Clinicians' Preferences for Sphingosine-1-Phosphate Receptor Modulators in Multiple Sclerosis Based on Clinical...

Area of Science:

• Neurology
• Pharmacology
• Clinical Decision Making

Background:

• Four sphingosine-1-phosphate receptor (S1PR) modulators are available for relapsing multiple sclerosis (MS) in the USA.
• These S1PR modulators demonstrate similar efficacy, necessitating consideration of clinical management factors for treatment selection.

Purpose of the Study:

• To estimate S1PR modulator choice based on clinical management preferences.
• To quantify the impact of individual clinical management aspects on treatment selection.

Main Methods:

• A multi-criteria decision analysis (MCDA) using a discrete choice experiment (DCE) with 200 US neurologists.
• Evaluated eight clinical management attributes including drug-drug interactions, first-dose observations, and immune recovery time.

Main Results:

• Ponesimod received the highest overall MCDA score (4.78), followed by siponimod (4.10), fingolimod (3.61), and ozanimod (2.38).
• Fewer drug-drug interactions, no first-dose observations, shorter immune recovery, and no tyramine food interactions were key preference drivers.

Conclusions:

• Ponesimod is the preferred S1PR modulator for US neurologists treating MS, based on clinical management convenience.
• Minimizing drug-drug interactions is the most significant factor influencing clinician preference in MS treatment selection.