Key result
Early ofatumumab is projected to reduce EDSS ≥ 7 progression ~36% vs teriflunomide.
Why the study?
The impact of early versus delayed ofatumumab initiation and the long-term outcomes of ofatumumab versus teriflunomide in relapsing multiple sclerosis patients from a Spanish societal perspective were not well established.
Does early ofatumumab initiation improve long-term clinical and economic outcomes compared to teriflunomide or delayed ofatumumab in relapsing multiple sclerosis patients?
Does early ofatumumab initiation improve long-term clinical and economic outcomes compared to teriflunomide or delayed ofatumumab in relapsing multiple sclerosis patients?
Early initiation of ofatumumab in relapsing multiple sclerosis is projected to improve long-term clinical outcomes and reduce costs compared to teriflunomide or delayed ofatumumab initiation.
May support early ofatumumab in MS modeling; hypothesis-generating and requires RCT confirmation before practice change.
OBJECTIVES: To evaluate the impact of early (at first-line) vs delayed (3-year delay) ofatumumab initiation and long-term clinical, societal, and economic outcomes of ofatumumab vs teriflunomide in relapsing multiple sclerosis (RMS) patients from a Spanish societal perspective. METHODS: A cost-consequence analysis was conducted using an Expanded Disability Status Scale (EDSS)-based Markov model. Inputs were sourced from ASCLEPIOS I and II trials and published literature. RESULTS: At the end of 10 years, compared with first-line teriflunomide treatment, early first-line ofatumumab initiation was projected to result in 35.6% fewer patients progressing to EDSS ≥ 7 and 27.8% fewer relapses. The ofatumumab cohort required 7.3% reduced informal care time and had 19% fewer disability-adjusted life years (DALYs) than the teriflunomide cohort. A 3-year delay in ofatumumab treatment (3-year teriflunomide + 7-year ofatumumab) was projected to result in 32.2% more patients progressing to EDSS ≥ 7, 20.2% more relapses, 5.4% increased informal care time, and 16.6% more DALYs compared with early ofatumumab initiation. Early ofatumumab initiation was associated with total annual cost savings (excluding disease-modifying-therapies' acquisition costs) of €35,328 ($34,549; conversion factor 1€= $1.02255) and €24,373 ($23,836) per patient vs teriflunomide and 3-year delayed ofatumumab initiation, respectively. CONCLUSIONS: This study highlights the benefits of early initiation of high-efficacy therapy such as ofatumumab vs its delayed initiation for improving the outcomes in RMS patients (having characteristics similar to those of patients included in the ASCLEPIOS trials). Ofatumumab treatment was projected to provide improved long-term clinical, societal, and economic outcomes vs teriflunomide treatment in RMS patients from a Spanish societal perspective.
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Vudumula et al. (2022) studied Relapsing multiple sclerosis. Early (first-line) ofatumumab vs. First-line teriflunomide or 3-year delayed ofatumumab was evaluated on Progression to EDSS ≥ 7 (35.6% relative reduction). Early first-line ofatumumab initiation was projected to result in 35.6% fewer patients progressing to EDSS ≥ 7 and 27.8% fewer relapses over 10 years compared with first-line teriflunomide.
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