{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T12:06:45Z","timestamp":1789387605844,"version":"build-2803163510"},"reference-count":34,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Multiple Sclerosis Journal \u2013 Experimental, Translational and Clinical"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Disease-modifying therapies (DMTs) for multiple sclerosis (MS) can be either high- or low-intensity. This study aims to examine predictors associated with high-intensity MS treatment strategies using commercial claims data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We used Merative MarketScan commercial and Medicare supplemental databases to examine patients with: outpatient MS diagnosis (ICD-9\/-10: 340.xx, G35.xx); DMT fill; no DMTs 1 year prior to MS diagnosis through DMT fill; and 6 months continuous database enrollment. The first DMT filled was classified as either high- (natalizumab, alemtuzumab, ocrelizumab, rituximab, ofatumumab, cladribine) or low-intensity (interferon, glatiramer acetate, teriflunomide, dimethyl fumarate, diroximel fumarate, fingolimod, ponesimod, siponimod, ozanimod). We used logistic regression to examine factors associated with high-intensity first-line MS treatments, and multilevel modelling to characterize provider-level variance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 16,405 patients met the study criteria, and they were 48 years old on average (SD\u2009=\u200912), and 75% female. High-intensity first-line DMT was used in 3%, increasing from &lt;1% in 2012 to 13% in 2021. Provider type was most commonly neurologist (49%) or MS specialist (36%). Provider-level effect accounted for 17% of variance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>The minority of MS patients initiated high-intensity treatment although this proportion increased over time, and later years were predictive of high-intensity treatment. Providers had a significant role in the approach selected.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/20552173261487868","type":"journal-article","created":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T14:26:29Z","timestamp":1789136789000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Predictors of high- versus low-intensity first-line multiple sclerosis treatments"],"prefix":"10.1177","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1380-4839","authenticated-orcid":false,"given":"Amanda V. 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