Reports / Neurology Reports / RealWorld Dynamix: Progressive Forms of Multiple Sclerosis US
RealWorld Dynamix: Progressive Forms of Multiple Sclerosis US
With the 2017 FDA approval of Genentech’s Ocrevus as the first DMT for the treatment of primary progressive multiple sclerosis (PPMS) and 2019 approval of Novartis’ Mayzent and EMD Serono’s Mavenclad for active secondary progressive MS (SPMS), US neurologists now have multiple options for progressive forms of multiple sclerosis (MS) subtypes. However, treatment of SPMS is complicated by heterogeneous presentation with inflammatory disease activity present in some, but not all, SPMS patients. There remains a strong unmet need for effective treatments for the not active form of SPMS, a niche that products in the late-stage SPMS pipeline, including MedDay’s MD-1003, MediciNova’s ibudilast, and AB Science’ masitinib, are attempting to address. With the availability of the new therapeutic options, it is imperative to understand the current treatment algorithm for progressive forms of MS (PfMS) including how patient characteristics and neurologist perceptions influence the decision to initiate or switch DMT and the resulting brand selection. Understanding when, why, and to which product a neurologist will prescribe for a PfMS patient is critical to building an effective commercial strategy for both first-line and later-line therapies targeting this patient population.
RealWorld Dynamix™: Progressive Forms of MS (US) blends attitudinal and demographic physician survey data with patient record data to uncover how practice type and setting and certain beliefs influence the treatment pathway and to understand which marketed DMTs are being used by physicians and for what PfMS patient types. The report also captures physician’s perspectives about products in development and the impact they will have on the current treatment paradigm among PfMS patients.
This 2019 wave is the second wave of the report (first published in 2018).
Learn more about RealWorld Dynamix™ reports here.
- What is the self-reported treatment rate for active SPMS, not active SPMS, and PPMS? What are the reasons for not treating patients with a DMT?
- What clinical assessments or tests are used to help identify when a relapsing-remitting MS patient has transitioned to SPMS? Why are some SPMS patients initiated on their first DMT following SPMS transition?
- What are the most frequently prescribed agents for active SPMS, not active SPMS, and PPMS? How has treatment patterns changed compared to previous years?
- How does line of therapy for these DMTs differ between secondarily versus primarily progressing MS?
- What are the key drivers (e.g., efficacy/safety/tolerability/patient/payer) for DMT selection?
- What is the profile of a previously treatment-naïve PPMS patient being started on an injectable vs. oral vs. monoclonal antibody DMT?
- Among patients on a second line or later DMT, how does switching decisions differ between active SPMS, not active SPMS, and PPMS patients? If previously treated, are SPMS patients typically switched to a different DMT following confirmed transition from RRMS to SPMS?
- What is the opportunity cost for each brand (e.g., where would their brand have been selected if the first choice was not available)?
- Are neurologists willing to sacrifice increased safety risk for more efficacy in certain populations of MS patients?
Bayer (Betaseron), Biogen [Avonex, Plegridy, Tecfidera, Tysabri, (historically) Zinbryta (with AbbVie)], EMD Serono (Rebif, Mavenclad), Genentech (Ocrevus, Rituxan), Genzyme (Aubagio, Lemtrada), Mylan (generic glatiramer acetate), Novartis (Mayzent, Gilenya, Extavia), Sandoz (Glatopa), Teva (Copaxone)
AB Science (masitinib), Biogen [diroximel fumarate (with Alkermes)], Celgene (ozanimod), J&J/Actelion (ponesimod), MedDay (MD-1003), MediciNova (ibudilast), Novartis (ofatumumab), TG Therapeutics (ublituximab)
*Could move to commercial products based upon regulatory outcomes
Recent Progressive Forms of Multiple Sclerosis Chart Audit Provides Evidence That the Institute for Clinical and Economic Review’s Comparators of Interest for Novartis’ Siponimod Assessment May Not Be Relevant for the Not Active Secondary Progressive Multiple Sclerosis Segment – November 13, 2018
Genentech’s Ocrevus Positioning as an Appropriate First-Line Option in Relapsing Remitting Multiple Sclerosis Appears to Be Resonating With a Subset of U.S. Neurologists – September 19, 2018