Risk tolerance to MS therapies: Survey results from the NARCOMS registry

• Published in: Multiple sclerosis and related disorders Vol. 4; no. 3; pp. 241 - 249
• Main Authors: Fox, Robert J, Salter, Amber, Alster, Joan M, Dawson, Neal V, Kattan, Michael W, Miller, Deborah, Ramesh, Sneha, Tyry, Tuula, Wells, Brian W, Cutter, Gary
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.05.2015
• Subjects: Decision Making; Disease modifying therapy; Female; Health Knowledge, Attitudes, Practice; Humans; Immunologic Factors - therapeutic use; Information seeking behavior; Male; Middle Aged; Multiple sclerosis; Multiple Sclerosis - psychology; Multiple Sclerosis - therapy; NARCOMS registry; Natalizumab - therapeutic use; Neurology; Registries; Risk; Risk tolerance; Surveys and Questionnaires; NAT; RT; Risk Tolerance; disease modifying therapy; NARCOMS; Decision making; MS; multiple sclerosis; PDDS; curing MS scenario; DMT; Information seeking behavior; PML; Institutional Review Board; CureMS; patient determined disease steps; natalizumab scenario; SG; progressive multifocal leukoencephalopathy; IRB; standard gamble; North American Research Committee on Multiple Sclerosis; NARCOMS registry; Multiple sclerosis; Disease modifying therapy; Risk tolerance
• ISSN: 2211-0348; 2211-0356
• DOI: 10.1016/j.msard.2015.03.003

Abstract Background There is little information about risk acceptance of multiple sclerosis (MS) patients to various MS therapies. Objective To determine MS patients׳ tolerance to risky therapies and identify associated characteristics. Methods MS patients from the North American Research Committee on Multiple Sclerosis (NARCOMS) Registry׳s online cohort were invited to complete questionnaires on decision making and risk tolerance (RT) to two therapeutic scenarios: a theoretical cure for MS [CureMS], with permanent reversal of all MS symptoms but a risk of immediate painless death; and natalizumab [NAT], a real-life scenario with benefits and risks as defined by Phase III trial results. Results The median RT for both scenarios was 1:10,000; 15–23% of respondents were not willing to take any risk for their MS therapy. Participants with greater disability or not taking any MS therapy showed a greater RT, while females and those caring for dependents had a lower RT. Females and older age were predictors of lower RT, while increasing disability and greater blunting attitude with respect to information seeking behavior were predictors of higher RT. Conclusion MS patients displayed a wide range of RT for MS therapies. Our study identified gender, age, disability and information seeking behavior to be associated with RT.