Disease Modifying Therapies (DMTs) are increasingly indicated for use in specific patient types, notably ‘active’ Multiple Sclerosis (MS). The need to understand how these patients are categorised amongst HCPs is growing and is of importance in SPMS, with the advent of novel treatments for this patient group.
To assess patient profiles of those categorised by HCPs as having active (a-SPMS) and non-active SPMS (na-SPMS) in both the 5EU (UK/France/Germany/Italy/ Spain) and the United States.
The Ipsos Global MS Therapy Monitor, a multi-centre cross-sectional survey of HCPs (Neurologists; MS nurses included in UK) and retrospective chart-review study of patients with MS runs on a bi-annual basis in 5EU and US. De-identified HCP perceptions and de-identified patient data are collected. HCPs are screened for practice duration (≥3yrs), patient volume (≥15 MS patients/mo.) and recruited from a large panel. HCP perceptions and charts of patients with SPMS abstracted from 10/2019-12/2019 were included in this analysis.
n=344 (5EU) and n=85 (US) patients with na-SPMS and n=275 (5EU) and n=122 (US) patients with a-SPMS were included. Mean average EDSS is similar in na-SPMS versus a-SPMS patients in EU5 and US; 5.41 vs 5.07 (5EU), 4.54 vs 4.45 (US). Despite literature definitions 75.0% of na-SPMS patients (5EU) and 75.0% (US) experienced at least 1 relapse in the last 24 mo. compared to 90.4% (5EU) and 94.4% (US) among a-SPMS patients. Increased lesion load on most recent MRI scan is the key difference between na-SPMS and a-SPMS patient profiles. Of n=333 (5EU) and n=80 (US) na-SPMS patients, 10.5%/3.3% (5EU) and 15.0%/3.8% (US) have ‘increased’ proportion of T2/Gd lesions, respectively. Compared to n=267 (5EU) and n=119 (US) a-SPMS patients where 47.2%/30.7% (5EU) and 60.5%/37.0% (US) have ‘increased’ proportion of T2/Gd lesions, respectively. 259 HCPs (5EU) and 99 HCPs (US) were asked how they monitor progression. Most reported using neurological exam (EU5: 92.3%, US: 94.9%), compared to T2 lesion load (5EU: 68.7%, US:71.7%) and Gd lesion load (5EU: 74.5%, US:73.7%).
In this cohort there is overlap in profiles of a-SPMS patients and na-SPMS patients. Although lesion load change is a key differentiator, the use of MRI to measure progression is not universal. Further investigation is warranted to fully understand diagnosis and categorisation of SPMS patients to ensure successful patient outcomes.