Oral Versus Injection Therapy for Patients With RRMS


An expert in neurology provides insight into the considerations of oral versus injectable therapies in patients with multiple sclerosis, highlighting their impact on quality of life, brain volume, and cognitive health.

Heidi Crayton, MD: We have a lot of data with our newer products and our not-quite-as-new products. In terms of efficacy with patients that started off on an injectable-platform therapy and then switched to an oral therapy, our oral therapy, for the most part, have shown to be more effective and beneficial in terms of outcome. Patients do very well, and the added benefit of not having to self-inject brings a lot of psychological benefit to people. When the first oral therapy came to market in 2010, it was a breath of fresh air for people, because for the first time, they felt normal. They felt like they could be like everybody else and just take a pill. When somebody must do an injection multiple times a week, it's very difficult to think of yourself as a well person. With the oral therapies, we've seen quality-of-life data that shows that there's been a positive impact on patients living with MS [multiple sclerosis]; their quality-of-life metrics are far better than they were when they were using self-injected products.

One thing that's come about with oral therapies—and the data that has accompanied those oral therapies—is benefit in terms of quality-of-life measures as well as brain preservation. Brain preservation is a newer concept that we're talking about, although it's something that's been around for a long time, and who doesn't want to preserve brain tissue? We're paying a lot more attention to the data as it stacks up in terms of staving off brain volume loss and brain atrophy because we know that correlates with cognitive dysfunction, which is a more important player in terms of disability than loss of walking ability. We can accommodate for people who don't walk well, but if you can't use your brain well, you lose a lot. You lose jobs, family connections, and that becomes a lot more of a disabling symptom from MS. We are paying a lot closer attention to that in our patients and what they have to say. We're following that in terms of having that measured by neuropsychological testing, we're looking and paying closer attention to areas of brain atrophy on the MRI scans, and starting to utilize the data that we have from those oral therapies to make a more appropriate choice for a patient that is showing signs of cognitive dysfunction or brain atrophy.

Transcript Edited for Clarity

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