REPORT FROM THE 63rd ANNUAL MEETING OF THE AMERICAN ACADEMY OF NEUROLOGY (AAN), HONOLULU, HAWAII, APRIL 9-16, 2011 - MS patients are inclined to accept new therapies regardless of the potential risks, according to a survey conducted by Wayne State University in the period 2007-2009 (Caon et al AAN 2011; abstract P01.208). A series of standardized questions were posed to 200 MS patients during a clinic visit. Patients were asked if they would consider switching to a new therapy. Treatment options were therapies with mild risk and vigilance; significant risk and vigilance; an oral therapy with mild risk and vigilance; and an oral therapy with significant risk and vigilance. Respondents were categorized as disease duration and disease-modifying treatment (DMT) duration of less than 5 years or more than 5 years.
 
In patients with disease duration/DMT use less than 5 years, 78% said they would switch to a new therapy with mild risk/vigilance, but only 28% would switch if there was significant risk/vigilance. A total of 92% would switch to an oral therapy with mild risk/vigilance, and 31% would switch to an oral therapy with significant risk/vigilance.
 
A majority of patients with disease duration/DMT use of more than 5 years were willing to accept any degree of risk:  84% said they would switch to a new therapy with mild risk/vigilance, and 63% would switch even if there was significant risk/vigilance. A total of 97% would switch to an oral therapy with mild risk/vigilance, and 59% would switch to an oral therapy with significant risk/vigilance.
 
However, a separate study questions whether treatment-related risks are understood by MS patients (Fox et al. AAN 2011; abstract P03.235). A total of 5,446 patients (mean age 52.7 years) in the NARCOMS registry completed a survey that used Standard gamble paradigms to evaluate risk tolerance. Two scenarios were presented: risk tolerance to cure MS, and risk tolerance to preventing a 1-step progression of disability on the Patient-defined Disease Steps scale. The goal was to determine if risk tolerances were rational. An illogical response was defined as risk tolerance for a cure < risk tolerance for preventing a 1-step progression in disability.
 
One-third (34%) of risk tolerances were determined to be illogical according to the definition used, suggesting that some MS patients do not understand the risks of serious complications and require more explanation of the benefits and risks of treatment. 
 
Guest Reviewer:  Dr. Michael Yeung, Multiple Sclerosis Clinic, Foothills Hospital, Calgary, Alberta

http://neuro-sens.com/congress-news/3-general/209269