Thursday, 24 July 2014

What do US MSers think about switching drugs

Salter AR, Marrie RA, Agashivala N, Belletti DA, Kim E, Cutter GR, Cofield SS, Tyry T.Patient perspectives on switching disease-modifying therapies in the NARCOMS registry.
Patient Prefer Adherence. 2014 Jul 4;8:971-9. doi: 10.2147/PPA.S49903. eCollection 2014

.INTRODUCTION: The evolving landscape of disease-modifying therapies (DMTs) for multiple sclerosis raises important questions about why patients change DMTs. Physicians and patients could benefit from a better understanding of the reasons for switching therapy.
PURPOSE: To investigate the reasons patients switch DMTs and identify characteristics associated with the decision to switch.
METHOD: The North American Research Committee on Multiple Sclerosis (NARCOMS) Registry conducted a supplemental survey among registry participants responding to the 2011 update survey. The supplemental survey investigated reasons for switching DMT, origin of the discussion of DMT change, and which factors influenced the decision. 
RESULTS: Of the 691 eligible candidates, 308 responded and met the inclusion criteria (relapsing disease course, switched DMT after September 2010). The responders were 83.4% female, on average 52 years old. The most recent prior therapy included first-line injectables (74.5%), infusions (18.1%), an oral DMT (3.4%), and other DMTs (4.0%). The discussion to switch DMT was initiated almost equally by physicians and participants. The primary reason for choosing the new DMT was based most frequently on physician's recommendation (24.5%) and patient perception of efficacy (13.7%).
CONCLUSION: Participants frequently initiated the discussion regarding changing DMT, although physician recommendations regarding the specific therapy were still weighed highly. Long-term follow-up of these participants will provide valuable information on their disease trajectory, satisfaction with, and effectiveness of their new medication.

Whilst the results are what they are and it is not surprising that there were large switches from the injectables because we know they have a a lower efficacy levels,  but why are the switches occurring?  

If you are treating to target of No evidence of Disease activity, it makes sense to switch and escalate. Prof G has mademany posts on this aspect 

1 comment:

  1. Huey Lewis and the News said it best in the song "I Want a New Drug."


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