Disease-Modifying Drug Uptake and Health Service Use in the Ageing MS Population

Area of Science:

• Neurology
• Pharmacology
• Public Health

Background:

• Limited evidence exists on disease-modifying drug (DMD) efficacy in older adults with multiple sclerosis (MS).
• This gap hinders evidence-based treatment recommendations for the aging MS population.
• The study investigates age-related differences in DMD effectiveness and healthcare utilization in MS patients.

Purpose of the Study:

• To examine the relationship between age (categorized as <55 and ≥55 years), exposure to disease-modifying drugs (DMDs), and health service utilization in individuals with multiple sclerosis (MS).
• To assess whether DMDs provide similar benefits in reducing hospitalizations and physician visits across different age groups within the MS population.

Main Methods:

• A population-based observational study utilizing linked administrative health data from British Columbia, Canada.
• Inclusion of 19,360 individuals with MS, followed from their index date until December 31, 2017.
• Assessment of DMD exposure (any vs. none, by generation, and individual drugs) and analysis of hospitalizations and physician visits using proportional means models and negative binomial regression.

Main Results:

• DMD exposure was associated with a 23% lower hazard of hospitalization in individuals <55 years old (aHR 0.77), but not in those ≥55 years old (aHR 0.95).
• These patterns held true for both first and second-generation DMDs.
• DMD exposure was not significantly associated with physician visit rates in either age group, though variations were noted across individual DMDs.

Conclusions:

• Disease-modifying drugs (DMDs) demonstrate beneficial effects on hospitalizations for multiple sclerosis (MS) patients younger than 55.
• For individuals aged 55 and older, DMD exposure did not significantly lower hospitalization risk.
• The findings contribute to understanding the age-specific benefits and risks of DMDs in the aging MS population.