Real-world phosphorodiamidate morpholino oligomer treatment patterns in Duchenne muscular dystrophy: a claims-based analysis

Aim: Phosphorodiamidate morpholino oligomers (PMOs) are exon-skipping therapies administered through once-weekly intravenous infusions used to treat Duchenne muscular dystrophy (DMD). This study assessed treatment patterns among patients with DMD receiving PMOs using administrative claims data wh...

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Main Authors: Shannon Grabich, Brian Ung, Aalok Nadkar, Kathryn DeYoung, James Signorovitch, Aravindhan Veerapandiyan
Format: Article
Language:English
Published: Becaris Publishing Limited 2025-07-01
Series:Journal of Comparative Effectiveness Research
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author Shannon Grabich
Brian Ung
Aalok Nadkar
Kathryn DeYoung
James Signorovitch
Aravindhan Veerapandiyan
author_facet Shannon Grabich
Brian Ung
Aalok Nadkar
Kathryn DeYoung
James Signorovitch
Aravindhan Veerapandiyan
author_sort Shannon Grabich
collection DOAJ
description Aim: Phosphorodiamidate morpholino oligomers (PMOs) are exon-skipping therapies administered through once-weekly intravenous infusions used to treat Duchenne muscular dystrophy (DMD). This study assessed treatment patterns among patients with DMD receiving PMOs using administrative claims data while accounting for limitations in claims data for these therapies. Materials & methods: This study used Inovalon R public and private closed claims data (1 June 2016–31 March 2024). Male patients with ≥1 claim for a PMO approved for DMD in the US (eteplirsen, casimersen, golodirsen and viltolarsen) were included. Index date was the first PMO claim. All available follow-up data were used to assess continuous PMO claims coverage, ≥60-day and ≥30-day gaps in PMO claims and PMO re-initiation after a gap. Adherence during 1 year after index was measured using proportion of days covered (PDC). Treatment patterns were also assessed in patients stratified by baseline algorithm-defined nonambulatory status (inferred from claims). Results: Among 397 patients included, median (IQR) follow-up time was 788 (484, 1109) days. Gaps in PMO claims coverage occurred in 190 (47.9%) and 254 (64.0%) patients using ≥60-day and ≥30-day gaps, respectively, among whom 110 (57.9%) and 176 (69.3%) had PMO reinitiation. Using ≥60-day and ≥30-day gap lengths, median (IQR) time to first gap in PMO claims was 25.5 (22.3, 32.9) months and 13.5 (10.2, 17.7) months, respectively and median (IQR) time to PMO reinitiation (not including gap time) was 4.4 (2.8, 8.7) months and 2.5 (1.7, 3.2) months. Median (IQR) PDC was 78.8% (38.8, 94.0) during 1 year after index. PMO treatment patterns were generally similar in patients stratified by algorithm-defined nonambulatory status. Conclusion: In an analysis of administrative claims data, adherence to PMO treatment for DMD was high. For patients with a gap in PMO claims, most subsequently re-initiated treatment, indicating lower discontinuation rates than previously reported.
