OBJECTIVES:

The treatment of relapsing-remitting multiple sclerosis (RRMS) is rapidly evolving, with several novel disease-modifying therapies (DMTs) entering the market. The various DMTs exert different effects on the attributes of the disease, including the rate of brain volume loss (BVL). This study sought to assess patient preferences for the benefits and risks associated with common and novel DMTs in RRMS among UK patients.

METHODS:

UK patients diagnosed with RRMS completed an online cross-sectional survey. A discrete choice experiment assessed preferences; patients were presented with a series of tasks and asked to choose between 2 treatment profiles that varied on 7 attributes identified in qualitative research: 2-year disability progression, 1-year relapse rate, rate of BVL, and risks of gastrointestinal symptoms, flu-like symptoms, infection, and life-threatening side effects. A hierarchical Bayes model was used to estimate attribute-level weighted preferences.

RESULTS:

Analyses included 144 patients with RRMS. Mean age was 43 years, 69% were female, 56% were employed, 18% were on long-term disability, and 73% were taking a prescription medication. Patients prioritized reducing the rate of BVL, followed by the risk of infection, slowing the rate of 2-year disability progression, 1-year relapse rate, risk of flu-like symptoms, risk of gastrointestinal symptoms, and risk of a life-threatening event. Reducing the rate of BVL and the risk of infection were approximately twice as important as reductions in the risk of flu-like symptoms, gastrointestinal symptoms, and a life-threatening event.

CONCLUSIONS:

In addition to traditional measures of treatment benefit in RRMS, UK patients in this analysis were willing to make tradeoffs for a reduction in the rate of BVL. These findings suggest that reducing BVL should be considered when physicians engage in shared decision making with their patients when selecting treatment.