Assessment of treatment satisfaction across oral DMTs for multiple sclerosis: a preliminary baseline analysis from the STATURE study

Introduction: Medication adherence is crucial to maximise disease modifying therapy (DMT) efficacy. Understanding treatment satisfaction, side-effects and perceived efficacy across different DMT administration schedules is important for clinical decision-making that maximises DMT adherence in people with multiple sclerosis (MS).
Objective: STATURE is a multi-site prospective longitudinal trial to assess the real-world relationship between treatment burden, medication adherence and quality of life in people newly prescribed oral DMTs: cladribine, dimethyl fumarate, fingolimod, teriflunomide and ozanimod, within routine care.
Aim: The current preliminary baseline data analysis aims identify differences in DMT satisfaction at time of initiation.
Methods: Participants include 91 people with MS (80.2% female; age M=43.3, SD=13.9) recruited across 10 Australian healthcare sites between September 2020 and 15 May 2022. Of these, 65 (71.4%) had commenced cladribine, 16 (17.6%), dimethyl fumarate, 6 (6.6%) fingolimod and 4 (4.4%) teriflunomide. The Treatment Satisfaction Questionnaire for Medication (TSQM) was administered at baseline. The TSQM measures four treatment domains: global satisfaction, effectiveness, side-effects and convenience. T-tests were used to identify between DMT differences.
Results: Participants prescribed fingolimod and cladribine reported significantly higher perceived convenience when compared to participants prescribed dimethyl fumarate (mean difference [MD] =22.8, t=2.7, p=.007; MD=11.2, t=2.7, p=.009, respectively). Fingolimod was also significantly higher for perceived convenience when compared to cladribine (MD=11.6, t=2.1, p=.04) and for global satisfaction when compared with teriflunomide (MD=25.0, t=2.7, p=.02). There were no other significant between group differences (all p>.05).
Conclusions: Understanding perceived satisfaction related to DMTs prescribed for people with MS is important. While results of this preliminary analysis require cautious interpretation because of the small sample sizes for fingolimod and teriflunomide, identification of baseline differences in medication satisfaction highlights the need for this current research that assesses the relationship between treatment burden, such as administration schedule and side-effects, with medication adherence and quality of life across oral DMT options for people with MS.