April 25, 2020
Changing Patterns in Disease-Modifying Therapy Selection for Treatment-Naive Multiple Sclerosis in the United States
Authors: Patricia K. Coyle, MD; Jennifer Robinson; Virginia R. Schobel. MSc
To evaluate changes in disease-modifying therapy (DMT) choice patterns for treatment-naive multiple sclerosis (MS) in the United States from 2016 to 2019.
Cross-sectional patient-level data was collected once-yearly. It was then reviewed by an independent market intelligence agency which specializes in tracking the MS market, including trending changes in management and treatment patterns.
Initiation of MS DMT in treatment-naive MS patients was evaluated in 2016 (N=1,020), 2017 (N=1,033), and 2018 (N=1,059) contributed online by neurologists (N=242, N=274, N=213). MS patients were analyzed as a whole, as well as by subsets of clinically isolated syndrome (CIS; N=138, N=84, N=79), relapsing-remitting MS (RRMS; N=777, N=801, N=758), and primary progressive MS (PPMS; N=25, N=32, N=80). 2019 data will be included in the presentation.
Overall selection of injectable interferon betas (IFNβs) decreased over this time period (26% in 2016 down to 17% in 2018; p<0.05; Fig. 1). Glatiramer acetate (brand and generics) selection remained stable (30% to 31%), although generic use is increasing. Oral DMT selection has also remained stable (36% to 35%), while mAb selection increased (8% to 18%; p<0.05). Initial DMT selection differed somewhat for CIS vs. RRMS. CIS DMT selection found increased use of glatiramer acetate (29% to 48%; p<0.05), declining use of IFNβ and oral DMT use, and little mAb use (≤7%; Fig. 3). RRMS over this time period showed falling IFNβselection (p<0.05), stable GA and oral DMT selection, and ≥7% mAb selection (Fig. 4). For PPMS, selection of IFNβs, GA, and orals have dropped to ≤13%, while mAb (largely ocrelizumab) accounted for 71% of new DMT starts (up from 24% in 2016; p<0.05; Fig. 5).
DMT selection patterns for MS are changing, with a decrease in IFNβ and an increase in mAb due to the availability of ocrelizumab for both treatment-naive RRMS and PPMS. Glatiramer acetate use has remained stable due to uptake of generic agents.
Patricia K. Coyle received consulting fees from Accordant, Alexion, Bayer, Biogen, Celgene, Genentech/Roche, Novartis, Sanofi Genzyme, Serono, and TG Therapeutics. She has received research support from Actelion, Alkermes, Genentech/Roche, MedDay, NINDS, and Novartis.
Jennifer Robinson is the founder of Spherix Global Insights, an independent market intelligence firm, and has received no industry funding to conduct and report on this study.
Virginia R. Schobel is an employee of Spherix Global Insights, an independent market intelligence firm, and has received no industry funding to conduct and report on this study.
Archived AAN Abstracts:
- Anti-CGRP Class Reduces Migraine Burden Regardless of Concomitant Therapies in US Clinical Practice
- Evolving Diagnosis and Treatment of Secondary Progressive Multiple Sclerosis in the United States
- Multiple Sclerosis Disease-Modifying Therapy: Recent Switch Patterns Among United States Neurologists