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TP3 FACTORS ASSOCIATED WITH PRESCRIBING OF ORAL DISEASE MODIFYING AGENTS IN MULTIPLE SCLEROSIS

      Objectives

      Introduction of oral disease modifying agents (DMAs) since 2010 has provided clinicians with more options to treat multiple sclerosis (MS) patients. Little is known about the determinants of DMA prescribing in MS patients. This study examined the factors associated with prescribing of oral DMAs in MS.

      Methods

      A retrospective longitudinal study was conducted using Trinetx, a federated global electronic health records (EHR) network of over 25 million patients from 2009–2018. The adult (≥18 years) MS patients were identified using either a MS diagnosis (ICD-9-CM: 340 or ICD-10-CM: G35) or a MS-specific DMA prescription. Patients with DMA prescription were classified as oral or injectable users based on their index medication during or after September 2010. A multivariable logistic regression model was used to determine the demographic and clinical factors associated with prescribing of an oral versus injectable DMA.

      Results

      The study cohort consisted of 20,655 MS patients; of whom most were 45–64 years (48.48%), female (71.42%), and whites (78.04%). About 77.39% MS patients were diagnosed with at least one comorbidity (mean±SD: 1.84±2.01). Over half (55.42%) of the patients were prescribed injectable DMAs, followed by orals (25.26%), infusions (18.60%), and combinations (0.72%). Multivariable regression revealed that 45–64 years old (Adjusted Odds Ratio [AOR]=0.90; 95% Confidence Interval [CI]: 0.84–0.97) and ≥65 years old; AOR=0.71, 95% CI: 0.62–0.83) were associated with decreased likelihood of receiving oral DMAs, whereas males (AOR=1.10, 95% CI: 1.01–1.19) and African-American race (AOR=1.13, 95% CI: 1.00–1.27) were more likely to receive oral DMAs. Comorbidities such as renal failure, depression, and uncomplicated hypertension decreased the odds of an oral DMA prescription.

      Conclusions

      About one in four MS patients initiated an oral DMA. Both demographic and clinical factors were associated with prescription of oral DMAs. Further research is needed to evaluate the outcomes of these DMA prescribing patterns in MS.