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spelling doaj-art-8686004c91c047c1833c84f7af81b24e2025-08-20T03:34:45ZengBecaris Publishing LimitedJournal of Comparative Effectiveness Research2042-63132025-07-0114810.57264/cer-2025-0037Real-world phosphorodiamidate morpholino oligomer treatment patterns in Duchenne muscular dystrophy: a claims-based analysisShannon Grabich0https://orcid.org/0000-0003-3474-6874Brian Ung1Aalok Nadkar2https://orcid.org/0000-0003-0158-9905Kathryn DeYoung3https://orcid.org/0000-0002-5439-7344James Signorovitch4https://orcid.org/0000-0002-4067-8962Aravindhan Veerapandiyan5https://orcid.org/0000-0002-3065-3956Sarepta Therapeutics, Inc, Cambridge, MA 02142 USASarepta Therapeutics, Inc, Cambridge, MA 02142 USASarepta Therapeutics, Inc, Cambridge, MA 02142 USASarepta Therapeutics, Inc, Cambridge, MA 02142 USAAnalysis Group, Inc, Boston, MA 02199, USAUniversity of Arkansas for Medical Sciences, Arkansas Children’s Hospital, Little Rock, AR 72202, USAAim: Phosphorodiamidate morpholino oligomers (PMOs) are exon-skipping therapies administered through once-weekly intravenous infusions used to treat Duchenne muscular dystrophy (DMD). This study assessed treatment patterns among patients with DMD receiving PMOs using administrative claims data while accounting for limitations in claims data for these therapies. Materials & methods: This study used Inovalon R public and private closed claims data (1 June 2016–31 March 2024). Male patients with ≥1 claim for a PMO approved for DMD in the US (eteplirsen, casimersen, golodirsen and viltolarsen) were included. Index date was the first PMO claim. All available follow-up data were used to assess continuous PMO claims coverage, ≥60-day and ≥30-day gaps in PMO claims and PMO re-initiation after a gap. Adherence during 1 year after index was measured using proportion of days covered (PDC). Treatment patterns were also assessed in patients stratified by baseline algorithm-defined nonambulatory status (inferred from claims). Results: Among 397 patients included, median (IQR) follow-up time was 788 (484, 1109) days. Gaps in PMO claims coverage occurred in 190 (47.9%) and 254 (64.0%) patients using ≥60-day and ≥30-day gaps, respectively, among whom 110 (57.9%) and 176 (69.3%) had PMO reinitiation. Using ≥60-day and ≥30-day gap lengths, median (IQR) time to first gap in PMO claims was 25.5 (22.3, 32.9) months and 13.5 (10.2, 17.7) months, respectively and median (IQR) time to PMO reinitiation (not including gap time) was 4.4 (2.8, 8.7) months and 2.5 (1.7, 3.2) months. Median (IQR) PDC was 78.8% (38.8, 94.0) during 1 year after index. PMO treatment patterns were generally similar in patients stratified by algorithm-defined nonambulatory status. Conclusion: In an analysis of administrative claims data, adherence to PMO treatment for DMD was high. For patients with a gap in PMO claims, most subsequently re-initiated treatment, indicating lower discontinuation rates than previously reported.adherenceduchenne muscular dystrophyexon-skipping therapiespersistencephosphorodiamidate morpholino oligomerstreatment patterns
spellingShingle Shannon Grabich
Brian Ung
Aalok Nadkar
Kathryn DeYoung
James Signorovitch
Aravindhan Veerapandiyan
Real-world phosphorodiamidate morpholino oligomer treatment patterns in Duchenne muscular dystrophy: a claims-based analysis
Journal of Comparative Effectiveness Research
adherence
duchenne muscular dystrophy
exon-skipping therapies
persistence
phosphorodiamidate morpholino oligomers
treatment patterns
title Real-world phosphorodiamidate morpholino oligomer treatment patterns in Duchenne muscular dystrophy: a claims-based analysis
title_full Real-world phosphorodiamidate morpholino oligomer treatment patterns in Duchenne muscular dystrophy: a claims-based analysis
title_fullStr Real-world phosphorodiamidate morpholino oligomer treatment patterns in Duchenne muscular dystrophy: a claims-based analysis
title_full_unstemmed Real-world phosphorodiamidate morpholino oligomer treatment patterns in Duchenne muscular dystrophy: a claims-based analysis
title_short Real-world phosphorodiamidate morpholino oligomer treatment patterns in Duchenne muscular dystrophy: a claims-based analysis
title_sort real world phosphorodiamidate morpholino oligomer treatment patterns in duchenne muscular dystrophy a claims based analysis
topic adherence
duchenne muscular dystrophy
exon-skipping therapies
persistence
phosphorodiamidate morpholino oligomers
treatment patterns
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