Treatment Patterns and Medication Adherence of Glaucoma Patients in South Korea

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PSS22 Comparison of Persistence between Adults with Psoriasis Initiating Apremilast or Biologics Feldman SR1, Kuznik A2, Clancy Z3 1Wake Forest University School of Medicine, Winston-Salem, NC, USA, 2Celgene Corp & Regeneron Pharmaceuticals, Warren, NJ, USA, 3Celgene Corporation, Warren, NJ, USA

Objectives: There are currently no comparative published data on the persistence among patients with psoriasis who have been treated with apremilast vs. biologic therapy in a real-world care setting. The objective of this study was to compare real-world persistence of psoriasis patients in the US initiating apremilast or biologic therapy within 6 months.  Methods: This observational, retrospective cohort study was conducted using MarketScan Commercial and Medicare Supplemental Databases (2014-2015). Adults with ≥ 2 diagnosis codes for psoriasis (ICD-10:L40) who initiated apremilast or biologics were selected. The first apremilast or biologic prescription date was defined as the index date and patients were required to be continuously enrolled for ≥ 6 months pre- and ≥ 3 months post-index. Persistence was measured as the time from initiation to discontinuation, defined as the end of days’ supply prior to at least a 60-day gap without medication. At 6 months postindex the percentage of patients persisting on drug was assessed.  Results: In total, 839 patients initiating apremilast and 1,981 initiating biologic therapies met the inclusion criteria and had similar baseline characteristics. Mean enrollment time post-index was 5.4 months for apremilast and 8.3 months for biologics. At 6 months post-index, persistence to initiated drug was not significantly different between the apremilast and biologic cohorts (apremilast: 67.1%, 95% CI: 70.5–63.6 vs. biologics: 68.5%, 95% CI: 70.6–66.3).  Conclusions: Apremilast use was associated with similar persistence compared with initiation of a biologic among adults with psoriasis in the US. PSS23 Treatment Patterns and Medication Adherence of Glaucoma Patients in South Korea Park KH1, Kim CY2, Cha J3, Kim Y3 1Seoul National University Hospital, Seoul, Korea, The Republic of, 2Yonsei University College of Medicine, Seoul, Korea, The Republic of, 3Pfizer Pharmaceuticals Korea Ltd., Seoul, Korea, The Republic of

Objectives: The objective of this study was to investigate treatment patterns and medication adherence of glaucoma. Also, it aimed to identify the key factors associated with non-adherence.  Methods: It was a cross-sectional, multicenter and observational study where glaucoma outpatients with less than two years of eye-drop use were recruited at 15 eye clinics from March to November 2013. Data was collected through a self-administered questionnaire and medical chart review. Medication adherence was evaluated using a patient self-report on pill count and defined as patients administering the drug for ≥ 80% of prescribed days. The medication adherence rate was calculated dividing the actual number of administration from the total prescribed number of administration for 7 days. In addition, patients whose self-reported prescription was different from the total number of prescribed daily doses by physicians were considered as non-adherence.  Results: 1,050 glaucoma patients included in the study, and medication adherence rate was evaluated in 1,046 patients whose verification of adherence was available. Of the total, 27.4% were non-adherent, and the medication adherence rates of the total, the adherent, and the non-adherent were found to be 90.6±17.8%, 96.8±5.5% and 56.6±24.7% respectively. The most commonly used medication was prostaglandin (PGA) alone and the second was combination of 2-class (β -blocker and carbonic anhydrase inhibitor, CAI) and three-class combination of PGA, β -blocker and CAI followed. In multivariate analysis, the risk of non-adherence was shown to be 1.466 times greater in males than in females (95% CI: 1.106-1.943), and also 1.328-fold greater as the daily number of administration was increased by one (95% CI: 1.186-1.487).  Conclusions: It revealed that about one third of glaucoma patients were non-adherent, and male and increased daily number of administration were associated with non-adherence. The study findings highlight more practical and systematic treatment strategies should be considered for better medication adherence which consequently leads to effective glaucoma management. PSS24 Health Utilities Associated with Best Corrected Visual Acuity Levels in Diabetic Macular Edema Patients and Factors Influencing Utility Values Park S, Choi I, Lee S, Suh D Chung-Ang University, Seoul, South Korea

