(61) Epidemiology, Patient Characteristics, Real-World Treatment Patterns, and Outcomes for Patients with Multifocal Motor Neuropathy (MMN).

Background: : MMN is a rare and progressive nerve disorder characterized by asymmetrical limb weakness due to motor nerve conduction blocks. Patient characteristics, treatment patterns, and economic burden of MMN are not well-established.

Objective: : To examine epidemiology, diagnostic and treatment patterns, healthcare resource utilization (HCRU), and healthcare costs associated with MMN in patients enrolled in a United States Medicare Advantage plan.

Methods: : This retrospective observational claims study included Humana Research Database enrollees (18–89 years) with ≥2 medical claims and diagnosis of MMN (January 2017 - June 2022). Individuals with evidence of prevalent MMN, CIDP, ALS, or immunosuppressant use were excluded. Index date was the date of the first MMN diagnosis. Descriptive outcomes were assessed during 12-month pre-index and post-index periods.

Results: : Patients (N=248) with newly diagnosed MMN were identified (mean [SD] age: 68.9 [10.3] years; 53.6% male); 59.7% were diagnosed by a primary care provider. Diagnostic procedures used included (pre-/post-index %) spinal MRI (21.4/18.1), nerve conduction studies (19.8/14.5), and electromyography (17.7/15.3). Anticonvulsants, pain medications, steroids, and muscle relaxants were used pre- and post-index. Post-index, 5.2% of patients received intravenous immunoglobulin (IVIG). Mean (SD) time to initiation was 63.1 (52.2) days, with an average of 6.5 (5.4) administrations, 28.7 (22.9) days between treatments, and 147.5 (133.9) days total treatment duration. Pre-index, 23.8% of patients had ≥1 inpatient stay, mean length of stay (LOS) per patient with an inpatient stay was 12.7 (SD 14.5) days; post-index, 27.8% of patients had ≥1 inpatient stay, with a mean LOS per patient with an inpatient stay of 13.4 (SD 16.2) days. Telehealth services were utilized by 18.5% of patients pre-index and 28.6% of patients post-index; 43.1% (pre-index) and 46.8% (post-index) of patients had ≥1 emergency department (ED) visit. Median spending (pre-/post-index) was $11,299/$16,074 for total healthcare, $1374/$1701 for pharmacy, and $6745/$10,630 for medical.

Conclusions: : All-cause HCRU and healthcare costs revealed that patients with MMN experienced inpatient hospitalizations and ED encounters before and after diagnosis. Since only a few patients were treated with IVIG post-diagnosis, there is a significant opportunity to identify potential barriers to appropriate use of IVIGs in the MMN population.

Sponsorship:: Takeda Pharmaceuticals USA, Inc., Cambridge, MA, USA.