Counseling Points Multiple Sclerosis - Winter 2015 - 5

Current NARCOMS data
trends show a greater proportion of patients starting oral
therapies, and in this study
patients on an oral DMT were
somewhat more likely to prefer staying on their current
therapy (81.3%) compared
with those on an infusion
therapy (77.5%) or first-line
injectable (63.6%).3 However,
patients on oral therapies were
also more likely than their
physician to have initiated the
discussion to switch. Interestingly, only 14% of those
surveyed said they had used
information obtained from the
Internet as a basis for initiating the discussion. As shown
in Figure 1, a large proportion of patients switched even
though there was an absence
of relapse activity (1A) or
worsening of MS symptoms in
the prior year (1B).3

Initial Therapy
Selection

Figure 1. Patients Switching Despite Absence of Relapse
Activity (A) or Absence of Symptom Worsening (B)
Reprinted from: Salter AR, Marrie RA, Agashivala N, et al. Patient perspectives on switching
disease-modifying therapies in the NARCOMS registry. Patient Prefer Adherence. 2014;8:971-979.
Creative Commons License 3.0 (http://creativecommons.org/licenses/by-nc/3.0/#)

The goal for therapy in MS
remains to select the best initial treatment based
on the disease presentation, the patient's baseline
characteristics, and other individual factors.4 However, there is no exact formula that presents us
with a clear choice based on patient characteristics
or medical history. With many potential options
available now for each patient, this decision-mak-

ing process has become more complex (Table 2).
Discussing initial therapy with the patient

Presenting a patient who is newly diagnosed with
MS with too many DMT choices is likely to be
confusing or overwhelming. A better way may
be to start with a general overview and then nar5

Winter 2015



Counseling Points Multiple Sclerosis - Winter 2015

Table of Contents for the Digital Edition of Counseling Points Multiple Sclerosis - Winter 2015

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