Treatment selection and experience in multiple sclerosis: survey of neurologists

Figures & data

Table 1 Sociodemographic characteristics

Characteristics	General neurologists N=63	MS specialists N=39	All neurologists N=102
Age
Mean (SD)	50.2 (11.0)	48.6 (10.0)	49.6 (10.6)
Median (minimum–maximum)	49 (20–88)	47 (33–75)	48 (20–88)
Sex, n (%)
Male	52 (82.5%)	31 (79.5%)	83 (81.4%)
Female	11 (17.5%)	8 (20.5%)	19 (18.6%)
Race/ethnicity, n (%)
American Indian or Alaska Native	0 (0.0%)	1 (2.6%)	1 (1.0%)
Asian	11 (17.5%)	11 (28.2%)	22 (21.6%)
Black or African American	0 (0.0%)	0 (0.0%)	0 (0.0%)
Hispanic or Latino	3 (4.8%)	1 (2.6%)	4 (3.9%)
Native Hawaiian or other Pacific Islander	0 (0.0%)	0 (0.0%)	0 (0.0%)
White	49 (77.8%)	25 (64.1%)	74 (72.5%)
Other	0 (0.0%)	1 (2.6%)	1 (1.0%)
Years in practice after completing all medical training
Mean (SD)	17.3 (8.7)	15.1 (8.2)	16.4 (8.6)
Median (minimum–maximum)	17 (3–35)	14 (2–35)	15 (2–35)
Location of medical school, n (%)
US	50 (79.4%)	34 (87.2%)	84 (82.4%)
Other	13 (20.6%)	5 (12.8%)	18 (17.6%)
Type of training,a n (%)
General neurology training	59 (93.7%)	30 (76.9%)	89 (87.3%)
MS fellowship	1 (1.6%)	24 (61.5%)	25 (24.5%)
Other fellowship	14 (22.2%)	5 (12.8%)	19 (18.6%)
Type of practice setting, n (%)
Private single specialty office (MS specialty center)	3 (4.8%)	9 (23.1%)	12 (11.8%)
Private single specialty office (non-MS specialty)	31 (49.2%)	6 (15.4%)	37 (36.3%)
Private multispecialty	15 (23.8%)	3 (7.7%)	18 (17.6%)
Academic	9 (14.3%)	20 (51.3%)	29 (28.4%)
Community hospital	5 (7.9%)	1 (2.6%)	6 (5.9%)

Note:

a The percentages can exceed 100%.

Abbreviations: N, total population; MS, multiple sclerosis; SD, standard deviation; n, sample population.

Figure 1 Mean percentage of patients prescribed individual DMTs, as reported by neurologists.

Note: *Includes patients on natalimumab (6.6%) and other medications (azathioprine, cladribine, cyclophosphamide, daclizumab, intravenous immunoglobulin, methotrexate, mycophenolate mofetil, naltrexone, rituximab, corticosteroids, teriflunimide [1.1% combined]).
Abbreviations: MS, multiple sclerosis; IM, intramuscular; IFN, interferon; SC, subcutaneous; DMTs, disease-modifying therapies.

Table 2 Neurologists’ perceptions of patient satisfaction and adherence with treatment: comparison with fingolimod

	Fingolimod	IM IFN β-1a		IFN β-1b (Betaseron^® /Extavia^®)		Glatiramer acetate		SC IFN β-1a
	N (%)	N (%)	P-value			N (%)	P-value	N (%)	P-value
				N (%)	P-value
Patient satisfaction, Na	87	99		92		101		96
Dissatisfied	5 (5.7%)	6 (6.1%)	0.0006	3 (3.3%)	0.0007	5 (5.0%)	0.017	3 (3.1%)	0.0020
Satisfied	55 (63.2%)	85 (85.9%)		83 (90.2%)		82 (81.2%)		85 (88.5%)
Very/extremely satisfied	27 (31.0%)	8 (8.1%)		6 (6.5%)		14 (13.9%)		8 (8.3%)
Patient adherence, Na,b	84	98		88		100		94
All/most	79 (94.0%)	91 (92.9%)	0.75	66 (75.0%)	0.0006	78 (78.0%)	0.0022	79 (84.0%)	0.035
Some/few	5 (6.0%)	7 (7.1%)		22 (25.0%)		22 (22.0%)		15 (16.0%)

Notes:

a The number of neurologists prescribing the medication;

b excludes neurologists reporting “I don’t know.” Betaseron^®; Bayer AG, Leverkusen, Germany. Extavia^®; Novartis AG, Basel, Switzerland.

Abbreviations: N, number; IM, intramuscular; IFN, interferon; SC, subcutaneous.

Table 3 Callers’ reasons for calling neurologists’ offices: comparison with fingolimod

Call reason	Fingolimod	IM IFN β-1a		IFN β-1b (Betaseron^® /Extavia^®)		Glatiramer acetate		SC IFN β-1a
	N=82	N=99	P-value			N=100	P-value	N=96	P-value
				N=84	P-value
Obtain medical information	15 (18.3%)	10 (10.1%)	<0.0001	7 (8.3%)	<0.0001	16 (16.0%)	0.0002	7 (7.3%)	<0.0001
Side effects	22 (26.8%)	81 (81.8%)		70 (83.3%)		59 (59.0%)		80 (83.3%)
Insurance coverage	34 (41.5%)	5 (5.1%)		5 (6.0%)		16 (16.0%)		4 (4.2%)
Financial assistance	5 (6.1%)	0 (0.0%)		0 (0.0%)		5 (5.0%)		2 (2.1%)
Other	6 (7.3%)	3 (3.0%)		2 (2.4%)		4 (4.0%)		3 (3.1%)

Notes: Betaseron^®; Bayer AG, Leverkusen, Germany. Extavia^®; Novartis AG, Basel, Switzerland.

Abbreviations: N, number; IM, intramuscular; IFN, interferon; SC, subcutaneous.