OBJECTIVES

As the treatment landscape for relapsing-remitting multiple sclerosis (RRMS) evolves, physicians must weigh the benefits and risks of disease-modifying therapies (DMTs) when choosing an appropriate treatment. This study sought to evaluate neurologist preferences for RRMS medications in the UK, weighing DMT-specific benefits and risks.

METHODS

Neurologists in the UK who treat RRMS patients completed an online cross-sectional survey. Treatment preferences for patients with non-highly active RRMS and highly active RRMS were evaluated via 2 discrete choice experiments (DCEs). Both DCEs included a series of tasks in which neurologists were 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 brain volume loss (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

A total of 101 neurologists, averaging 13 years in practice (80% in academic settings), were included in this analysis. For non-highly active RRMS patients, neurologists were most concerned with reducing the rate of BVL, followed by slowing the rate of 2-year disability progression, risk of infection, 1-year relapse rate, risk of flu-like symptoms, risk of a life-threatening event, and risk of gastrointestinal infections. For highly active patients, neurologists prioritized reducing 1-year relapse rate, followed by reducing the rate of BVL, slowing the rate of 2-year disability progression, risk of infection, risk of life-threatening event, risk of flu-like symptoms, and risk of gastrointestinal symptoms. Rate of BVL was approximately twice as important as reductions in the risk of flu-like symptoms, gastrointestinal symptoms, and a life-threatening event for both patient groups.

CONCLUSIONS

Among neurologists in the UK, BVL was the most important treatment consideration in non-highly active RRMS, whereas both BVL and relapse rate were prioritized in highly active RRMS.