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Influence of Physicians’ Risk Perception on Switching Treatments Between High- Efficacy and Non–High-Efficacy Disease‑Modifying Therapies in Multiple Sclerosis

2023Journal article Open access
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dc.contributor.authorSeifer, G
dc.contributor.authorArun, T
dc.contributor.authorCapela, C
dc.contributor.authorLaureys, G
dc.contributor.authorJones, E
dc.contributor.authorDominguez-Castro, P
dc.contributor.authorSanchez-de la Rosa, R
dc.contributor.authorHiltl, S
dc.contributor.authorIaffaldano, P
dc.date.accessioned2024-08-22T13:20:23Z
dc.date.available2024-08-22T13:20:23Z
dc.date.issued2023
dc.description.abstractBackground: The decision of initiating treatment for multiple sclerosis (MS) with a high-efficacy DMT (HE DMT) or non-high-efficacy DMT (non-HE DMT) is influenced by several factors, including risk perception of patients and physicians. Objective: Investigate the influence of physicians' risk perception on decision-making when switching treatments for MS and the reasons for switching. Methods: Data were drawn from the Adelphi Real-World MS Disease-Specific Program (a retrospective survey) and analysis included people with RMS identified between 2017- 2021. Results: Of 4129 patients with reasons for switch available, 3538 switched from non-HE DMT and 591 from HE DMT. Overall, 4.7% of patients were switched treatment by their physicians due to the risk of malignancies and infections including PML risk. The proportion of switches that were made due to the risk of PML were 23.9% in the HE DMT and 0.5% in the non-HE DMT groups. The top reasons for switching were relapse frequency (non-HE DMT vs HE-DMT: 26.8% vs 15.2%), lack of efficacy (20.9 vs 11.7) and increased number of MRI lesions (20.3% vs 12.4%). Conclusions: Physicians' risk perception of malignancies and infection excluding PML was not a leading factor when switching treatment. The risk of PML was a key factor, especially for switching patients from HE DMTs. In both groups, lack of efficacy was the key contributing factor for switching. Initiating the treatment with HE DMTs may potentially reduce the number of switches due to sub-optimal efficacy. These findings might help physicians to engage more in discussions with patients about the benefit/risk profile of DMTs.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationMult Scler Relat Disord . 2023 Aug:76:104770pt_PT
dc.identifier.doi10.1016/j.msard.2023.104770pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/4997
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherElsevierpt_PT
dc.subjectHSJ NEUpt_PT
dc.subjectHumanspt_PT
dc.subjectAdultpt_PT
dc.subjectMalept_PT
dc.subjectFemalept_PT
dc.subjectRiskpt_PT
dc.subjectCross-Sectional Studiespt_PT
dc.subjectTreatment Outcomept_PT
dc.subjectHealth Care Surveyspt_PT
dc.subjectInfections / chemically inducedpt_PT
dc.subjectLeukoencephalopathy, Progressive Multifocal / chemically inducedpt_PT
dc.subjectMultiple Sclerosis* / drug therapypt_PT
dc.subjectMultiple Sclerosis, Relapsing-Remitting / drug therapypt_PT
dc.subjectNatalizumab / administration & dosagept_PT
dc.subjectNatalizumab / adverse effectspt_PT
dc.subjectNatalizumab / therapeutic usept_PT
dc.subjectNeoplasms / chemically inducedpt_PT
dc.subjectPhysicians* / psychologypt_PT
dc.subjectPractice Patterns, Physicians'*pt_PT
dc.subjectRetrospective Studiespt_PT
dc.titleInfluence of Physicians’ Risk Perception on Switching Treatments Between High- Efficacy and Non–High-Efficacy Disease‑Modifying Therapies in Multiple Sclerosispt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.startPage104770pt_PT
oaire.citation.titleMultiple Sclerosis and Related Disorderspt_PT
oaire.citation.volume76pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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