Profile of Patients with Multiple Sclerosis on Oral Disease-Modifying Therapies in North American Registry for Care and Research in Multiple Sclerosis

Background: Multiple sclerosis (MS) is a chronic neurologic disease that for more than 2 decades has been treated with injectable disease-modifying therapies (DMTs) as first-line treatment. More recently, oral DMTs have become available. The North American Registry for Care and Research in Multiple Sclerosis (NARCRMS), initiated in 2016, is a physician-based registry/longitudinal database for patients with MS.

Objectives: We characterized patients with MS who were receiving oral DMTs at enrollment compared with all patients with MS in NARCRMS.

Methods: This retrospective analysis of NARCRMS data (May 2016–July 2021) compared patients with MS receiving daily oral DMTs (dimethyl fumarate, fingolimod, teriflunomide) at enrollment with the overall NARCRMS population. Patients aged 18–65 with MS onset dates within 15 years and Expanded Disability Status Scale (EDSS) scores ≤6.5 at enrollment were included. Descriptive statistics were used for patient demographics, treatment patterns, EDSS scores, and work productivity.

Results: The overall MS and oral DMT cohorts included 889 and 151 patients, respectively; the majority were female (75% and 78%), were white (85% and 90%), and had mean age of ~34 (34.6 and 34.3) years at diagnosis, respectively. Patients with follow-up decreased over time in the overall and oral DMT cohorts: Year 1, 46.0% and 61.0%; Year 2, 11.1% and 21.2%; Year 3, 1.4% and 2.0%, respectively. Mean enrollment EDSS scores did not differ between the overall and oral DMT cohorts (1.9 and 1.7, respectively) but were significantly higher in the overall cohort at first and second follow-up: Year 1, 1.96 and 1.55 (P = 0.02); Year 2, 1.82 and 1.28 (P = 0.04). Employment rates did not differ significantly between the overall (73.2%) and oral DMT (70.8%) cohorts; both had a large proportion of patients receiving disability income at first follow-up (overall, 87.6%; oral DMT, 90.0%), and 35.3% of overall patients and 45% of oral DMT patients who had worked the week prior reported that MS affected work output.

Conclusions: Our results suggest that real-world patients taking oral DMTs are similar to patients with MS overall. As MS registries are growing and more treatment options become available, capturing high-quality, long-term data is increasingly important.