Objective: To examine comorbidities and co-medications in patients with multiple system atrophy (MSA) compared to a matched-control in real-world setting

Background: Currently MSA is managed by treating its symptom.

Method: This was a retrospective study using US MarketScan claims database. Newly diagnosed individuals >30 years old with ≥2 MSA diagnosis codes between 2017−2021 (1^st diagnosis defined as index date), no MSA before index date, and 1-year continuous enrollment pre- and post-index date, were identified. A comparator group without MSA was matched with 1:4 ratio by gender, age and +/- 1-year index date. MSA-related comorbidities and prescriptions were compared between the groups during 1-year post-index period. Conditional logistic regression models examined the association between each symptom/treatment and MSA.

Results: We identified 1187 MSA patients and 4748 matched comparators.

During the 1-year post-index period, the following MSA-related diagnoses were recorded in MSA and comparator groups (OR and 95% CI), respectively: orthostatic hypotension−38.7% and 0.8% (89.6, 57.3−140.2); memory disorders−22.4% and 3.6% (9.2, 7.3−11.6); motor symptoms–78.1% and 33.1% (7.5, 6.4−8.7); fall−11.1% and 2.2% (6.4, 4.8−8.5); intestinal disorders−19.0% and 4.0% (5.9, 4.8−7.3); fatigue−46.6% and 13.6% (5.8, 5.0−6.7); mood disorder−62.3% and 24.2% (5.5, 4.8−6.4); urinary dysfunction–30.8% and 9.1% (4.9, 4.1−5.8); insomnia−14.2% and 4.2% (3.7, 3.0−4.6); sleep disorders–34.0% and 14.9% (3.0, 2.6-3.5). The ORs were statistically significant (p<.0001).

During the 1-year post-index period, ≥1 prescription indicated for MSA-related symptoms were recorded in MSA and comparator groups (OR and 95% CI), respectively: orthostatic hypotension−38.8% and 0.3% (260.4, 123.4−549.3); motor symptoms–31.1% and 0.7% (142.2, 75.8−266.5); sleep disorders–35.7% and 11.0% (4.6, 3.9−5.3); anxiety/depression–48.9% and 20.6% (3.7, 3.2−4.3); urinary dysfunction–23.0% and 10.7% (2.8, 2.3−3.3); erectile dysfunction (ED)–2.4% and 3.1% (0.8, 0.5−1.2). The ORs were statistically significant (p<.0001) except for ED.

Similar patterns in diagnoses and prescriptions were observed in 1-year pre-index period. An increase in OR was observed in orthostatic hypotension treatment from pre- to post-period.

Conclusion: MSA-related symptoms and treatment showed significant association with MSA patients. These findings are important for informing about disease burden.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/treatment-patterns-and-comorbidities-associated-with-multiple-system-atrophy-a-comparative-study/