Abstract
To examine the utilisation of monoclonal antibody (mAb) therapies over time and identify differences among MS patients using mAb therapies vs. non-mAb therapies. A multi-centre, online retrospective chart-review study of MS patients was conducted in the 5EU (UK/Germany/France/Italy/Spain) and the US. Neurologists collected de-identified data on their next 10 consecutive MS patients within the respective study windows on diagnosis, clinical measures and treatment patterns. Data on relapsing MS patients receiving disease-modifying treatment (e.g., mAb therapies, platform injectables, orals) were abstracted in Q42013 (5EU; n=2130 and US; n=891) and Q22018 (5EU; n=2515 and US; n=933). Data were analysed using descriptive statistics. There was a 2% and ∼6% increase in the use of mAbs over the 4.5-year period (15.5%/9.9% in Q42013 to 18.2%/17.5% in Q22018) in the 5EU and US, respectively. A higher proportion of patients on mAb therapies (versus those on non-mAb therapies) had moderate/severe disease severity as per physician judgement (5EU Q42013: 76.0% vs 36.5%; Q22018: 70.8% vs 30.2%; US Q42013: 81.9% vs 32.6%; Q22018: 75.0% vs 30.0%) in mAb vs non-mAb groups, respectively. Additionally, the mean EDSS scores and annualised relapse rate were higher in patients on mAb therapies vs. non-mAb therapies. Over time, use of mAb therapies has shifted to slightly milder patients in terms of both mean EDSS (5EU 3.84 vs 3.20; US 4.03 vs 3.85 in Q42013 vs Q22018 respectively) and moderate/severe disease severity (5EU 76.0% vs 70.8%; US 81.9% vs 75.0% in Q42013 vs Q22018 respectively). In this study, increased adoption of mAb therapy use was evident over the four years. Whilst mAb therapy use continues to be among those with greater disease severity vs non-mAb patients, greater comfort with these therapies and a clinically milder profile over time indicates risk management is becoming less of a barrier to prescription.
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