{ "abstract": "Brisa, a companion app designed for multiple sclerosis (MS) patients, can support the patient journey by collecting longitudinal real-world data. This study aimed to characterize the demographic and clinical profile of Brisa users and longitudinal trends in app engagement, self-reported symptoms and patient-reported outcomes (PROs). This retrospective analysis included Brisa users aged ≥18 years, reported use of category 1 (low), 2 (medium), or 3 (high efficacy) disease-modifying therapy (DMT) according to German DGN guidelines, and had no medication switching. Users diagnosed within 0–1 years were classified as newly diagnosed cases. App engagement was defined as any screen activity; disengagement was defined as >180 consecutive days without engagement and analysed using Cox proportional hazards regression. Symptoms were rated on a 1–5 emoticon-based scale (1 = poor, 5 = excellent). PROs included the MFIS, PDDS, PDQ-5, IVIS, and PES. Among 4,194 users, the majority were female (80.8%), aged 26–35 years (30.5%) and diagnosed with relapsing-remitting MS (77.4%), with 27.9% newly diagnosed. Consistent with a shift towards high-efficacy treatment, use of category 3 (high-efficacy) DMTs among newly diagnosed users significantly increased from 2023 to 2024/2025 (χ2, p < 0.0001). In engagement analyses, users receiving category 3 DMTs, those aged ≥36 years, and newly diagnosed users showed a significantly lower risk of disengagement compared with users on category 1 DMTs, aged 18–25 years or diagnosed ≥2 years prior. Overall, about 76.0% of users tracked at least one symptom or PRO. Longitudinally, among users with ≥1 year of tracking, symptom and PRO scores remained largely stable. A shift toward higher efficacy treatment in newly diagnosed users was observed, while symptom and PRO scores remained largely stable over time. These findings highlight the potential of digital health tools for tracking treatment patterns, patient engagement and self-reported symptom changes in MS. Author summary: Managing multiple sclerosis requires long-term monitoring of symptoms, treatment use, and daily functioning, yet much of this information is not captured between clinical visits. Digital companion applications offer an innovative way to collect real-world, patient-reported data that can complement routine care. In this study, we analysed longitudinal data from more than 4,000 adults in Germany who used Brisa, a digital companion app designed for people living with multiple sclerosis. We sought to understand who uses the app, how patients engage with it over time, which treatments they report, and how their symptoms and self-reported functioning evolve. We observed increasing use of higher-efficacy treatments among newly diagnosed users, reflecting recent changes in clinical practice. At the same time, most users who actively engaged with the app reported stable symptoms and daily functioning over at least one year. Users receiving higher-efficacy treatments and those recently diagnosed were also more likely to remain engaged over time. These findings demonstrate the value of digital health tools for monitoring treatment patterns, patient engagement, and longitudinal outcomes in real-world settings. Digital companion apps like Brisa may help support more personalized, data-informed care and offer scalable opportunities to enhance disease monitoring and clinical decision-making in multiple sclerosis.", "abstract_shown": true, "affiliations": [ "Temedica GmbH, Munich, Germany", "Roche Pharma AG, Grenzach-Wyhlen, Germany", "Department of Neurology, Medical Faculty and University Hospital, Heinrich Heine University Düsseldorf, Düsseldorf, Germany", "Center of Clinical Neuroscience, Department of Neurology, University Clinic Carl Gustav Carus and Dresden University of Technology, Dresden, Germany" ], "article_type": "Research