Patient-Reported Treatment Satisfaction in Treatment-Naive and -Experienced RRMS Patients Receiving Oral Disease-Modifying Therapies

Background: Patient-reported outcomes can be useful to assess real-world value of disease-modifying therapies (DMTs). Oral DMTs currently available for MS include teriflunomide, fingolimod and dimethyl fumarate (DMF).

Objectives: To assess patient-reported treatment satisfaction in treatment-naïve (TN) and treatment-experienced (TE) relapsing-remitting MS (RRMS) patients receiving an oral DMT.

Methods: Data were collected from self-administered online surveys taken by US and European RRMS patients receiving oral DMTs. Treatment satisfaction was measured by the Treatment Satisfaction Questionnaire for Medication (TSQM; v1.4); higher scores indicate greater satisfaction. Descriptive and bivariate analyses were performed to compare responses between TN and TE subgroups.

Results: Of 320 patients completing the survey, 53 (of whom 17% were TN), 124 (20% TN), and 143 (24.5% TN) were receiving teriflunomide, fingolimod, or DMF, respectively. Teriflunomide-treated patients scored higher in the TSQM Convenience domain in TN (mean [SD]=95.68 [5.40]) and TE (95.71 [9.27]) groups vs DMF (TN: 87.14 [14.37], P=0.0077; TE: 87.91 [17.92], P=0.0006) and fingolimod (TN: 84.22 [23.33], P=0.0293; TE: 92.09 [13.86], P=0.0691); and higher in the Side Effects domain compared with DMF (TN: 88.19 [22.41] vs 75.36 [25.45], P=0.1751; TE: 92.33 [13.67] vs 83.45 [20.85], P=0.0025), and similar to fingolimod (TN: 94.00 [14.49], P=0.3813; TE: 93.31 [17.13], P=0.7387). Patients receiving teriflunomide scored numerically higher than the DMF cohort for Effectiveness (TN: 77.78 [22.74] vs 63.33 [22.72], P=0.0963; TE: 71.21 [20.17] vs 70.63 [21.78], P=0.8784) and Global Satisfaction (TN: 84.92 [22.99] vs 68.57 [21.44], P=0.0507; TE: 74.35 [21.69] vs 71.96 [25.14], P=0.5812). Similar Effectiveness scores were seen between teriflunomide and fingolimod cohorts (TN: 77.78 [22.74] vs 76.22 [18.88], P=0.8420; TE: 71.21 [20.17] vs 71.55 [19.59], P=0.9252). Global Satisfaction scores for TN teriflunomide patients were numerically higher vs fingolimod patients (84.92 [22.99] vs 71.43 [23.33], P=0.1452), with similar scores observed between TE cohorts (74.35 [21.69] vs 74.68 [20.79], P=0.9324).

Conclusions: This study presents evidence that teriflunomide results in higher scores on all TSQM measures of treatment satisfaction relative to DMF, regardless of prior treatment experience. Except for the Side Effects domain, teriflunomide scores were higher than, or similar to, fingolimod. TSQM scores were often higher in the TE subgroups across all 3 oral DMTs.