Patient adherence higher with inebilizumab compared with other biologics for NMOSD

Key takeaways:

• Most individuals were taking inebilizumab for their neuromyelitis optica spectrum disorder symptoms.
• Adherence to inebilizumab was higher compared with eculizumab and satralizumab.

Among individuals who were prescribed approved biologics for neuromyelitis optica spectrum disorder, those on inebilizumab had significantly higher medication adherence, according to a study presented at ECTRIMS 2024.

“The research aimed to evaluate adherence to approved biologics among patients with neuromyelitis optica spectrum disorder (NMOSD) in the U.S.,” Kristina Patterson, senior medical director of medical affairs at Amgen and co-author of the study, told Healio in an email. “NMOSD patients are at risk of life-altering relapses and hospitalizations, so treatment adherence is a key concern.”

The researchers, led by Bruce A.C. Cree, MD, PhD, MAS, professor of clinical neurology at the Weill Institute for Neurosciences at the University of California, San Francisco, conducted a retrospective cohort study using data from the Komodo Research Database between 2020 and 2023 on 111 individuals (mean age, 43 years; 85.6% women; 34.2% Black) with NMOSD who were prescribed Uplizna (inebilizumab, Amgen), Soliris (eculizumab, Alexion) or Enspryng (satralizumab, Genentech), all of which are approved to treat the condition.

Overall, 45% of the participants were given inebilizumab, 28% were given eculizumab and 27% were given satralizumab. The mean duration of follow up was 17.3±6.9 months for the entire study group. Follow-up duration varied by treatment: 16.4±6.3 months for inebilizumab, 20.6±7.4 months for eculizumab and 15.5±6.6 months for satralizumab.

Treatment adherence was defined as the percentage of days covered (PDC), which the researchers measured as a continuous and binary variable (PDC 80% = adherent) from initiation of treatment to the time when data became available.

Patterson and colleagues adjusted for characteristics such as age, sex, race, geography, type of insurance, as well as NMOSD-associated conditions (neuropathic pain, bladder dysfunction, hemiplegia/paraplegia) at baseline.

According to the results, medication adherence was substantially higher for individuals on inebilizumab (mean PDC = 85.2%±19; adherent = 72%) compared with those on eculizumab (mean PDC = 73.2%±21.5; adherent = 45.2%) and satralizumab (mean PDC = 66.5%±30; adherent = 53.3%).

The researchers additionally reported that fractional regression, when adjusting for covariates, revealed those on inebilizumab recorded “significantly” higher adherence compared with satralizumab and higher compared with eculizumab.

“These results provide insight into real-world adherence patterns that may help guide clinical decision-making and highlight the need to consider factors that could influence adherence,” Patterson said.