Treatment satisfaction in patients with relapsing-remitting multiple sclerosis initiated on teriflunomide in routine clinical practice: Australian observational data

Todd A Hardy; John Parratt; Heidi Beadnall; Stefan Blum; Richard Macdonell; Roy G Beran; Neil Shuey; Andrew Lee; William Carroll; Cameron Shaw; Richard Worrell; Jana Moody; Mamdouh Sedhom; Michael Barnett; Steve Vucic

doi:10.1136/bmjno-2022-000315

Treatment satisfaction in patients with relapsing-remitting multiple sclerosis initiated on teriflunomide in routine clinical practice: Australian observational data

BMJ Neurol Open. 2022 Jul 4;4(2):e000315. doi: 10.1136/bmjno-2022-000315. eCollection 2022.

Authors

Todd A Hardy^{1

2}, John Parratt³, Heidi Beadnall², Stefan Blum⁴, Richard Macdonell⁵, Roy G Beran^{6

7}, Neil Shuey⁸, Andrew Lee^{9

10}, William Carroll¹¹, Cameron Shaw¹², Richard Worrell¹³, Jana Moody¹³, Mamdouh Sedhom¹³, Michael Barnett², Steve Vucic^{14

15}

Affiliations

¹ Department of Neurology, Concord Repatriation General Hospital, Concord, New South Wales, Australia.
² Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia.
³ Department of Neurology, Royal North Shore Hospital, St Leonards, New South Wales, Australia.
⁴ Department of Neurology, Princess Alexandra Hospital Health Service District, Woolloongabba, Queensland, Australia.
⁵ Department of Neurology, Austin Health, Heidelberg, Victoria, Australia.
⁶ Department of Medicine, South Western Sydney Clinical School, University of New South Wales, Sydney, New South Wales, Australia.
⁷ Department of Legal Medicine, Griffith University Faculty of Health, Gold Coast, Queensland, Australia.
⁸ Department of Neurology, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia.
⁹ College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia.
¹⁰ Department of Neurology, Calvary Adelaide Hospital, Adelaide, South Australia, Australia.
¹¹ Perron Institute for Neurological and Translational Research, Nedlands, Western Australia, Australia.
¹² Geelong Clinical School, Deakin University, Geelong, Victoria, Australia.
¹³ Sanofi Australia, Macquarie Park, New South Wales, Australia.
¹⁴ Brain and Nerve Research Centre, Concord Clinical School, Concord, New South Wales, Australia.
¹⁵ Faculty of Medicine, The University of Sydney, Sydney, New South Wales, Australia.

Abstract

Background: Adherence and persistence are critical to optimising therapeutic benefit from disease-modifying therapies (DMTs) in relapsing-remitting multiple sclerosis (RRMS). This prospective, open-label, multicentre, observational study (AubPRO), conducted in 13 hospital-based neurology clinics around Australia, describes treatment satisfaction in patients newly initiated on teriflunomide (Aubagio) and evaluates the use of an electronic patient-reported outcome (PRO) tool.

Methods: Patients (≥18 years) newly initiated on teriflunomide (14 mg/day) were followed up at 24 and 48 weeks. Patients completed questionnaires and pill counts electronically using MObile Data in Multiple Sclerosis. The primary endpoint was treatment satisfaction, measured by the Treatment Satisfaction Questionnaire for Medication (TSQM, V.1.4), at week 48. Secondary endpoints included treatment satisfaction at week 24, other PRO scales, clinical outcomes, medication adherence and safety.

Results: Patients (n=103; 54 (52.4%) treatment naive) were mostly female (n=82 (79.6%)), aged 49.5 (11.8) years, with MS duration since symptom onset of 9.1 (11.8) years and a median Expanded Disability Status Scale score of 1.0. Mean treatment satisfaction scores were high (≥60%) across all domains of the TSQM V.1.4 at week 24 and at week 48. Compared with week 24, week 48 treatment satisfaction increased for patients who were treatment naïve and for those previously on another oral or injectable DMT. Over 48 weeks, PROs remained stable across a range of measures including disability, physical health, emotional health and mobility, and there were improvements in work capacity and daily life activity. Adherence was high throughout the study with mean compliance (pill counts) of 93.2%±6.26%, and 98 of 103 (95.1%) patients remained relapse-free.

Conclusion: This cohort of Australian patients with RRMS, newly initiated on teriflunomide, and treated in a real-world clinical practice setting, reported high treatment satisfaction and adherence at 24 and 48 weeks. Patient-reported measures of disability remained stably low, work capacity and daily life activity improved, and most patients remained relapse-free.

Keywords: MEDICINE; MULTIPLE SCLEROSIS; ORAL MEDICINE; QUALITY OF LIFE.