ORLANDO – When neurologists select or switch medications for multiple sclerosis, they are most concerned with the drugs’ efficacy and patients’ relapse frequency, according to an online survey.
The survey, which included 63 neurologists and 39 multiple sclerosis specialists, also showed that the most commonly prescribed disease-modifying therapies were glatiramer acetate and subcutaneous and intramuscular interferon beta-1a.
The results of such a survey among physicians are "what you might expect," said Dr. Robert P. Lisak, professor of neurology at Wayne State University, Detroit, and president-elect of the Consortium of Multiple Sclerosis Centers (CMSC).
"I think you’ll see a lot of patients on those [drugs] in my own experience, because a lot of patients do very well on them, although there could be injection fatigue. But a lot of patients and physicians work on, ‘If it ain’t broke, don’t fix it.’ I think you’re going to see that people either get resistant, or finally get tired of the injection, and you’ll probably see an increasing shift towards the oral agents," he said. Meanwhile, insurance coverage and side effects are two issues to take into account, added Dr. Lisak, who was not involved with the survey.
So far, "little is known about how neurologists select available disease-modifying therapies (DMTs) for their patients," said Kristin A. Hanson, Pharm.D., of United BioSource, Dorval, Que., who presented her poster at the fifth Cooperative Meeting of the Consortium of Multiple Sclerosis Centers and the Americas Committee for Treatment and Research in Multiple Sclerosis.
Dr. Hanson and colleagues sent out the online survey to members of a physician market research panel between December 2012 and January 2013.
All physicians, 81% of whom were male, lived in the United States and were treating at least 20 MS patients.
Respondents said that the most important medication attributes for patients starting their first DMT, in order, were efficacy, safety, tolerability, patient preference, and convenience.
Nearly 95% of the respondents said that they would switch medications if they observed an increase in relapse frequency. Other factors influencing the change in medication were worsening of MRI (75% of respondents) and worsening of disability (73%).
On average, 5.5% of the physicians’ patients were not on therapy for their condition, with individual physician reports ranging from 0% to 23% of patients not being on any therapy.
The study was supported by Novartis Pharmaceuticals. Dr. Hanson had no disclosures. Some of her coauthors are employees of Novartis, or have been speakers or advisors for Acorda, Avanir, Bayer, Genzyme/Sanofi, Novartis, Questcor, and Teva. Dr. Lisak has received research grants from and has been an advisor for several companies, including Avanir, Bayer, Novartis, Questcor, and Teva.
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