High Adherence, Low Adverse Events Reported Across Different Oral Disease-Modifying Therapies


Research presented at Academy of Managed Care Pharmacy’s 2021 virtual conference evaluated tolerance and adherence to oral disease-modifying therapies for relapsing-remitting multiple sclerosis.

multiple sclerosis

Patients who received oral FDA-approved therapies for relapsing forms of multiple sclerosis (MS) demonstrated high tolerance, low rates of adverse events (AEs), and similar medication adherence rates across all study medications, according to the results of a retrospective study conducted by AllianceRx Walgreens Prime.

The findings were presented April 13-14 at the Academy of Managed Care Pharmacy’s 2021 virtual conference. 

The study aimed to evaluate oral disease-modifying therapies (DMTs) FDA-approved up until 2019 used for the treatment of relapsing-remitting multiple sclerosis (RRMS). According to investigators, even though more treatment options have become available to patients over the years, choice of therapy is often patient specific and there are currently no formal guidelines on switching DMTs.

For the study, participants were prescribed teriflunomide, fingolimod, simponimod, dimethyl fumarate, and/or diroximel fumarate. Patients completed initial clinical assessment and at least 1 MS refill clinical assessment between July 1, 2019 and December 31, 2020.

Investigators analyzed pharmacy claims and clinical data of 10370 patients who met study inclusion criteria. Study participants were mostly female, between 4 and 59 years of age, and lived in the Midwest and South. According to the data, 257 patients switched from 1 oral DMT to another, including 46.3% who switched to a different oral DMT drug class and 53.7% who switched within the same oral DMT drug class.

Overall, the investigators reported no statistically significant difference in medication adherence as measured by Proportion of Days Covered (PDC) based upon the presence or absence of a patient-reported adverse drug event (ADE).

“This may be an indication oral DMTs are well tolerated from an ADE perspective,” said lead author Scott Carson, PGY-1 resident at AllianceRx Walgreens Prime. “However, an analysis only accounted for presence/absence of an ADE and did not account for their type, frequency, or severity.”

The authors also noted that real world ADE data reported in the study aligned with clinical trial ADE data reported in the package inserts of the medications.

Carson concluded that the findings help demonstrate to providers the current utilization of these medications and provide insight on what patients can expect from switching therapies.


  1. Study Affirms Oral Disease-Modifying Therapies Are Well Tolerated With High Medication Adherence Rates. AllianceRx Walgreens Prime. News release; April 15, 2021. Accessed April 21, 2021. https://www.alliancerxwp.com/contents/press-releases/study-affirms-oral-disease-modif.html
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