Refractory MG patients have significantly greater clinical burden and are more likely to utilize intensive healthcare resources than nonrefractory patients. Furthermore, refractory patients may be at greater risk of crises throughout the disease course than previous studies have suggested. Muscle Nerve, 2018.

This study was sponsored and funded by Boehringer-Ingelheim, which contracted with Optum to conduct the research. The sponsor collaborated with Optum on the preparation, writing, revision, and approval of the manuscript. Bengston, Cao, Hulbert, Wolbeck, Elliott, and Buikema are employees of Optum. Yu and Wang are employed by Boehringer-Ingelheim. Study concept and design were contributed by Bengston, Yu, and Wang. Cao, Hulbert, and Wolbeck collected the data, and data analysis was performed by Bengston, Yu, and Wang. The manuscript was written by Bengston, along with Yu and Wang, and revised by Bengston, Yu, and Wang, along with the other authors.

possession ratio (MPR) and proportion of days covered (PDC); and persistence, days to the first ≥ 30-day gap on index DMT. Outcomes were compared between the GA40 and oral DMT cohorts. Results: The final sample was 1,779 patients (232 GA40, 1547 oral DMT), with mean age 45.5 years and 77.9% female. The GA40 and oral DMT cohorts had 0.39 versus 1.07 discontinuations/person-year, respectively, for an incidence rate ratio of 2.75 (p< 0.001). Kaplan-Meier analysis showed that GA40 cohort was more persistent per post-index 90-day interval (p< 0.001). Mean (standard deviation) MPR and PDC in the GA40 cohort were 0.88 (0.18) and 0.87 (0.20), respectively, versus 0.84 (0.18) and 0.70 (0.30) in the oral DMT cohort (both p< 0.001). To account for differences in follow-up, MPR was examined in patients with maximum 210, 270, and 330 post-index days. Mean MPR was 0.90 (0.16) in the GA40 cohort with ≤ 210 post-index days versus 0.86 (0.16) for oral DMT (p< 0.05); mean MPR was not significantly different between the cohorts with maximum 270 or 330 post-index days. Mean PDC was higher in the GA40 cohort in all comparisons (all p< 0.001). ConClusions: MS patients starting GA40 were more persistent and at least as adherent (similar on MPR and better on PDC) compared with those starting oral DMTs, possibly due to GA40's safety profile and less-frequent dosing schedule. PND101 CharaCteristiCs of PatieNts With relaPsiNg remittiNg multiPle sClerosis (rrms) takiNg iNjeCtable aND oral Disease moDifyiNg treatmeNts (Dmt) iN euroPe (eu)

A637 survey date) linaclotide use. Logistic regression models were used to determine which claims-based variables (eg medication use patterns [number of fills, days' supply], healthcare resource use, patient characteristics and demographics) best predicted treatment success by examining concordance/discordance between the predicted satisfaction, based on claims, and patient-reported treatment satisfaction with linaclotide. Results: Of 627 eligible patients identified from CONTOR (mean age 46.0 years, 94.4% female), 64.6% (n= 405) reported satisfaction with linaclotide treatment. Patients who reported treatment satisfaction had significantly more linaclotide fills compared to unsatisfied patients (mean 2.2 vs 0.5, respectively; p< 0.001), as well as a higher number of days' supply of linaclotide (mean 71.5 vs 20.0 days, respectively; p< 0.001). The number of linaclotide fills was the strongest predictor of patient-reported treatment satisfaction (odds ratio= 1.87; p< 0.0001). For a cutoff point of ≥ 2 linaclotide fills during the past 6 months, the satisfaction model had a sensitivity of 0.52 and a specificity of 0.89. ConClusions: A refill of a linaclotide prescription is the best claims-based method of defining patient satisfaction with linaclotide treatment, consistent with behavioural expectations.

The mean basal insulin daily dose increased by 2.04 units (SD= 16.71) compared to pre switch insulin dose. The dose increase was driven by an increased dose in the first 90 days after index date. Hereafter a return to the baseline insulin dose level was observed. There was no significant weight change and of as for health expenditure there was a small increase in visits to diabetes specialist and use of self-blood glucose measurement sticks. ConClusions: In a real life setting, switch from another insulin to IDeg significantly improved glycemic control in Type 2 DM patients with no significant weight gain and only a minor initial dose increase after IDeg initiation.