Objectives: To elicit utilities for health state of diabetic macular edema(DME) classified by best corrected visual acuity(BCVA) levels and find factors influencing utility values.  Methods: Health states were divided into 6 different BCVA levels: L1(logMAR≤ 0.2), L2(0.2< logMAR≤ 0.4), L3(0.4< logMAR≤ 0.6), L4(0.6< logMAR≤ 0.8), L5(0.8< logMAR≤ 1.0), L6(logMAR≥ 1.0). Detailed health state descriptions were developed through several steps: (1)literature search for DME health state descriptions, (2)developing health state descriptions based on EQ5D and other vision specific HRQOL questionnaires, and (3)consulting with ophthalmologists to confirm the appropriateness of the descriptions. Health state descriptions were measured by members of the general public in South Korea using the standard gamble method. Interviewees were selected based on stratification sampling method to represent the Korean population. Analysis of variance (ANOVA) was used to test the differences in utilities stratified by study variables. Generalized linear model (GLM) was used to find the significant factors influencing disutility(1-utility) with log link function and gamma distribution.  Results: A total of 102 Koreans were interviewed with an average age of 47.3(±11.8) and 51% females. Utilities were 0.95(±0.04), 0.93(±0.05), 0.88(±0.08), 0.84(±0.10), 0.74(±0.14) and 0.59(±0.18) for L1 to L6, respectively. Utilities were significantly different between males and females(p< 0.05 for L2, L4, L5), with males reporting lower utilities. Interviewees with a full time job reported

significantly lower utilities than those without full time jobs (p< 0.05 for L1,L2,L4). For all levels of BCVA, utility for interviewees in their 50s were higher than subjects in their 30s. Education levels did not significantly impact utilities for all levels of the health states.  Conclusions: Health utilities associated with BCVA levels were affected by sex, age and employment status of the interviewees, which may reflect the burden of visual impairment to obtain work. It is important to prevent and treat DME appropriately to improve HRQOL. PSS25 Prevalence of Metamorphopsia in Patients with Vitreomacular Traction, with or without Macular Hole, and its Impact on Quality of Life: The Memo Study Brazier J1, Hirneiß C2, Tangelder M3, Lescrauwaet B4, Patel P5 1University of Sheffield, Sheffield, UK, 2Ludwig Maximilians University München, München, Germany, 3ThromboGenics NV, Leuven, Belgium, 4Xintera Ltd., London, UK, 5NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK

Objectives: Metamorphopsia (MM) is a common symptom of visual function disturbance in macular disorders. MM is disabling to the patient and may cause deterioration of quality of life (QoL). There is no evidence on the prevalence of MM and its impact on QoL in patients with VMT.  Methods: A multi-centre, observational, cross-sectional study in the UK, prospectively enrolled patients with a recent diagnosis of VMT, with or without MH. Data were collected on demographics, medical history, ocular comorbidities and interventions, retinal and OCT findings, and ocular diagnosis of the affected and fellow eyes. Patients completed the VFQ-25, HUI3, and EQ-5D questionnaires. The presence and severity of MM was self-reported using a validated metamorphopsia questionnaire. The impact of MM on QoL was adjusted for relevant demographic and clinical covariates using linear regression models.  Results: 185 patients with a VMT diagnosis were enrolled at 19 ophthalmology clinics. Patients were predominantly female [MM: 69.0%; no MM: 62.5%] with a mean age of 72.8 years (SD: 8.7). Significant differences were observed for visual acuity (LogMAR) (mean; SD) [MM: 0.44 (0.32); no MM: 0.33 (0.25), p= 0.038] and for presence of a MH [MM: 31.8%; no MM 12.5%, p= 0.006]. Self-reported MM prevalence was 69.7% (95% CI 62.6-76.3%), while MM prevalence based on physician assessment was 53.0% (95% CI 46.5-60.3%. Self-reported MM was significantly higher in patients with a MH (85.4%) compared to patients without MH (64.2%) (p= 0.006). MM questionnaire score was 0.63 and differed significantly between patients with MH (0.66) compared to those without MH (0.36, p= 0.001). All QoL scores indicated significantly poorer QoL in patients with MM compared to patients without MM. Differences in QoL depending on MM presence remained significant after adjusting for covariates.  Conclusions: MM is highly prevalent in VMT, especially in patients with concomitant MH. MM significantly impacts QoL after adjusting for covariates including visual acuity. PSS26 Incremental Burden of Cardiovascular Comorbidity or Psoriatic Arthritis among Individuals with Moderate-to-Severe Psoriasis Augustin M1, Tian H2, Gilloteau I3, Mollon P3, Vietri J4 Medical Center Hamburg-Eppendorf, Hamburg, Germany, 2Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA, 3Novartis Pharma AG, Basel, Switzerland, 4Kantar Health, Horsham, PA, USA

