2SPD-003 Evolution of treatment consumption in secondary-progressive multiple sclerosis (2018–2023)

<h3>Background and Importance</h3> Secondary-progressive multiple sclerosis (SPMS) is a clinical phenotype that develops in about 50% of patients with relapsing-remitting multiple sclerosis (RRMS). There is a progressive worsening of symptoms without remission periods and progression may not present outbreaks. <h3>Aim and Objectives</h3> The aim of our study is to compare the variation in consumption patterns of SPMS drugs dispensed in a Hospital Pharmacy Service during the 2018–2023 period. <h3>Material and Methods</h3> This was a retrospective, single-centre and observational study, conducted from 2018–2023. The comparison of treatment consumption was carried out by calculating the defined daily doses (DDD)/1000 inhabitants/day through the DDD established by the WHO Collaborating Centre for Drug Statistics Methodology, the information provided by the Athos-Stock programme and the census of inhabitants of the hospital area. <h3>Results</h3> The DDD/1000 inhabitants/day data obtained are: siponimod 2 mg (0;0;0;0.0083;0.0311; 0.038), interferon beta 1B 250 mcg (Betaferon/Extavia) (0.0229; 0.0224; 0.0139; 0.0115; 0.0088; 0.0082), interferon beta 1A 22/44 mcg (Rebif)(0.0119;0.0162;0.0088;0.011;0.0087;0.0104) and ofatumumab 20 mg (0;0;0;0.0021;0.0234). These values show opposite patterns of evolution. On the one hand, siponimod and ofatumumab showed a growing trend in consumption. In 2022, subsidised use of ofatumumab was authorised, which explains why it reached a DDD of 0.0234 in just 2 years. It has a first-line indication for RRMS and a second-line indication for SPMS, and no distinctions have been made in consumption by indication. Siponimod was approved in 2021 as a first-line treatment, reaching a DDD of 0.038 in 2023, which makes it the most widely consumed drug in 2023. Meanwhile, the consumption of the two types of interferon decreased during the same period. The Betaferon/Extavia reduction was more pronounced (65%) compared to the 2018 levels, while Rebif showed a more gradual reduction (12%). Both drugs are indicated for both RRMS and SPMS with relapses or active disease. <h3>Conclusion and Relevance</h3> The consumption of IFN-based older treatments has shown a gradual decrease over the last 6 years, coinciding with an increase in the consumption of the new available therapeutic options. The appearance of siponimod has displaced the previous treatments indicated for SPMS, making it the most widely used drug in 2023. We expect that this increasing consumption will continue, favoured by the scarcity of alternatives for this clinical phenotype. <h3>References and/or Acknowledgements</h3> <h3>Conflict of Interest</h3> No conflict of interest