Selection of first-line therapy in multiple sclerosis using risk-benefit decision analysis.

ABSTRACT:

Objective

To integrate long-term measures of disease-modifying drug efficacy and risk to guide selection of first-line treatment of multiple sclerosis.

Methods

We created a Markov decision model to evaluate disability worsening and progressive multifocal leukoencephalopathy (PML) risk in patients receiving natalizumab (NTZ), fingolimod (FGL), or glatiramer acetate (GA) over 30 years. Leveraging publicly available data, we integrated treatment utility, disability worsening, and risk of PML into quality-adjusted life-years (QALYs). We performed sensitivity analyses varying PML risk, mortality and morbidity, and relative risk of disease worsening across clinically relevant ranges.

Results

Over the entire reported range of NTZ-associated PML risk, NTZ as first-line therap

SUBMITTER: Bargiela D 

PROVIDER: S-EPMC5317380 | biostudies-literature | 2017 Feb

REPOSITORIES: biostudies-literature