Author Of 1 Presentation
P1008 - Brain volume loss is an important treatment attribute among RRMS patients: findings from a discrete choice experiment (ID 489)
Abstract
Background
The treatment landscape for relapsing-remitting multiple sclerosis (RRMS) is rapidly evolving, with several novel disease-modifying therapies (DMTs) entering the market and varying substantially in their treatment attributes, including modifying the rate of brain volume loss (BVL). Although research has sought to understand patient preferences for MS treatments, these preferences have not included the importance of BVL.
Objectives
The objective of this study was to assess patient preferences for the benefits and risks associated with common and novel DMTs in RRMS.
Methods
US patients diagnosed with RRMS who had not been administered a therapy typically prescribed in advanced RRMS (alemtuzumab, natalizumab, rituximab, and cladribine) completed an online cross-sectional survey. Preferences were assessed via a discrete choice experiment that presented patients with a series of tasks and asked them to choose between 2 treatment profiles that varied on 7 attributes identified in qualitative research: 2-year disability progression; 1-year relapse rate; rate of BVL; and risks of gastrointestinal (GI) symptoms, flu-like symptoms, infection, and life-threatening side effects. A hierarchical Bayes model was used to estimate attribute-level weighted preferences.
Results
This analysis included 150 patients with RRMS; mean age was 54 years, 84% were female, 31% were employed, 24% were on long-term disability, and 83% were currently taking a prescription medication. Patients were most concerned with reducing the rate of BVL, followed by the risk of infection, risk of flu-like symptoms, slowing the rate of 2-year disability progression, risk of life-threatening event, reducing the 1-year relapse rate, and risk of GI symptoms. Reducing the rate of BVL and risk of infection were approximately twice as important as reducing the 1-year relapse rate and risk of GI symptoms.
Conclusions
In addition to traditional measures of treatment benefit in RRMS, reducing the rate of BVL is a key outcome prioritized by patients for which they are willing to make tradeoffs. These findings suggest that reducing BVL should be considered when physicians engage in shared decision making with their patients.