A new study published in Patient Preference and Adherence highlights differences in treatment preferences between neurologists and patients with non-highly active relapsing-remitting multiple sclerosis (RRMS).

 The most important treatment attributes for patients were reducing the rate of brain volume loss (BVL), lowering the risk of infection, and decreasing the risk of flu-like symptoms. Neurologists prioritized reducing the risk of life-threatening events, slowing the rate of 2-year disability, and decreasing the risk of infection.

Kumar et al stated, “the importance placed by patients on slowing the rate of BVL makes this a key topic that should be covered in the shared decision-making process.” The authors also noted that BVL monitoring is not currently standard practice but should be considered given the fact that it has been associated with disease progression and long-term disability.

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Analysis of the results did show that both patients and neurologists placed greater importance on slowing disease progression than on slowing the relapse rate. Further analysis of the study results also revealed that patients perceived the risk of life-threatening side effects as less important than reducing the rate of disability progression when selecting treatment options.

Physicians, in contrast, were more concerned with reducing the rate of life-threatening adverse events. The authors stated this was most likely due to physicians being more risk-averse because of the potential fear of litigation.

The study utilized a discrete choice experiment survey to assess the treatment preferences of patients and neurologists. During the survey, respondents had to choose between two treatment profiles that had 7 attributes presented at different levels. The attributes included 2-year disability progression, 1-year relapse rate, rate of BVL, risk of gastrointestinal symptoms, risk of flu-like symptoms, risk of infection, and risk of life-threatening events.

After removing responses that were flagged for potential inattention, 150 patients and 150 neurologist responses were considered in the study. Patients were aged 54 years on average and were mostly female (84.0%). The neurologists had been practicing an average of 17.4 years in mostly nonacademic settings (73.3%). The neurologists were also very familiar with RRMS patients as they had treated a median of 57 patients in the 3 months prior to the survey.


Kumar J, Cambron-Mellott MJ, Tencer T, Will O, Mackie DS, Beusterien K. Patient and neurologist preferences in the United States for relapsing-remitting multiple sclerosis treatments: findings from a discrete choice experiment. Patient Prefer Adherence. 2021;15:1515-1527. doi:10.2147/PPA.S306498