Original Research
Tuesday, November 14, 2023
08:30 AM–10:00 AM
Abstract
Introduction: Ocrelizumab and rituximab are medications used to treat multiple sclerosis (MS). These medications are typically administered every 6 months. The use of extended interval dosing (EID) has limited evidence; however, delayed infusions did occur during the COVID-19 pandemic.
Research Question or Hypothesis: Understand the impact of COVID-19 on EID of ocrelizumab and rituximab for MS.
Study Design: This is a quality improvement, retrospective, descriptive database analysis.
Methods: Medical benefit claims with an associated MS diagnosis from 2017 through 2022 were collected for ocrelizumab and rituximab. Patients included in the analysis had two or more administered infusions. Administrations less than 197 days apart were defined as standard interval dosing (SID), while administrations equal to or greater than 197 days were considered EID. An index date of March 20, 2020 was used to classify infusions as pre- or post-COVID-19. The primary endpoint evaluated the proportion of SID or EID claims before and after the index date. Additional exploratory analysis of medical and pharmacy benefit claims for last known interval and high dose steroids were reviewed.
Results: A total of 2,359 claims for ocrelizumab and rituximab were identified. Prior to the index date, most claims were for SID (92% ocrelizumab, 78% rituximab). After the index date, a shift in the proportion of claims to EID was observed. The subgroup analysis of ocrelizumab and rituximab claims and use of high dose corticosteroids in 2022 identified three individual patients. The last known treatment interval for these patients were SID (1 rituximab) and EID (1 ocrelizumab, 1 rituximab). Overall, the last claims analysis revealed a moderate shift back to SID (71% ocrelizumab, 48% rituximab).
Conclusion: The claims-based analysis indicates that EID was a practice before and after COVID-19, although a shift to greater use of EID was observed. Further analysis is needed to understand the implications of EID on clinical outcomes.
Presenting Author
Jason Chau Pharm.D.Authors
Shannon Panther Pharm.D., MBA
Kaiser Permanente