(P-293) Factors Associated with Different Dosage Forms of Disease-modifying Agents in Older Adults with Multiple Sclerosis

Background: Limited real-world data exists regarding the use of Disease Modifying Agents (DMAs) in older adults with Multiple Sclerosis (MS).

Objectives: This study examined utilization patterns and factors associated with the selection of dosage forms of Disease Modifying Agents (DMAs) for older adults with MS using electronic medical records (EMR) data.

Methods: This retrospective cohort study involved 2016–2019 TriNetX, a federated EMR network data, of over 38 million patients from the US. Older adults (≥60 years) with MS diagnosis (ICD-9/ ICD-10 CM codes: 340/ G35) and any prescribing record during the study period were included. Based on the last DMA prescription during the study period, patients were classified into injectable, oral, and infusion DMA users. Multinomial logistic regression model was used to determine the factors associated with the selection of oral and infusion DMAs relative to injectable DMAs in older adults.

Results: Of 2,445 older adults with MS receiving DMA prescriptions, majority (55.30%) were prescribed injectables, followed by orals (32.02%) and infusion (12.68%) DMAs. Most commonly prescribed DMAs, among injectables, orals and infusions were: glatiramer acetate (60.13%), teriflunomide (44.06%), and ocrelizumab (58.06%), respectively. Multinomial regression revealed 60–64 years old had higher odds of receiving infusions [Adjusted Odds Ratio (aOR)=2.10] and orals (aOR=1.60) than injectables compared to 70 years and older. Males (aOR=1.66) had higher odds of receiving infusion over injectable DMAs. Older adults with cerebellar symptoms (aOR=1.84) and relapse drugs (aOR=8.14) had higher odds of being prescribed with infusions than injectables. Further, few comorbidities and symptomatic medications were associated with receiving DMAs. Healthcare utilization in terms inpatient admissions (aOR=0.31) were associated with lower odds of receiving infusions, while outpatient visits (aOR=2.03) had higher odds of receiving infusions than injectables.

Conclusions: Older adults with MS mostly used injectable DMAs. Several predisposing and need factors were associated with prescribing of a particular DMA dosage form in older adults with MS.