PMID- 31903096 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20220412 IS - 1756-2856 (Print) IS - 1756-2864 (Electronic) IS - 1756-2856 (Linking) VI - 12 DP - 2019 TI - Reasons to switch: a noninterventional study evaluating immunotherapy switches in a large German multicentre cohort of patients with relapsing-remitting multiple sclerosis. PG - 1756286419892077 LID - 10.1177/1756286419892077 [doi] LID - 1756286419892077 AB - BACKGROUND: With a large array of disease modifying therapies (DMTs) for relapsing-remitting MS (RRMS), identifying the optimal treatment option for the individual patient is challenging and switching of immunotherapies is often required. The objective of this study was to systematically investigate reasons for DMT switching in patients on immunotherapies for mild/moderate MS, and provide real-life insights into currently applied therapeutic strategies. METHODS: This noninterventional, cross-sectional study (ML29913) at 50 sites in Germany included RRMS patients on therapies for mild/moderate MS who switched immunotherapy in the years 2014-2017. The key outcome variable was the reason to switch, as documented in the medical charts, based on failure of current therapy, cognitive decline, adverse events (AEs), patient wish, or a woman's wish to become pregnant. Expectations of the new DMT and patients' assessment of the decision maker were also recorded. RESULTS: The core analysis population included 595 patients, with a mean age of 41.6 years, of which 69.7% were female. More than 60% of patients had at least one relapse within 12 months prior to the switch. The main reasons to switch DMT were failure of current therapy (53.9%), patient wish (22.4%), and AEs (19.0%). Most patients (54.3%) were switched within DMTs for mild/moderate MS; only 43.5% received a subsequent DMT for active/highly active MS. While clinical and outcome-oriented aspects were the most frequently mentioned expectations of the new DMT for physicians, aspects relating to quality of life played a major role for patients. CONCLUSIONS: Our data indicate suboptimal usage of DMTs, including monoclonal antibodies, for active/highly active MS in German patients. This illustrates the medical need for DMTs combining high efficacy, low safety risk, and low therapy burden. CI - (c) The Author(s), 2019. FAU - Maurer, Mathias AU - Maurer M AD - Klinikum Wurzburg Mitte, Standort Juliusspital, Wurzburg, Germany. FAU - Tiel-Wilck, Klaus AU - Tiel-Wilck K AD - Neurologisches Facharztzentrum Berlin, Berlin, Germany. FAU - Oehm, Eckard AU - Oehm E AD - Group practice for Neurology, Psychiatry and Psychotherapy, Freiburg, Germany. FAU - Richter, Nils AU - Richter N AD - Group practice for Neurology, Dusseldorf, Germany. FAU - Springer, Michael AU - Springer M AD - Neurological practice Dr. Springer, Pirmasens, Germany. FAU - Oschmann, Patrick AU - Oschmann P AD - Klinikum Bayreuth, Bayreuth, Germany. FAU - Manzel, Arndt AU - Manzel A AD - Roche Pharma AG, Grenzach-Wyhlen, Germany. FAU - Hieke-Schulz, Stefanie AU - Hieke-Schulz S AD - Roche Pharma AG, Grenzach-Wyhlen, Germany. FAU - Zingler, Vera AU - Zingler V AD - F. Hoffmann-La Roche Ltd., Basel, Switzerland. FAU - Kandenwein, Julia A AU - Kandenwein JA AD - Roche Pharma AG, Grenzach-Wyhlen, Germany. FAU - Ziemssen, Tjalf AU - Ziemssen T AUID- ORCID: 0000-0001-8799-8202 AD - Universitatsklinikum Carl Gustav Carus, Centre for Clinical Neuroscience, Dresden, Germany. FAU - Linker, Ralf A AU - Linker RA AUID- ORCID: 0000-0002-8740-3106 AD - Neurologische Klinik der Universitat Regensburg, Universitatsstrasse 84, Regensburg, 93053, Germany. LA - eng PT - Journal Article DEP - 20191219 PL - England TA - Ther Adv Neurol Disord JT - Therapeutic advances in neurological disorders JID - 101480242 PMC - PMC6923693 OTO - NOTNLM OT - disease modifying therapies OT - multiple sclerosis OT - real-world data OT - relapsing-remitting multiple sclerosis OT - treatment switch COIS- Conflict of interest statement: All authors received support for their contribution to this study as well as medical writing support for the development of this manuscript from Roche Pharma AG, Grenzach-Wyhlen, Germany. RAL received compensation for activities with Almirall, Bayer, Biogen, Celgene, Genzyme, Merck, Novartis Pharma, Roche and TEVA as well as research support from Biogen, Merck, and Novartis. MM received compensation for activities with Almirall, Bayer, Biogen, Celgene, Genzyme, Merck, Novartis, Roche, and TEVA. EO received honoraria for studies from Abbvie, Allergan, Bayer, Biogen, Genzyme, Merck & Co., Merck Serono, Merz, Novartis, Roche, Sanofi, TEVA, UCB, and Zambon. PO received compensation for activities with Bayer, Biogen, Genzyme, Merck, Novartis, Roche, and TEVA. NR has no additional disclosures. MS received honoraria for lectures, studies and consulting from Merck, Sanofi, Novartis, and Genzyme. KTW received honoraria for lectures, studies, and consultancy from Almirall, Bayer, Biogen, Genzyme, Merck Serono, Novartis, Roche, Sanofi, and TEVA. TZ received reimbursements for participation in scientific advisory boards from Almirall, Bayer Healthcare, Biogen, Celgene, Novartis, Merck Serono, TEVA, Genzyme, and Roche; he also received speaker honoraria from Almirall, Bayer Healthcare, Biogen, Celgene, Genzyme, Novartis, Roche, TEVA, and research support from Bayer Healthcare, BAT, Biogen, Genzyme, Novartis, and TEVA. AM, SHS, JAK are current employees of Roche Pharma AG. VZ is a current employee of F. Hoffmann-La Roche. EDAT- 2020/01/07 06:00 MHDA- 2020/01/07 06:01 PMCR- 2019/12/19 CRDT- 2020/01/07 06:00 PHST- 2019/04/08 00:00 [received] PHST- 2019/10/22 00:00 [accepted] PHST- 2020/01/07 06:00 [entrez] PHST- 2020/01/07 06:00 [pubmed] PHST- 2020/01/07 06:01 [medline] PHST- 2019/12/19 00:00 [pmc-release] AID - 10.1177_1756286419892077 [pii] AID - 10.1177/1756286419892077 [doi] PST - epublish SO - Ther Adv Neurol Disord. 2019 Dec 19;12:1756286419892077. doi: 10.1177/1756286419892077. eCollection 2019.