Reduced Disability Progression, Adverse Events Top Considerations When Selecting MS Therapy

Both individuals with multiple sclerosis (MS) and guideline panelists rate reduced disability progression, perceived risk for adverse events, and effects on relapse rate as top priorities that influence their selection of disease-modifying therapy (DMT), according to a survey conducted among participants from the North American Research Committee on Multiple Sclerosis (NARCOMS) Registry and members of the American Academy of Neurology (AAN) MS DMT guideline development panel. Results of the survey were published in Neurology: Clinical Practice.

Investigators understood that the selection of DMT for MS is influenced by the priority that patients and their practitioners assign to specific clinical outcomes. Therefore, the investigators invited 9126 participants from NARCOMS and 18 members of the AAN MS DMT guideline development panel to complete a brief survey in which they prioritized outcomes they considered to be important in the MS DMT selection process. The frequency of outcomes rated as first, second, and third priorities by the respondents were then compared across the groups.

Overall, 2056 of the 9126 NARCOMS participants and all 18 members of the MS DMT guideline development panel completed the survey. A majority of the respondents in both groups identified reduced disability progression as a priority. Guideline panelists were significantly more likely than patients with MS to prioritize relapse rate reduction as a priority (P =.055). 

Respondents in both groups commonly cited the “selection of therapies most likely to lead to improvements in quality of life measures, MS symptoms, and preservation of cognition” as top priorities when choosing a DMT. Of note is that these priorities were reported in <20% of the clinical trials used to inform MS DMT guideline development.

The results of this survey demonstrate priority outcomes that influence MS DMT selection. With several of these priorities not shown to be routinely reported in clinical trials, this helps pave the way for future evidence development.

Reference

Day GS, Rae-Grant A, Armstrong MJ, Pringsheim T, Cofield SS, Marie RA. Identifying priority outcomes that influence selection of disease-modifying therapies in MS [published online April 23, 2018]. Neurol Clin Pract. doi: 10.1212/CPJ.0000000000000449