Disease-modifying therapies (DMTs) for multiple sclerosis (MS) have shifted substantially since 2001, with more patients now taking oral medications instead of platform injectables, according to a new study published in JAMA Neurology.
Researchers identified 153,846 DMT initiation episodes among adults (median age, 46 years) and 583 among children (median age, 16 years) from 2001 through 2020. Their main outcome of interest was defined as the proportion of total initiations per year attributable to each type of DMT. Trends in initiations were evaluated annually.
The study found that among adults, the use of platform injectables has declined by almost 74% since 2001. The researchers also observed that the 2010 introduction of oral DMTs caused an appreciable rise in their use from 1.1% (2010) to 62.3% (2020) of all DMT initiations. Infusion therapy initiations remained relatively low over the study period, accounting for just 3.2% of all initiations since their introduction in 2004.
Children showed similar initiation patterns and preferred oral therapies, the researchers noted.
“Current MS treatment guidelines emphasize shared decision-making between patients and clinicians to balance treatment efficacy, safety, cost, and convenience. This study found that oral DMTs were the predominant DMT type initiated by 2020. The cause of this shift cannot be determined from this study, but may reflect several factors, including convenience of administration, direct-to-consumer advertising, or insurance restrictions,” the researchers concluded.