Multiple Sclerosis Makes Patients Avoid Risks


People who have multiple sclerosis become less likely to take risks, for both clinical and demographic reasons, a study found.

Some demographic and clinical features of multiple sclerosis (MS) influence tolerance for risk in those who have the disease, according to recent research conducted by Bonnie Glanz, PhD, of the Department of Neurology at Harvard Medical School and colleagues. Her paper is in Multiple Sclerosis Journal -- Experimental, Translational and Clinical on September 2, 2016.

The authors begin by saying, “Since 1993, 13 drugs have been approved by the Food and Drug Administration (FDA) for the treatment of relapsing forms of multiple sclerosis (MS).” Many of those disease modifying therapies (DMTS), though, have side-effects, and some can cause adverse events. “Decisions regarding the selection of a particular DMT are becoming more complicated both for patients and physicians,” say the researchers. The risk tolerance of the patient may influence decisions about treatment plans.

“Risk attitude was measured using two rating scales and a standard gamble scenario,” say the researchers. The first scale was a single-item measure, in which participants were asked to rate their comfort level, and the second was the Risk Propensity Scale (RPS), which is a 7-item self-report measure. They also “used a standard gamble scenario that asked individuals to consider a new MS drug that promised no new relapses or worsening of MS symptoms, but could cause death,” they said, adding, “participants were asked to indicate their likelihood of taking the new drug if the risk of death was 1:2, 1:10, 1:100, 1:1000, 1:10,000, and 1:100,000.”

There were 223 responses to the questionnaire sent out by the researchers. Based on the single-item measure, “the majority of participants (68.8%) were risk neutral, and the mean score was almost exactly equal to the middle of the scale,” say the researchers. The RPS showed “an overall aversion to taking risks,” they say.

The standard gamble scenario results showed that 6% of participants would take the new drug if the risk was 1:2; 16% would if the risk of death was 1:1000; and 41% would if the risk was 1:100,000. “Approximately 45% of participants indicated that they were unlikely/extremely unlikely to take the drug even if the probability of a fatal side effect was 1:100,000,” report the authors.

“In summary, we found that individuals with MS are risk averse and that risk attitudes and risk perceptions are associated with some demographic and clinical features of the disease,” say the researchers. The further suggest that additional studies with larger numbers of participants would be necessary to determine if risk tolerance influences treatment decision making.

Related Coverage:

Clinician and Patient Preferences, Risk Tolerance Guide Relapsing Multiple Sclerosis Treatment Strategies

PML Risk with Natalizumab in Multiple Sclerosis

Multiple Sclerosis Treatment Algorithms

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