Article", "arxiv": null, "author_total": 7, "authors": [ { "affs": [ 0 ], "name": "Ann-Sophie Stratil" }, { "affs": [ 1 ], "name": "Steffeni Papukchieva" }, { "affs": [ 2 ], "name": "Julia Steinmetz-Späh" }, { "affs": [ 3 ], "name": "Natalie Joschko" }, { "name": "Lars Masanneck" }, { "name": "Benjamin Friedrich" }, { "name": "Tjalf Ziemssen" } ], "bibtex": "https://research.draconitic.com/paper/4gw4jcs99wj8j.bib", "cited_by": 0, "doi": "10.1371/journal.pdig.0001751", "fulltext_url": "https://journals.plos.org/digitalhealth/article?id=10.1371/journal.pdig.0001751", "id": "4gw4jcs99wj8j", "issns": [ "2767-3170" ], "landing_url": "https://journals.plos.org/digitalhealth/article?id=10.1371/journal.pdig.0001751", "language": "eng", "licence": "CC-BY", "licence_label": "CC BY", "licence_source": "article", "licence_url": "https://creativecommons.org/licenses/by/4.0/", "metadata_licence": null, "native_subjects": [ [ "openalex", "2734|Multiple Sclerosis Research Studies" ], [ "plos", "/Biology and life sciences/Biochemistry/Proteins/Interferons" ], [ "plos", "/Biology and life sciences/Immunology/Clinical immunology/Autoimmune diseases/Multiple sclerosis" ], [ "plos", "/Medicine and health sciences/Clinical medicine/Clinical immunology/Autoimmune diseases/Multiple sclerosis" ], [ "plos", "/Medicine and health sciences/Clinical medicine/Signs and symptoms/Pain" ], [ "plos", "/Medicine and health sciences/Health care/Patients" ], [ "plos", "/Medicine and health sciences/Immunology/Clinical immunology/Autoimmune diseases/Multiple sclerosis" ], [ "plos", "/Medicine and health sciences/Medical conditions/Demyelinating disorders/Multiple sclerosis" ], [ "plos", "/Medicine and health sciences/Medical conditions/Neurodegenerative diseases/Multiple sclerosis" ], [ "plos", "/Medicine and health sciences/Neurology/Demyelinating disorders/Multiple sclerosis" ], [ "plos", "/Medicine and health sciences/Neurology/Neurodegenerative diseases/Multiple sclerosis" ], [ "plos", "/Medicine and health sciences/Pharmaceutics/Drug therapy" ], [ "plos", "/People and places/Geographical locations/Europe/European Union/Germany" ], [ "plos", "/People and places/Population groupings/Age groups" ], [ "plos", "/Physical sciences/Materials science/Materials physics/Material fatigue" ], [ "plos", "/Physical sciences/Physics/Classical mechanics/Damage mechanics/Material fatigue" ], [ "plos", "/Physical sciences/Physics/Materials physics/Material fatigue" ] ], "openalex": "W7221693532", "pdf_url": "https://journals.plos.org/digitalhealth/article/file?id=10.1371/journal.pdig.0001751&type=printable", "pmcid": "PMC13660917", "pmid": null, "published": "2026-10-01", "publisher": "Public Library of Science", "ris": "https://research.draconitic.com/paper/4gw4jcs99wj8j.ris", "sources": [ { "first_seen": "2026-10-30T12:17:30Z", "native_id": "10.1371/journal.pdig.0001751", "source": "plos", "url": "https://journals.plos.org/digitalhealth/article?id=10.1371/journal.pdig.0001751" }, { "first_seen": "2026-10-30T12:17:35Z", "native_id": "PMC:PMC13660917", "source": "europepmc", "url": "https://europepmc.org/article/PMC/PMC13660917" } ], "subjects": [ { "field": "biology", "origin": "plos:immunology", "subfield": "immunology" }, { "field": "chemistry", "origin": "plos:materials science", "subfield": "materials-polymers" }, { "field": "medicine", "origin": "plos:neurology", "subfield": "neurology" } ], "title": "A longitudinal analysis of real world symptom tracking and patient-reported outcomes in Brisa, a German Digital Health App for multiple sclerosis", "title_text": "A longitudinal analysis of real world symptom tracking and patient-reported outcomes in Brisa, a German Digital Health App for multiple sclerosis", "type": "peer-reviewed", "updated_at": "2026-10-30T12:17:35Z", "url": "https://research.draconitic.com/paper/4gw4jcs99wj8j", "venue": "PLOS Digital Health", "versions": [] }