzyme, Novartis, Teva.
Shiv Saidha has received consulting fees from Medical Logix for the development of CME programs in neurology and has served on scientific advisory boards for Biogen-Idec, Genzyme, Genentech Corporation, EMD Serono & Novartis. He is the PI of investigator-initiated studies funded by Genentech Corporation and Biogen Idec, and received support from the Race to Erase MS foundation. He has received equity compensation for consulting from JuneBrain LLC, a retinal imaging device developer. He is also the site investigator of a trial sponsored by MedDay Pharmaceuticals.
Jennifer Robinson is the founder of Spherix Global Insights, an independent market intelligence firm, and has received no industry funding to conduct and report on this study.
Virginia R. Schobel is an employee of Spherix Global Insights, an independent market intelligence firm, and has received no industry funding to conduct and report on this study.
Archived AAN Abstracts:
Identifying SPMS: Are U.S. Neurologists Aligned on the Most Influential Disease and Patient Metrics?