April 25, 2020
Multiple Sclerosis Disease-Modifying Therapy: Recent Switch Patterns Among United States Neurologists
Authors: Patricia K. Coyle, MD; Jennifer Robinson; Virginia R. Schobel. MSc
To examine multiple sclerosis (MS) disease-modifying therapy (DMT) switch patterns by US Neurologists over the last 4 years.
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.
DMT switches were evaluated on an annual basis over a 4 year period, from late 2015 to early 2020. Data was based on N=1,002 to N=1,035 MS patient chart reviews contributed online by Neurologists (N=194 to N=260).
78% of recent DMT switches involve a first switch (up from 69% in 2015), 17% involve a second switch, and only 5% involve a third or higher switch (Figure 1). Overall, the most common 2020 switches have been from injectables, glatiramer acetate (GA; 32%) and interferon betas (IFNβs; 28%; Figure 2). Patients frequently switched to an oral DMT (36%) or a monoclonal antibody (mAb; 30%); few switched to an injectable (34%), either IFNβ (12%) or GA (22%; Figure 3). Over the past 4 years, switching from an IFNβ to an oral DMT is decreasing (22% in 2015 vs. 11% in 2020), while switching from GA to a mAb (5% vs. 8%), or from an oral DMT to a mAb (3% vs. 11%), is increasing (Figure 4). Over the same period, the most common first switch was consistently from an injectable to an oral DMT (35% vs. 27%); GA agents were a slightly larger source of first switches (36%) than IFNβ (32%) in 2020. The most common second switch in 2020 was from an oral DMT to a mAb (26%), followed by within the mAb (12%) or oral class (11%) switches (Figure 6).
MS DMT switch patterns are changing. There are fewer second or later switches perhaps related to earlier use of a higher efficacy DMT as a switch agent.
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:
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- Changing Patterns in Disease-Modifying Therapy Selection for Treatment-Naive Multiple Sclerosis in the United States
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