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MSVirtual2020: MSers willing to trade relapses, disability to reduce fatigue

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  • MSVirtual2020: MSers willing to trade relapses, disability to reduce fatigue

    How challenging is MS fatigue? This study shows just how far many of us would go to reduce it. -D

    P1064 - Treatment Preferences of Patients with Relapsing Multiple Sclerosis: A Discrete Choice Experiment (ID 935)

    B. Levitan
    T. Scherz N. Boyanova1 A. Brooks G. Chua A. Beyer B. Levitan B. Hennessy T. Tervonen
    Presentation Number
    Presentation Topic
    Patient-Reported Outcomes and Quality of Life


    A variety of treatments are available to slow the progression of multiple sclerosis (MS). Understanding patient preferences for efficacy and safety attributes of MS treatment can help clinicians and other decision-makers ascertain which treatments are acceptable to patients based on their overall benefit-risk profiles.

    To quantify the relative importance of treatment attributes to patients with relapsing MS and to measure how large a change in disease progression or relapse rate patients are willing to tolerate for improvements in other attributes.

    A cross-sectional online Discrete Choice Experiment (DCE) in adults with relapsing MS was conducted in Poland, Russia, the United States, and the United Kingdom. Participants were considered relapsing if they had ≥1 MS attack within the last year or ≥2 MS attacks within the past 2 years prior to start of treatment. Preferences were elicited for 7 MS treatment attributes: drug interactions, cognitive fatigue, physical fatigue, immune system recovery time, monitoring visits, time to disease progression, and number of relapses. Multinomial logit models were used to estimate maximum decrease in time to disease progression and increase in relapses within 2 years that is acceptable in exchange for improvements in other attributes. P<0.05 was considered statistically significant.

    The DCE was completed by 201 participants. The mean age was 39 10 years. All attributes included in the DCE significantly affected participant choices, although cognitive fatigue, physical fatigue, and time to disease progression were the most valued. Participants were willing to accept up to 4.4 years (95% CI, 2.3–6.4) decrease in time to disease progression or up to 4.6 additional relapses (95% CI, 2.0–7.2) within 2 years in exchange for an improvement in physical fatigue from ‘quite a bit difficulty’ to ‘moderate difficulty’. Further, participants were willing to accept up to 2.8 years (95% CI, 1.1–4.4) decrease in time to disease progression or up to 2.9 additional relapses (95% CI, 1.1–4.6) within 2 years in exchange for a similar improvement in cognitive fatigue.

    Of the attributes tested, patients with relapsing MS most valued improvements in physical and cognitive fatigue and they were willing to accept significant increase in number of relapses and decrease in time to disease progression to obtain improvements in fatigue.
    Dave Bexfield

  • #2
    Reminds me of the silly game teenagers play, "would you rather" ex
    would you rather eat a live coakroach or a rotten egg warmed in the microwave? Its a false choice but highlights your perspective. MS fatigue sucks. It isolates and can bankrupt you. Yet it is hard to quantify and not understood by others. The authors of this presentation essentially played "would you rather" with MSers and it demonstrates how desperate MSers are to overcome fatigue. Not a surprise if you are a MSer. Is it shocking to the doctors who care for us??? Idk. Maybe they should munch on a cockroach. (My choice)