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MS Treatment Trends Shifting to Orals

Today, MS patients have many options when it comes to medications
used to slow the progression of their disease – but this was not always the case. In fact, the first medications (the interferons) designed
specifically to treat MS were not introduced until 1993. Then, in the next few years, more self-injectable medications were introduced. The market became flooded with self-injectables to be used at home,
intravenous medications to be administered at an infusion center, and oral medications to be taken independently over the next few decades.

New Medications Introduced

New medication introductions with different action mechanisms and administration routes have been based on the need to improve MS treatment effectiveness while reducing side effects (some deadly). They also make it easier to administer these medications to improve compliance.
Like fashion trends, there are obvious trends in the groups of medications. In fact, there has been a significant shift to disease-modifying therapies (DMT) in the 2000s. Currently, oral medications are
the most commonly used.

Initiation Patterns in MS Patients

JAMA Neurology published a recent study on the initiation patterns in approximately 150,000 adults diagnosed with MS. Injectable DMTs were the most common in the first decade but their use reduced after 2010 when oral agents came onto the market, leading to a close to 75% decline of injectable uses by 2001. Since 2020, oral treatments have been the most initiated therapies. Infusion therapy initiations have been far less popular, dropping to an overall 5%. The authors of the study attribute the increasing use of oral agents to insurance dictation, advertising directed at consumers, and, last but not least, ease of use.

Interestingly, the authors did not attribute efficacy to the overall change in therapy. What is not clear from this discussion is how efficacy has affected this trend. There is no question that therapies have become increasingly more effective over the years. Additionally, many patients are switched from one therapy to another based on the need for better disease control. As all the newer therapies have
become increasingly effective, and the number of relapses and disabilities have been reduced, convenience and cost likely have become a larger part of the conversation.

It is of vital importance that patients and their physicians be able to track the course of their disease. As flares become less frequent, progression may take on the form of an insidious slide. This can be harder to appreciate even by the patient. The result is a switch to a different medication and potentially altering the trajectory of future disability.

       BeCare MS Link    

The BeCare MS Link App can objectively track neurologic function and identify a decline earlier
then patients and their physicians. 


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