EXTON, Penn.–(EON: Enhanced Online News)–Biogen Idec’s Avonex and Bayer’s Betaferon capture the greatest share of first-line prescribing of disease-modifying agents (DMAs) for the treatment of multiple sclerosis (MS) according to patient-level data provided by EU5 neurologists. when switching occurs, patients started on the most common first-line DMAs are likely to be switched to either Teva’s Copaxone or Biogen Idec’s Tysabri for their second-line DMA. Patient audit data show that relapse rate and disability progression reduction are the primary drivers of current DMA choice. however, a comparison of self-reported perceptions and audit data suggests that tolerability profile and route of administration may be more important in the choice of DMA brand than neurologists realize. overall, EU5 neurologists are highly satisfied with the clinical response achieved by just over one-half of their DMA-treated patients, although neurologists tend to be more satisfied with the clinical response achieved by patients currently treated with Avonex or Tysabri compared to those treated with Betaferon.
while the majority of EU5 neurologists agree that the availability of the anti-JC virus antibody assay would increase their prescribing of Tysabri, as of the time of study fielding, only 8% of DMA-treated audit patients had been tested with the assay. Patients currently treated with Tysabri represent 48% of assay-tested patients, although neurologists in the UK report testing significantly more of their patients prior to initiating any DMA therapy compared to neurologists in other EU5 countries.
the recently released ChartTrends®: Multiple Sclerosis in the EU report finds that 74% of DMA-treated audit patients currently experience at least some MS-related symptoms. while abnormal sensory perceptions, fatigue, and ataxia are the most common MS-related symptoms, depression / apathy, pain syndromes, spasticity, and bladder / bowel dysfunction are the symptoms most frequently managed using chronic pharmacotherapy. Almirall / Bayer’s Sativex, a symptomatic management agent recently approved for spasticity in the EU and commercially available in the UK and Spain at the time of fielding, has been prescribed to 7% of DMA-treated audit patients in the UK and Spain.
when asked to hypothetically switch audit patients to one of the DMAs in late stage clinical development, 44% of EU5 neurologists identify the greatest opportunity for Novartis’ Gilenya followed by Biogen Idec’s PEG-Avonex and Teva’s laquinimod. among audit patients identified as potential Gilenya candidates, the greatest percentage are currently prescribed Tysabri indicating that these two products may compete directly. a number of patient characteristics appear to help identify the types of patients who are perceived by neurologists as more likely to be switched to either Gilenya or one of the other DMAs in development.
ChartTrends®: Multiple Sclerosis is a syndicated annual patient audit designed to compare what physicians report about disease management to what actually occurs at the patient level. the 2011 audit captures information from 1068 patient charts provided by 228 neurologists from France, Germany, Spain, Italy, and the UK in April and may 2011. all patients are on a DMA at the time of the audit with all commercially-available DMA brands (Avonex, Betaferon, Copaxone, Extavia, Rebif, Tysabri) represented. a parallel report covering the U.S. market, which includes Novartis’ Gilenya, is also available. through an in-depth review of specific patient charts, details such as product initiation, switching, exacerbation management, and a host of test and patient demographic variables help define patient types and identify therapy triggers. Patient profiles for the seven DMAs in late clinical development (alemtuzumab, BG-12, teriflunomide, laquinimod, PEG-Avonex, daclizumab, ocrelizumab) are also characterized.
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