The newest kids on the MS block, disease-modifying therapies (DMT) such as Genentech’s Ocrevus (ocrelizumab) and Sanofi Genzyme’s Lemtrada (alemtuzumab), are attracting a lot of interest these days. But, some DMTs that have been around for more than two decades are still being prescribed by a lot of neurologists.
A new report on what’s being prescribed was released by the research firm Spherix Global Insights. It shows that the interferon class of DMTs is still hanging in there. Though their use has declined significantly compared to a year ago, interferon therapies such as EMD Serono’s Rebif, Bayer’s Betaseron, Biogen’s Avonex and Plegridy, and Novartis’ Extavia remain the current therapy for more than 25 percent of MS patients being treated with a DMT. Spherix expects the interferons to maintain their current share of MS patients through the end of 2018.
Rebif is the leader of the interferons
The Spherix report says that almost two-thirds of neurologists who were surveyed preferred one of the “high dose, high frequency interferons.” Rebif garnered the highest percentage of those doctors at 40 percent, followed by Betaseron with 23 percent. The neuros who prescribed Rebif said they did so because it’s effective, easy to use, and has been on the market a long time. It was also the only DMT for which some of the doctors volunteered other positive information, noting that its clinical trials were strong, its support by manufacturer EMD Serono is good, and it was usually covered by a patient’s insurance.
Interferons not the top choice for new MS patients
When I was diagnosed in 1980, no DMTs existed. Betaseron and Avonex came along in the mid-1990s and were the “magic bullet” at the time. Not so anymore.
In this survey, only 14 percent of the neurologists said they would prescribe an interferon for a young patient newly diagnosed with MS. The largest number of doctors, 41 percent, preferred one of the three oral DMTs: Aubagio, Gilenya, or Tecfedera. But almost as many, 37 percent, like glatiramer acetate, which is the generic for Teva’s Copaxone. Only 8 percent were ordering the monoclonal antibody DMTs Tysabri, Ocrevus, or Lemtrada for their patients.
Neurologists and their patients in the U.S. now have 16 DMTs from which to choose, balancing efficacy, side-effects, and cost. No doubt, we’ll see more shifts in what’s being prescribed down the road.
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