Case scenario, questions and answers | Overall (n = 205) | Sub-group by number of MS patients under care | P value | |||
---|---|---|---|---|---|---|
Group 1: 1–3 patients (n = 69) | Group 2: 4–9 patients (n = 58) | Group 3: ≥10 patients (n = 78) | Group comparison* | Trend test† | ||
Question 1: Assuming a patient is currently receiving treatment, what is the minimum number of clinical relapses over 6 months or 12 months that would prompt you to suggest a change in DMD‡? | ||||||
Number of relapses over 6 months, n (%) | ||||||
1 clinical relapse | 120 (58.5) | 38 (55.1) | 34 (58.6) | 48 (61.5) | 0.799a 0.288b 0.684c | 0.238 |
2 clinical relapses | 78 (38.0) | 27 (39.1) | 22 (37.9) | 29 (37.2) | ||
3 clinical relapses | 7 (3.4) | 4 (5.8) | 2 (3.4) | 1 (1.3) | ||
≥ 4 clinical relapses | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | ||
Number of relapses over 12 months, n (%) | ||||||
1 clinical relapse | 56 (27.3) | 13 (18.8) | 21 (36.2) | 22 (28.2) | 0.175a 0.454b 0.731c | 0.308 |
2 clinical relapses | 102 (49.8) | 39 (56.5) | 25 (43.1) | 38 (48.7) | ||
3 clinical relapses | 36 (17.6) | 12 (17.4) | 9 (15.5) | 15 (19.2) | ||
≥ 4 clinical relapses | 11 (5.4) | 5 (7.2) | 3 (5.2) | 3 (3.8) | ||
Case 1: Assuming a patient with clinically stable RRMS has been receiving the same treatment for 2 years, and no changes in MRI were seen on scans after 1 year of therapy, but activity was seen on a routine MRI performed after 2 years of treatment. | ||||||
Question 2: What is the lowest number of new T2 or Gd + lesions that would prompt you to suggest a change in DMD‡? | ||||||
Number of T2 lesions, n (%) | ||||||
1 T2 lesion | 30 (14.6) | 7 (11.9) | 14 (28.0) | 9 (13.2) | 0.006a 0.985b 0.010c | 0.987 |
2 T2 lesions | 67 (32.7) | 27 (45.8) | 10 (20.0) | 30 (44.1) | ||
3–4 T2 lesions | 68 (33.2) | 23 (39.0) | 19 (38.0) | 26 (38.2) | ||
≥ 5 T2 lesions | 12 (5.9) | 2 (3.4) | 7 (14.0) | 3 (4.4) | ||
Number of Gd + lesion, n (%) | ||||||
1 Gd + lesion | 97 (47.3) | 29 (45.3) | 30 (58.8) | 38 (52.8) | 0.318a 0.471b 0.376c | 0.267 |
2 Gd + lesions | 71 (34.6) | 27 (42.2) | 15 (29.4) | 29 (40.3) | ||
≥ 3 Gd + lesions | 19 (9.3) | 8 (12.5) | 6 (11.8) | 5 (6.9) | ||
Case 2: Assuming a patient with clinically stable RRMS has been receiving the same treatment for 2 years, and no changes in MRI were seen on scans at 1 and 2 years. | ||||||
Question 3: What is the lowest number of new T2 or Gd + lesions on a subsequent routine MRI that would prompt you to suggest a change in DMD‡? | ||||||
Number of T2 lesions, n (%) | ||||||
1 T2 lesion | 23 (11.2) | 5 (8.6) | 11 (22.4) | 7 (10.0) | 0.118a 0.841b 0.205c | 0.888 |
2 T2 lesions | 69 (33.7) | 25 (43.1) | 14 (28.6) | 30 (42.9) | ||
3–4 T2 lesions | 64 (31.2) | 23 (39.7) | 17 (34.7) | 24 (34.3) | ||
≥ 5 T2 lesions | 21 (10.2) | 5 (8.6) | 7 (14.3) | 9 (12.9) | ||
Number of Gd + lesion, n (%) | ||||||
1 Gd + lesion | 95 (46.3) | 27 (42.9) | 29 (56.9) | 39 (54.2) | 0.224a 0.180b 0.927c | 0.082 |
2 Gd + lesions | 63 (30.7) | 22 (34.9) | 16 (31.4) | 25 (34.7) | ||
≥ 3 Gd + lesions | 28 (13.7) | 14 (22.2) | 6 (11.8) | 8 (11.1) |