Assessing long-term prognosis improvement as a consequence of treatment pattern changes in MS

Area of Science:

• Neurology
• Clinical Research
• Epidemiology

Background:

• Multiple sclerosis (MS) is a chronic neurological disease characterized by progressive disability.
• The introduction of novel disease-modifying therapies (DMTs) has altered the treatment landscape for MS.
• Assessing the long-term impact of these therapies on disability progression is crucial for patient management.

Purpose of the Study:

• To determine if the age at which multiple sclerosis patients reach Expanded Disability Status Scale (EDSS) milestones has changed.
• To evaluate the potential impact of new MS drugs on disability progression over time.
• To investigate changes in the age of reaching EDSS milestones in relation to diagnosis periods.

Main Methods:

• Retrospective analysis of data from 1324 MS patients over 30 years.
• Comparison of the age at reaching EDSS=6 between different diagnosis periods.
• Multivariate Cox regression model adjusting for age at diagnosis and interval between EDSS visits.

Main Results:

• Patients diagnosed in more recent periods (post-2000) reached EDSS=6 at a significantly older age.
• A 37% reduction in the rate of reaching EDSS=6 for patients diagnosed in 2001-2005 (HR=0.63, p=0.05).
• A 46% reduction in the rate of reaching EDSS=6 for patients diagnosed in 2006-2010 (HR=0.54, p<0.02).

Conclusions:

• A significant modification in the course of MS has been observed since 2000.
• This modification is potentially linked to evolving treatment patterns and the availability of new MS therapies.
• Therapeutic advancements may contribute to delaying disability progression in multiple sclerosis patients.