Have Your Say About Disease Modifying Therapies for RRMS

You have just one week from today to have your say about the effectiveness of various disease modifying therapies (DMT) used to treat relapsing remitting multiple sclerosis (RRMS). Public comments are welcome in response to an early draft paper that is planned to be the basis for a future report to evaluate the health and economic outcomes of multiple treatment regimens for relapsing remitting MS.

The Institute of Clinical and Economic Review (ICER) released the early draft, titled “Disease Modifying Therapies for Relapsing Remitting Multiple Sclerosis: Effectiveness and Value, Draft Background and Scope.” If you would like to add your views, now is the time to act.

Comments from the public can be submitted to [email protected], and must be received by 5 p.m. Pacific Time, July 15.

ICER says the draft was developed with input from stakeholders, including relevant multiple sclerosis organizations, clinical experts, and pharmaceutical manufacturers of the disease-modifying drugs included in the study.

There are a number of therapies being included in the study. They are as follows (I put generic names in parentheses):

• Platform agents: interferon beta-1a, peginterferon beta-1a, interferon beta-1b, and glatiramer acetate; particular focus should be given to the comparison of two competing formulations of interferon beta-1a, Rebif and Avonex.
• Oral agents: Gilenya (fingolimod), Aubagio (teriflunomide), and Tecfidera (dimethyl fumarate).
• Other injectable or infused agents:  Tysabri (natalizumab), Lemtrada (alemtuzumab), Rituxan (rituximab),Zinbryta (daclizumab), and Ocrevus (ocrelizumab).

Have your say on controversy

The draft paper says: “The disease modifying therapies therapeutic goal of DMTs is to decrease the frequency of relapses and to prevent the disability that accumulates with disease progression over decades. Some neurologists believe that the goal of treatment should be to eradicate all evidence of disease activity including magnetic resonance imaging (MRI) findings.

“There is controversy about the relative efficacy of the drugs, and several of the newer drugs can cause life-threating adverse events (CNS infections, autoimmune diseases, cardiac toxicity, liver toxicity, cancers). In addition, RRMS is a heterogeneous disease, which complicates comparisons across studies of DMTs.

“There is no definitive clinical guideline to help clinicians with decisions about both initial therapy and choices about subsequent therapies following treatment failures. Patient preference plays a role in the selection of therapy, and the advocacy organizations that ICER received input from indicated that patients have a strong preference for oral medications over injectable ones because of their dislike of needles, injection site reactions, and the difficulty of storing medications that require refrigeration.

“In addition, the advocacy organizations emphasized that some patients have a low tolerance for risk and are less likely to choose DMTs with known, potentially severe side effects. These combined factors demonstrate the considerable uncertainty about the interpretation and application of the current evidence base to guide clinical practice and insurance coverage policy.“

Remember, your comments have to be received in just one week, so don’t delay.

Note: Multiple Sclerosis News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.