Abstract Details

Title Risk Perception in Multiple Sclerosis: Reasons for Switching Treatment Between High Efficacy and Non-high Efficacy Disease-modifying Therapies

Topic Multiple Sclerosis

Presentation(s) P3 - Poster Session 3 (5:30 PM-6:30 PM)

Poster/Presentation
Number 12-004

Background Disease-modifying therapies (DMTs), approved for MS, have variable benefit-risk profiles. Previous studies have shown that the decision for prescribing a non-HET or a HET can be strongly influenced by an individual’s risk perception, with HETs potentially being perceived by physicians as having greater safety concerns (malignancies/infections) than non-HETs.

Objective To investigate the influence of risk perception on physicians when switching treatments for multiple sclerosis (MS) and the reasons for switching when prescribing high-efficacy treatments (HETs) or non-HETs.

Design/Methods Data were drawn from the Adelphi Real-World MS Disease-Specific Program, a retrospective non-interventional cross-sectional, multi-cohort study. Analysis was conducted on RMS patients identified between 2017-2021, with both current and immediately prior treatment. Descriptive statistics (n, %) and Fisher’s Exact test were used to compare risk perception (malignancies/infections), and reasons for influencing treatment switches.

Results A total of 4129 patients were included in the study; of those, 3538 switched from non-HET and 591 from HETs. Overall, very few patients switched treatment for risk of malignancies/infections versus those switched for no risk of malignancies/infections (0.9% vs. 99.1%). The primary reason for switching was lack of efficacy (non-HET vs. HET: 53.3% vs. 35.9%; p<0.0001) including relapse frequency (26.8% vs.15.2%; p<0.0001), increased number of lesions (20.3% vs.12.4%; p<0.0001) and relapse severity (18.6% vs.14.7%; p=0.0241). Other reasons for switching included patient request (20.6% vs. 9.5%; p<0.0001), injection-site reactions (16.2% vs. 0.3%; p<0.0001) and patient compliance issues (12.1% vs. 2.5%; p<0.0001).

Conclusions These results indicate that physicians’ risk perception of malignancies and infection is not a leading factor when switching from HETs or non-HETs. Lack of efficacy, including relapse frequency, increased lesions, relapse severity and patient request are the main-factors influencing treatment switching, especially in the case of non-HETs. These findings support early initiation of HET in treating MS and underscores the need for evaluation of the current approach of escalation therapy.

Authors/Disclosures
Gustavo Seifer, Prof PRESENTER	Gustavo Seifer, Prof has received personal compensation for serving as an employee of Novartis.
	No disclosure on file
	No disclosure on file
Eddie Jones, BA	Eddie Jones, BA has nothing to disclose.
Rainel Sanchez-De La Rosa, MD, PhD (Novartis Pharma AG)	No disclosure on file