Edaravone Utilization and Outcomes Within a Nationally Integrated Health System

Objective: This is a pharmacovigilance surveillance initiative to evaluate the patient characteristics, utilization, safety and effectiveness of edaravone use. Background: The Department of Veterans Affairs (VA) provides care for over 4,000 Veteran patients with amyotrophic lateral sclerosis (ALS).Given limited real-world data, the VA initiated a surveillance effort to monitor the safe and appropriate use of edaravone. Design/Methods: Retrospective, matched cohort (edaravone vs. riluzole) analysis. Veteran patients with a diagnosis of ALS with a prescription of edaravone or riluzole between 8/1/2017 to 12/31/2018. Results: Mortality (acutely and among chronic users) was similar between cohorts. Both acute and long-term discontinuation events were more common within the riluzole cohort compared to within the edaravone cohort. More acute all-cause hospitalization events, with shorter time to hospitalization, occurred in the edaravone cohort compared to the riluzole cohort. Conclusions: Preliminary trends show increased risk of acute and long term ALS associated hospitalization and PEG placement with edaravone compared to riluzole. Discontinuation, both acute and long-term were greater with riluzole compared to edaravone, potentially related to greater ALS progression with riluzole. Disclosure: Dr. Tortorice has nothing to disclose. Dr. Vu has nothing to disclose. Dr. Wei has nothing to disclose. Dr. Dong has nothing to disclose. Dr. Hur has nothing to disclose. Dr. Zacher has nothing to disclose. Dr. Cunningham has nothing to disclose. Dr. Glassman has nothing to disclose. Dr. Good has nothing to disclose.