Changing the treatment paradigm in multiple sclerosis: are the attitudes of patients and physicians aligned?

Objective To compare patient and clinician experiences of MS-managment, to identify whether their views on MS-management are aligned and to explore the factors which influence these views. Background Current research show that disability accumulation and health status deterioration occur early in multiple-sclerosis suggesting that early intervention represents the best opportunity to reduce irreversible long-term disability and to decrease personal and societal burden. This study is aimed at shedding light on attitudes to a paradigm shift to early intervention and the factors which affect patient and clinician choice. Methods-Data was collected through online-surveys/interviews. Patients include adults at all levels of disease severity across Europe/USA. They were enrolled through MS-societies/clinics or by personal contacts. A core list of clinicians was developed, supplemented by experts drawn from participants at the European Academy of Neurology 2015 and the MS literature. Results Data collection is underway and full results will be available for presentation at the congress. Ad-interim analysis shows that patients present mixed views on the outcomes of being treated before receiving diagnosis (avoiding unnecessary disability vs. receiving wrong treatment). Early treatment after diagnosis to maintain no-evidence-of-disease-activity is gaining support as appropriate practice. Similar key factors of effectiveness, tolerability and safety drive treatment more than costs, route of administration and convenience for both groups. They all recognise that there is more to disease activity than just relapse/disability progression. Conclusions The findings appear to support changing practice towards earlier diagnosis/treatment. Clinicians should give patients accurate information on efficacy, tolerability and safety aspects of treatments. Patients should be encouraged to discuss the expected benefit and potential risks of treatment, including quality of life, work and other personally important factors. Clinicians should incorporate the patients’ views when deciding treatment. The project was funded by a grant from Roche.Disclosure: Dr. Mossman has nothing to disclose. Dr. Kanavos has nothing to disclose. Dr. Tinelli has nothing to disclose.