GEOGRAPHIC VARIATION IN HOW PHYSICIANS CONCEPTUALISE, ASSESS AND ACT ON DISEASE ACTIVITY AND PROGRESSION IN MULTIPLE SCLEROSIS: A REAL-WORLD MULTI-COUNTRY SURVEY
Author(s)
Tom Chambers, PhD1, Katya Galactionova, PhD1, Ana Ferro, PhD2, Gerardo Machnicki, PhD1, Mia Unsworth, BSc3, Kristie Fitzmaurice, MScEcon3.
1Hoffman-La Roche, Basel, Switzerland, 2Roche Products Ltd, Welwyn Garden Cuty, United Kingdom, 3Adelphi Real World, Manchester, United Kingdom.
1Hoffman-La Roche, Basel, Switzerland, 2Roche Products Ltd, Welwyn Garden Cuty, United Kingdom, 3Adelphi Real World, Manchester, United Kingdom.
OBJECTIVES: Effective management of multiple sclerosis (MS) requires alignment among disease activity definitions and measurement tools used to assess them. Geographic variation in these domains remains poorly characterised. We evaluated how physicians across the US and EU5 conceptualise disease activity, assess progression and respond to Progression Independent of Relapse Activity (PIRA).
METHODS: Data for this descriptive analysis were extracted from the Adelphi Real World MS Disease Specific Programme™, a cross-sectional survey of neurologists across the US (n=90) and EU5 (Germany, France, Spain, Italy, UK) (n=320) conducted between 04/2024 and 08/2025
RESULTS: In this survey, regional variations emerged; EU5 physicians defined “disease activity” by relapses (83% EU5 & 57% US) and MRI changes (79% & 60%), while US physicians by worsening disability/mobility (57% & 71%) and worsening symptoms (53% & 68%), with lesion-load prioritised for both (82% & 79%). When differentiating low/moderate from high disease activity, EU5 prioritised relapse frequency (80% EU5 & 59% US), MRI activity (76% & 64%) and relapse severity (64% & 52%), with disability progression prioritised in the US (52% & 72%). Most physicians (76%) reported switching disease-modifying therapies for PIRA (from Spain 88% to Germany 61%) and, for these physicians, EU5 physicians relied primarily on EDSS to assess progression (EU5 86% & 52% US) while US physicians prioritised physical examinations (70% & 90%). Importantly, 44% of physicians reported that current instruments do not provide a complete picture of progression (from 61% in Spain to 28% in Germany), with 77% of these seeking improved progression markers and 72% better use of biomarkers
CONCLUSIONS: Variation exists in how disease activity and progression are clinically defined and assessed. Despite multiple instruments being available, nearly half of physicians deem them insufficient, and yet these metrics drive treatment decisions. Standardising progression metrics and integrating emerging biomarkers is essential to reduce fragmentation and optimise patient outcomes
METHODS: Data for this descriptive analysis were extracted from the Adelphi Real World MS Disease Specific Programme™, a cross-sectional survey of neurologists across the US (n=90) and EU5 (Germany, France, Spain, Italy, UK) (n=320) conducted between 04/2024 and 08/2025
RESULTS: In this survey, regional variations emerged; EU5 physicians defined “disease activity” by relapses (83% EU5 & 57% US) and MRI changes (79% & 60%), while US physicians by worsening disability/mobility (57% & 71%) and worsening symptoms (53% & 68%), with lesion-load prioritised for both (82% & 79%). When differentiating low/moderate from high disease activity, EU5 prioritised relapse frequency (80% EU5 & 59% US), MRI activity (76% & 64%) and relapse severity (64% & 52%), with disability progression prioritised in the US (52% & 72%). Most physicians (76%) reported switching disease-modifying therapies for PIRA (from Spain 88% to Germany 61%) and, for these physicians, EU5 physicians relied primarily on EDSS to assess progression (EU5 86% & 52% US) while US physicians prioritised physical examinations (70% & 90%). Importantly, 44% of physicians reported that current instruments do not provide a complete picture of progression (from 61% in Spain to 28% in Germany), with 77% of these seeking improved progression markers and 72% better use of biomarkers
CONCLUSIONS: Variation exists in how disease activity and progression are clinically defined and assessed. Despite multiple instruments being available, nearly half of physicians deem them insufficient, and yet these metrics drive treatment decisions. Standardising progression metrics and integrating emerging biomarkers is essential to reduce fragmentation and optimise patient outcomes
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
RWD91
Topic
Clinical Outcomes, Organizational Practices, Real World Data & Information Systems
Disease
Neurological Disorders