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. 2023 Jan 23;9(1):20552173221150370.
doi: 10.1177/20552173221150370. eCollection 2023 Jan-Mar.

Treatment preferences in relation to fatigue of patients with relapsing multiple sclerosis: A discrete choice experiment

Tommi Tervonen  1 , Robert J Fox  2 , Anne Brooks  3 , Tatiana Sidorenko  4 , Neli Boyanova  4 , Bennett Levitan  5 , Brian Hennessy  4 , Andrea Phillips-Beyer  6
Affiliations

Treatment preferences in relation to fatigue of patients with relapsing multiple sclerosis: A discrete choice experiment

Tommi Tervonen et al. Mult Scler J Exp Transl Clin. .

Abstract

Background: Treatment decisions for multiple sclerosis (MS) are influenced by many factors such as disease symptoms, comorbidities, and tolerability.

Objective: To determine how much relapsing MS patients were willing to accept the worsening of certain aspects of their MS in return for improvements in symptoms or treatment convenience.

Methods: A web-based discrete choice experiment (DCE) was conducted in patients with relapsing MS. Multinomial logit models were used to estimate relative attribute importance (RAI) and to quantify attribute trade-offs.

Results: The DCE was completed by 817 participants from the US, the UK, Poland, and Russia. The most valued attributes of MS therapy to participants were effects on physical fatigue (RAI = 22.3%), cognitive fatigue (RAI = 22.0%), relapses over 2 years (RAI = 20.7%), and MS progression (RAI = 18.4%). Participants would accept six additional relapses in 2 years and a decrease of 7 years in time to disease progression to improve either cognitive or physical fatigue from "quite a bit of difficulty" to "no difficulty."

Conclusion: Patients strongly valued improving cognitive and physical fatigue and were willing to accept additional relapses or a shorter time to disease progression to have less fatigue. The impact of fatigue on MS patients' quality of life should be considered in treatment decisions.

Keywords: Multiple sclerosis; discrete choice experiment; disease progression; disease-modifying therapies; fatigue; patient preference; relapsing-remitting.

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Conflict of interest statement

The authors declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: TT and AB were employees of Evidera, who were paid by Actelion Pharmaceuticals Ltd, now a Janssen Pharmaceutical Company of Johnson & Johnson, for work on this study. TS is employee of Actelion Pharmaceuticals Ltd, a Janssen Pharmaceutical company of Johnson & Johnson, and may hold stock in Johnson & Johnson. NB and BH are employees of Actelion Pharmaceuticals Ltd, a Janssen Pharmaceutical company of Johnson & Johnson. BL is an employee of Janssen Research and Development, LLC. BL, BH, and NB are stockholders in Johnson & Johnson and have a portfolio that at times includes other pharmaceutical and healthcare-related companies. APB is a director of Innovus Consulting Ltd and holds a stock portfolio that at times includes pharmaceutical and healthcare-related companies. RF has received personal consulting fees from AB Science, Biogen, Celgene, EMD Serono, Genentech, Genzyme, Greenwich Biosciences, Immunic, Janssen, Novartis, Sanofi, and TG Therapeutics. RF has served on advisory committees for AB Science, Biogen, Genzyme, Immunic, Janssen, Novartis, Sanofi, and TG Therapeutics, and received a clinical trial contract and research grant funding from Biogen, Novartis, and Sanofi.

Figures

Figure 1.
Figure 1.
Example choice task. Participants were introduced to a vignette of a physician telling them they needed to start MS treatment that day and that the physician was reviewing different medication options with them. The choice tasks in the discrete choice experiment (DCE) included those options.
Figure 2.
Figure 2.
Multinomial logit model results: marginal utilities and RAI.
See this image and copyright information in PMC

References

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