OBJECTIVES: Therapeutic approaches differ among the available treatments for anti-acetylcholine receptor antibody-positive (AChR-Ab+) gMG, but there are limited studies on patient treatment preference to help guide shared treatment decisions. This analysis aimed to identify characteristics of patients with gMG that were associated with a higher likelihood of choosing a ravulizumab-like profile over profiles similar to gMG therapies currently available.
METHODS: US adults self-reporting a physician diagnosis of AChR-Ab+ gMG completed a web-based, best–worst scaling (BWS) survey to assess preferences across unlabeled treatment profiles similar to available gMG therapies: ravulizumab, eculizumab, efgartigimod intravenous and subcutaneous, and zilucoplan. Self-reported characteristics of respondents who preferred a ravulizumab-like profile were evaluated via multivariate logistic regression with clinical and sociodemographic characteristics as variables. Estimated coefficients are reported as odds ratios (ORs), indicating the association between patient characteristic covariates and the likelihood of choosing a ravulizumab-like profile.
RESULTS: Of 153 respondents, mean (SD) age was 49 (14.9) years, 77% female, 84% White, 54% with college degree or higher, 41% employed, and 27% had been diagnosed for ≤3 years. Mean (SD) MG-Activities of Daily Living (MG-ADL) total score was 8.0 (3.9) across all respondents. In the BWS survey, respondents rated the ravulizumab-like profile as the most preferred, on average. Patients preferring ravulizumab were primarily female (80%) and <65 years old (83%). Per the multivariate analysis, characteristics significantly associated with a higher likelihood of selecting the ravulizumab-like profile (all P<0.05) were: not living with children (OR 3.2; 95% CI 1.3-7.4), having a gMG diagnosis for <3 years (OR 3.0; 95% CI 1.3-6.8), having insurance other than Medicare (OR 2.9; 95% CI 1.3-6.4), not having anxiety (OR 2.6; 95% CI 1.2-5.5), and lack of experience with regular injections (OR 2.6; 95% CI 1.1-6.0).
CONCLUSIONS: This study provides patient-centered insights, which can assist shared decision-making when selecting gMG therapies.
