Those who have read my posts over the years are familiar with my distrust of Big Pharma when it comes to the world of MS medications. The following published articles are but one reason why I have this opinion.
The first article was written by Dr. A. N. Wilner.
Glatiramer Acetate Reduces Relapses With Lower Cost in Patients With Multiple Sclerosis: Presented at ANA
By Andrew N. Wilner, MD
SALT LAKE CITY, Utah -- September 25, 2008 -- Glatiramer acetate decreases the chance of relapse in patients with multiple sclerosis (MS) and lowers medical costs compared with interferon beta-1b (IFN-B-1b), according to a retrospective analysis of data collected from a national commercial managed care database in the United States.
The findings were presented here on September 23 at the American Neurological Association (ANA) 133rd Annual Meeting by Kenneth Johnson, MD, University of Maryland, Baltimore, Maryland.
"These data come from managed care and practicing physicians' prescribing decisions nationwide, and the study was not funded by a pharmaceutical company," observed Dr. Johnson.
The study compared 308 patients who were taking glatiramer acetate and 110 patients taking IFN-B-1b for 2 years who were in the i3 LabRx database from July 2001 to June 2006. Direct medical costs and the likelihood of relapse were determined using multivariate regression analyses.
Relapse was defined as hospitalisation with MS or prescription of steroids within 7 days of an MS diagnosis. Medical costs included inpatient, outpatient, and prescription drug services.
Baseline patient characteristics such as age, number of diagnoses, number of outpatient prescription medications, and comorbidities were not significantly different between the treatment arms. The study only included patients with medical and prescription benefit coverage that were in the administrative claims database.
Relapse rate was significantly lower in the patients who used glatiramer than in patients on IFN-B-1b (2.09% vs 10.9%; P = .0018).
In addition, costs were significantly lower in the glatiramer acetate group compared with the IFN-B-1b ($48,130 vs $53,185; P = .0345).
"This direct comparison study shows that the use of [glatiramer] is associated with significantly fewer MS relapses than use of IFN-B-1b," the researchers concluded. "Also there were significantly lower 2-year total direct medical costs associated with GA treatment."
The current study received funding for data analysis from TEVA, the manufacturer of glatiramer acetate.
[Presentation title: Glatiramer Acetate Versus Interferon Beta-1b: Direct Comparison of Multiple Sclerosis Relapses and Total Medical Costs Over 2 Years. Abstract WIP-9]
The second article is also written by Dr. Wilner.
September 25, '08: Disease Modifying Drugs Tie for Efficacy in Multiple Sclerosis
Posted by: stuart
Disease Modifying Drugs Tie for Efficacy in Multiple Sclerosis: Presented at ANA
By Andrew N. Wilner, MD
Source: DG Dispatch
SALT LAKE CITY, Utah -- September 24, 2008 -- The different disease-modifying drugs available on the market for treatment of relapsing-remitting multiple sclerosis (MS) result in similar rates of disease relapse when examined over the long term, according to a retrospective chart review.
Loren Rolak, MD, The Marshfield Clinic, Marshfield, Wisconsin, presented the results of the study here on September 23 at the American Neurological Association (ANA) 133rd Annual Meeting.
Dr. Rolak and colleagues reviewed the clinical course of 573 patients with relapsing-remitting MS treated with disease modifying agents at The Marshfield Clinic. They evaluated 176 patients for >5 years, 47 patients for >10 years, and 27 patients for >12 years.
Results show that relapse rates (RR) were similar among the 4 disease-modifying therapies: 0.29 with glatiramer acetate subcutaneous (n = 224), 0.32 with beta interferon-1a intramuscular (n = 180), 0.30 with beta interferon -1a subcutaneous (n = 43), and 0.31 with beta interferon-1b subcutaneous (n = 126).
There was no association between major histocompatibility complex class II DR beta 1 (HLA-DRB1) or nitric oxide synthase (NOS2A) genotypes and relapse rate among the different drugs.
"Switching to another drug doesn't matter in terms of relapses; if you fail one drug, switching to another one doesn't result in clinical improvement," Dr. Rolak added.
Dr. Rolak's data also demonstrated similar degrees of disability for patients on the different treatments during follow-up that extended to 12 years. At the onset of follow-up, patients had an Extended Disability Status Scale (EDSS) scores ranging from 1.5 to 2.5. At the end of 12 years, the EDSS scores ranged from 4 to 4.5. EDSS scores with the different drugs were similar at 7, 10, and 12 years.
These results are consistent with recent head-to-head trials that compared these drugs, Dr. Rolak observed. These studies failed to show significant differences in the efficacy of these drugs, he said.
"None of the drugs demonstrate superiority in relapse rate or EDSS when followed for up to 12 years," Dr. Rolak concluded.
[Presentation title: No Difference Among Disease-Modifying Drugs for the Long-Term Treatment of Multiple Sclerosis. Abstract T-103]
It's all about marketing, sales and trying to get that extra few percent share of the MS drug market. If the truth gets "bent" a little bit along the way, so be it!