OBJECTIVES:

Immunomodulatory agents, which includes newer disease modifying treatments such as monoclonal antibodies, have shown to be beneficial for patients with relapse-remitting multiple sclerosis (MS). The current study aimed to examine demographics and real-world treatment patterns among patients with MS in a large, de-identified electronic health records (EHR) database in the US.

METHODS:

Patients with an ICD-10 or SNOMED code for MS were identified from January 2015 to June 2022 in a large (100 million+ patients total), nationally representative EHR database which includes inpatient and outpatient encounters in the US. Demographics (e.g., age, gender, race/ethnicity) and prescription treatments were examined using descriptive statistics.

RESULTS:

A total of 116,782 patients with MS were identified. More females had MS than males (75% vs. 25%) and there was a higher prevalence among higher attitude regions (e.g., Mountain: 17.1%, East North Central: 13.6%, West North Central: 12.1%, East South Central: 3.1%, West South Central: 4.4%). A higher proportion of MS was among those of 60 years old and over and 50-59 years old (46.8% and 22.3%, respectively). Across the total population of MS, the most used treatments were glatiramer (22.6%) and dimethyl fumarate (15.3%), however treatment regimens did not differ by gender or region. Among Blacks/African Americans, there was a higher proportion on natalizumab or ocrelizumab compared with whites (8.82% vs. 8.04% and 13.01% vs. 11.73%).

CONCLUSIONS:

Gender and attitude findings were consistent with recent published epidemiological findings using health claims data for MS. Findings of higher use of the newer monoclonal antibodies among Blacks/African Americans are consistent with published clinical trial data showing greater benefits of these treatments over interferon beta-1b among Blacks/African Americans, who tend to have more severe disease courses. Further explorations in understanding social determinants of health factors and access to newer and more efficacious treatments in MS is needed.