1University

Objectives: To assess incremental burden of cardiovascular (CV) comorbidity or psoriatic arthritis (PsA) among individuals with moderate-to-severe psoriasis (PsO) in Europe.  Methods: All measures were self-reported and came from the 20102013 EU National Health and Wellness Surveys (NHWS), cross-sectional surveys of adults in France, Germany, Italy, Spain, and the UK. Moderate-to-severe PsO respondents were identified by > 10% body surface area affected by PsO and/or use of therapies for moderate-to-severe disease. Respondents were compared according to the presence of CV comorbidity or PsA. Outcomes were SF-12v2/SF-36v2 mental and physical component summary scores (MCS & PCS, respectively), SF-6D health utility, Work Productivity and Activity Impairment (WPAI) questionnaire, and healthcare use in the past 6 months. Generalized linear models compared across CV or PsA groups vs. non-CV or non-PsA groups with appropriate link functions to adjust for covariates (sociodemographics & length of illness).  Results: Among moderate-to-severe PsO respondents (n= 957), 19.8% (n= 190) reported physician-diagnosed CV comorbidity, and 12.3% (n= 118) reported PsA. After adjustment for covariates, CV respondents had decrements of 2.9 points for MCS, 3.2 points for PCS (minimally important difference [MID] = 3.0 for both), and 0.05 points for SF-6D (MID= 0.03) relative to non-CV respondents (all p< 0.01). Likewise, they had greater mean work impairment (47% vs. 33%), more activity impairment (48% vs. 38%), more healthcare provider visits (8.7 vs. 7.0), emergency room visits (0.62 vs. 0.32), and hospitalizations (0.57 vs. 0.23) (all p< 0.05). Compared to nonPsA respondents, PsA respondents also had worse mean MCS (2.6 points), PCS (6.3 points), and SF-6D scores (0.07 points), more work impairment (52% vs. 34%), activity impairment (54% vs. 38%), and healthcare provider visits (10.5 vs. 6.9) (all p< 0.05).  Conclusions: Moderate-to-severe PsO patients with CV comorbidity or PsA in Europe reported significantly greater burden, with decrements in physical health status and health utility exceeding the minimally important differences for these measures. PSS27 Patient Perceptions of Psoriasis: A Review of the Survey Literature by Geography Mordin M1, Haydysch E2, Graham-Clarke P3, Gnanasakthy A4, Nikai E5 1RTI Health Solutions, Ann Arbor, MI, USA, 2RTI Health Solutions, Research Triangle Park, MI, USA, 3Eli Lilly Australia, West Ryde, Australia, 4RTI Health Solutions, Research Triangle Park, NC, USA, 5Eli Lilly and Company, Brussels, Belgium

Objectives: Understanding what matters to patients may assist with targeting treatments and improving outcomes. Surveys conducted among patients with