The delay in diagnosing secondary progressive multiple sclerosis (SPMS) in relapsing remitting multiple sclerosis (RRMS) patients who show potential signs of progression in Europe and the United States
ECTRIMS Online Library. White J. 09/13/19; 278319; P1117
Joanna White
Joanna White
Contributions
Abstract

Abstract: P1117

Type: Poster Sessions

Abstract Category: Clinical aspects of MS - Progressive MS

J. White1, S. Teoh2, J. Vindici3, H. Brown1, S. Gabriele1

1Ipsos MORI UK Ltd, London, United Kingdom, 2Ipsos Insight LLC, Kuala Lumpur, Malaysia, 3Ipsos Insight LLC, New Jersey, NJ, United States

Introduction: SPMS patients typically don't suffer relapses and experience increasing disability. With no test available to confirm SPMS, the criteria to determine transition from RRMS to SPMS is challenging. Until March 2019 there were no disease-modifying therapies (DMTs) specifically indicated for SPMS: whilst this remains the case in EU5, two DMTs are now indicated for use in active SPMS in the US.
Objective: To assess perceptions of diagnosing SPMS in current RRMS patients among healthcare professionals (HCPs) in both the 5EU (UK/France/Germany/Italy/Spain) and the United States.
Methods: The Ipsos Global MS Therapy Monitor, a multi-centre cross-sectional survey of HCPs (Neurologists; MS nurses included in UK) and chart-review study of patients with MS is run on a bi-annual basis in 5EU and US. De-identified HCP perceptions and de-identified patient data are collected. HCPs are screened for practice duration (≥3yrs) and patient volume (≥15 MS patients/mo.) and recruited to be geographically representative within respective countries. HCP perceptions and charts of patients with RRMS abstracted from 10/2018-12/2018 were included.
Results: 267 HCPs in 5EU and 106 HCPs in the US were included. 41% and 59% of HCPs in the 5EU and US respectively, report personally refraining from recording RRMS patients as having progressed to SPMS to ensure they can continue with DMTs. US HCPs were more likely to say they did this often vs those in the 5EU; 16% vs 6% respectively. 48% and 69% of HCPs in the 5EU and US, respectively, said the launch of specific DMTs for SPMS would allow them to move progressed RRMS patients to an SPMS diagnosis. N=2252 (5EU) and N=751 (US) patients with RRMS and 323 (5EU) and 111 (US) patients with SPMS were included in the study. 37% in 5EU and 17% in US, of 2nd+ line SPMS patients have transition to SPMS as a reason for switching off their most recent DMT, of which 66% and 44% discontinued DMTs altogether. Of those with RRMS, 17% in and 5EU 21% in US have an EDSS score ≥4.0.
Conclusions: In this cohort, some HCPs in both 5EU and US refrain from recording progression to SPMS to ensure continued DM treatment. Patient chart data suggests a proportion of RRMS patients have initial signs of progression; this prescribing behaviour could indicate the SPMS population will increase now specific DMTs are indicated for active SPMS. Further research into improving earlier diagnosis of SPMS is warranted to assess the impact on patient outcomes.
Disclosure: Joanna White employee of Ipsos and nothing to disclose
Sandra Teoh employee of Ipsos and nothing to disclose
Joseph Vindici employee of Ipsos and nothing to disclose
Hannah Brown employee of Ipsos and nothing to disclose
Simone Gabriele employee of Ipsos and nothing to disclose

Abstract: P1117

Type: Poster Sessions

Abstract Category: Clinical aspects of MS - Progressive MS

J. White1, S. Teoh2, J. Vindici3, H. Brown1, S. Gabriele1

1Ipsos MORI UK Ltd, London, United Kingdom, 2Ipsos Insight LLC, Kuala Lumpur, Malaysia, 3Ipsos Insight LLC, New Jersey, NJ, United States

Introduction: SPMS patients typically don't suffer relapses and experience increasing disability. With no test available to confirm SPMS, the criteria to determine transition from RRMS to SPMS is challenging. Until March 2019 there were no disease-modifying therapies (DMTs) specifically indicated for SPMS: whilst this remains the case in EU5, two DMTs are now indicated for use in active SPMS in the US.
Objective: To assess perceptions of diagnosing SPMS in current RRMS patients among healthcare professionals (HCPs) in both the 5EU (UK/France/Germany/Italy/Spain) and the United States.
Methods: The Ipsos Global MS Therapy Monitor, a multi-centre cross-sectional survey of HCPs (Neurologists; MS nurses included in UK) and chart-review study of patients with MS is run on a bi-annual basis in 5EU and US. De-identified HCP perceptions and de-identified patient data are collected. HCPs are screened for practice duration (≥3yrs) and patient volume (≥15 MS patients/mo.) and recruited to be geographically representative within respective countries. HCP perceptions and charts of patients with RRMS abstracted from 10/2018-12/2018 were included.
Results: 267 HCPs in 5EU and 106 HCPs in the US were included. 41% and 59% of HCPs in the 5EU and US respectively, report personally refraining from recording RRMS patients as having progressed to SPMS to ensure they can continue with DMTs. US HCPs were more likely to say they did this often vs those in the 5EU; 16% vs 6% respectively. 48% and 69% of HCPs in the 5EU and US, respectively, said the launch of specific DMTs for SPMS would allow them to move progressed RRMS patients to an SPMS diagnosis. N=2252 (5EU) and N=751 (US) patients with RRMS and 323 (5EU) and 111 (US) patients with SPMS were included in the study. 37% in 5EU and 17% in US, of 2nd+ line SPMS patients have transition to SPMS as a reason for switching off their most recent DMT, of which 66% and 44% discontinued DMTs altogether. Of those with RRMS, 17% in and 5EU 21% in US have an EDSS score ≥4.0.
Conclusions: In this cohort, some HCPs in both 5EU and US refrain from recording progression to SPMS to ensure continued DM treatment. Patient chart data suggests a proportion of RRMS patients have initial signs of progression; this prescribing behaviour could indicate the SPMS population will increase now specific DMTs are indicated for active SPMS. Further research into improving earlier diagnosis of SPMS is warranted to assess the impact on patient outcomes.
Disclosure: Joanna White employee of Ipsos and nothing to disclose
Sandra Teoh employee of Ipsos and nothing to disclose
Joseph Vindici employee of Ipsos and nothing to disclose
Hannah Brown employee of Ipsos and nothing to disclose
Simone Gabriele employee of Ipsos and nothing to disclose

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