Treatment Satisfaction Across Injectable, Infusion, and Oral Disease-Modifying Therapies for Multiple Sclerosis

Background: The recent approval of disease-modifying therapies (DMTs) for multiple sclerosis (MS) has provided patients with a new mode of therapy administration. Little research has compared patients’ experiences with and perceptions of injectable, infusion and oral MS therapies.

Objectives: To investigate treatment satisfaction among patients treated with injectable, infusion, and oral DMTs.

Methods: Three hundred seventy-seven treated MS patients enrolled in the CLIMB study completed the Treatment Satisfaction Questionnaire for Medication (TSQM). The TSQM provides information regarding perceived effectiveness, side effects, convenience and overall satisfaction.  The selected patients were treated with either interferon beta-1a intramuscular (IFNβ-1a IM) (n = 43), interferon beta-1a subcutaneous (IFNβ-1a SC) (n = 46), glatiramer acetate (GA) (n = 126), natalizumab (NTZ) (n = 51), fingolimod (n = 67), or dimethyl fumarate (BG-12) (n = 44). Multivariable linear regression models were used to compare treatment satisfaction across all DMTs and between patients treated with injectable (n = 215), infusion (n = 51), and oral (n = 111) DMTs. All models were adjusted for race, sex, age, disease duration, and disease category.

Results: Compared to those taking oral DMTs, patients taking injectable or infusion DMTs did not have significantly different mean scores for overall treatment satisfaction, perceived efficacy, or presence of side effects. Further, there were no significant differences in the mean scores when comparing all six DMTs separately. In terms of convenience, patients taking injectable DMTs reported a significantly (p < 0.0001) lower mean score (M = 68.68, SD = 17.69) than those taking oral DMTs (M = 88.23, SD = 16.76). Patients taking the infusion DMT also reported a significantly lower mean score for treatment convenience (M = 70.04, SD = 19.97) than those taking oral DMTs (p < 0.0001). When specific treatment comparisons were completed, both types of oral medication showed a significant benefit relative to all injectable treatments, and fingolimod showed significant benefit relative to NTZ and BG-12 (p< 0.05 for each comparison).

Conclusions: While there are no significant differences among treatment modalities and specific medications for patient reports of efficacy, side effects, and overall treatment satisfaction, patients report treatment with the oral medications as more convenient than the injectable and infusion DMTs.