May 30, 2025
Key Takeaways
- Long-term fumarate therapy in MS patients showed significantly lower infection-related HCRU compared to anti-CD20 therapies, with a 30% lower risk of infection events.
- MS-related healthcare encounters were 26% lower at year 3 and 31% lower at year 4+ for fumarates versus anti-CD20s.
A study reveals long-term fumarate therapy significantly reduces infection-related healthcare utilization in multiple sclerosis patients compared to anti-CD20 treatments.
Kyle E. Smoot, MD
In a comparative study of nearly 2000 patients with multiple sclerosis (MS), findings showed that those on long-term fumarates (FUM) had significantly lower infection-related healthcare resource utilization (HCRU) over a 2-year follow-up than those on anti-CD20-targeting medications. Overall, these data underscored the importance of long-term risk-benefit considerations when selecting disease-modifying therapies in MS management.1
Presented at the 2025 Consortium of Multiple Sclerosis Centers (CMSC) Annual Meeting, held May 28-31, in Phoenix, Arizona, the study was the first to compare long-term infection-related HCRU between FUM versus anti-CD20 therapies. After 1:2 propensity-scoring matching, 652 patients on FUM (dimethyl fumarate: n = 614; diroximel fumarate: n = 38) were pitted against 1304 patients on anti-CD20s such as ocrelizumab (n = 1296) and ofatumumab (n = 8). Coming into the study, the baseline demographics between the two treatment groups were balanced (standardized mean differences ≤.0.10).
Led by Kyle E. Smoot, MD, a neurologist at the Providence MS Center in Portland, Oregon, the study revealed a significantly lower number of annualized infection-related healthcare encounter rate per patient per year (PPPY) with FUM relative to anti-CD20s (1.75 vs 2.22; P <.001). In addition, the mean infection events PPPY were lower for those on FUMs compared with anti-CD20s from year 2 (2.31 vs 2.75; P = .016) to year 4+ (2.54 vs 3.64; P = .021), representing a 30% lower risk (rate ratio [RR], 0.70; 95% CI, 0.52-0.95; P = .021).
This retrospective analysis pulled from Komodo Health Claims Database from January 2016 to May 2022, using patients aged 18 to 64 with at least 1 claim for MS. Infection events were identified based on ICD-10 codes while MS relapses were identified based on a previously published algorithm. Annualized relapse rate (ARR) and HCRU were calculated as the total number of relapses or healthcare encounters observed divided by the total number of patient-years.
