While there are currently 17 approved disease-modifying therapies (DMTs) for patients with relapsing forms of multiple sclerosis (MS), for progressive forms of MS there are limited options. HCPs may prescribe DMTs for progressive patients off-label with the goal of slowing disease progression. However, outcomes for off-label DMT use in progressive MS are not well understood.
To leverage patient-reported outcomes for understanding how progressive patients are responding to DMT and how their use affects quality of life. To help HCPs better discern the efficacy of DMT use in progressive patients.
The Multiple Sclerosis In America survey (MSIA) was fielded by Health Union, LLC in 2019 to patients with MS via online sources including MultipleSclerosis.net. Survey questions included symptoms, relapse experience, HCP interaction, DMT usage, and quality of life measures. Descriptive statistics and comparison tests were used to examine outcomes.
1,531 patients with a progressive form of MS were included in the analysis (76.3% female, 92.6% Caucasian, mean age 58.1 years); 41.0% PPMS, 59.0% SPMS, 47.2% on disability, and 98.7% had health coverage. 686 patients were not currently using a DMT, and among the 845 currently using, 211 described their MS as controlled on their current treatment plan, and 634 reported their MS not controlled. Progressive MS patients were similar in how they reported their disability as moderate or severe. Those controlled on a DMT were less likely to report depression as a recent symptom (39.8% vs. 53.7%) and cited fewer cerebral symptoms in the past month than their counterparts (75.8% vs. 84.2%). Additionally, controlled patients report shorter relapse durations and unchanged or fewer lesions on recent MRIs. 53.6% of progressive MS patients who described their MS as controlled felt in control of their life despite their MS and 63.5% were confident in how they are managing their MS. Conversely, 61.7% of progressive patients who were not using a DMT or reported uncontrolled MS on a DMT felt their MS had negatively impacted overall quality of life, and 39.6% cited its impact on their emotional well-being.
The survey results demonstrate positive outcomes for a subset of patients with progressive MS currently using a DMT, as compared to their counterparts who do not use a DMT or report their MS uncontrolled. HCPs may find these results encouraging; future research should seek to learn why DMT use is not successful for all progressive patients and develop alternative therapies for those whose MS is uncontrolled. Future research should seek to understand why DMT use is not successful for all progressive patients and develop alternative therapies for those whose MS is uncontrolled.