Disease-modifying therapy usage in patients with multiple sclerosis in France: A 6-year population-based study

Area of Science:

• Neurology
• Public Health
• Pharmacovigilance

Background:

• Limited data on disease-modifying therapy (DMT) use in multiple sclerosis (MS) often stems from biased clinical series.
• French national health administrative data offers comprehensive MS population coverage and DMT prescription information.

Purpose of the Study:

• To characterize DMT usage patterns across the entire French MS patient population between 2010 and 2015.
• To analyze longitudinal therapeutic sequences and classify patients based on treatment patterns.

Main Methods:

• Utilized French national health data system (covering 97% of the population) to identify MS patients over six years.
• Employed state sequence analysis to longitudinally track patients initiating DMTs in 2010 and categorize them into distinct therapeutic pattern groups.
• Compared characteristics of treated versus untreated patients and analyzed healthcare service utilization.

Main Results:

• Identified 112,415 MS patients; 54.0% received at least one DMT. Treatment probability decreased with age.
• Four patient clusters emerged from state sequence analysis: primarily first-line DMT users (57.0%), second-line DMT users (13.1%), off-label users (7.3%), and minimally treated (22.6%).
• Treatment group classification correlated with age, disease duration, pregnancy, disability, care utilization, and mortality.

Conclusions:

• Exhaustive French national health data enabled a detailed, national-level description of MS DMT use.
• State sequence analysis successfully identified four homogeneous patient groups based on longitudinal treatment data.
• First-line treatments remain predominant, though specific agents may have evolved post-2015.