Latent Class Analysis (LCA) of Treatment Preferences Among Adults with Anti-aquaporin-4 Antibody-positive (AQP4-Ab+) Neuromyelitis Optica Spectrum Disorder (NMOSD) in the United States
Devon Conway1, Adrian Kielhorn2, Jeffrey Yu2, Sami Fam2, Cannon Kent3, Kelley Myers3, Christine Poulos3, Justin Abbatemarco1
1Mellen Center for Multiple Sclerosis, Cleveland Clinic, 2Alexion, AstraZeneca Rare Disease, 3RTI Health Solutions
Objective:
To examine treatment preference heterogeneity among US adults with AQP4-Ab+ NMOSD by identifying segments of individuals with similar characteristics.
Background:
Prior findings from a survey of respondents with AQP4-Ab+ NMOSD showed that respondents prioritized reducing chance of relapse in the first year of treatment over other treatment attributes.
Design/Methods:
Data from a cross-sectional, web-based survey of US adults with AQP4-Ab+ NMOSD were used in a latent class model to identify patient segments with heterogeneous preferences.
Results:
Among 255 respondents, 3 segments with heterogeneous preferences were identified: relapse reducers (42.3%); benefit-risk balancers (33.8%); convenience seekers (23.9%). Relapse reducers placed greatest importance on reducing chance of relapse (60.0%) but lower importance on avoiding treatments with meningococcal infection risk (4.0%). Benefit-risk balancers prioritized both reducing chance of relapse (34.2%) and avoiding treatments with elevated liver enzyme risk (19.6%) but placed lower weight on administration frequency changes (11.8%). Convenience seekers prioritized treatments with less frequent dosing (18.3%) administered subcutaneously (13.4%). Relapse reducers had higher rituximab use (63.7% vs 42.9%/31.0%), were older (mean: 44.0yrs vs 40.4yrs/38.1yrs), and had the longest diagnosis time (mean: 7.1yrs vs 6.6yrs/5.8yrs) compared with benefit-risk balancers and convenience seekers. Benefit-risk balancers had more relapses in the past 12mo (mean: 10.0 vs 5.5/7.5) and the lowest proportion of respondents who were very/extremely satisfied with their treatment (45.2% vs 61.1%/46.6%) when compared with relapse reducers and convenience seekers. Convenience seekers had the longest travel time to treatment (mean: 56.6min vs 44.4min/41.1min) and the lowest rate of relapse-related hospitalizations (43.1% vs 66.4%/52.4%) compared with relapse reducers and benefit risk balancers.
Conclusions:
In this survey of respondents with AQP4-Ab+ NMOSD, most were relapse reducers (42.3%) or benefit-risk balancers (33.8%) and prioritized reducing chance of relapse; convenience seekers (23.9%) prioritized mode/frequency of administration. These results show differences in treatment preferences among patient subgroups, which can inform patients’ treatment plan development.
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