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Neurology(R) Neuroimmunology & Neuroinflammation
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Disease-modifying drugs (DMDs) for multiple sclerosis (MS) are linked to better survival. Early DMD initiation showed a significant survival benefit, though this advantage lessened over time.

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Area of Science:

  • Neurology
  • Immunology
  • Public Health

Background:

  • Multiple sclerosis (MS) is a chronic neurological disease.
  • Disease-modifying drugs (DMDs) are crucial for managing MS.
  • Understanding the long-term impact of DMDs on survival is essential.

Purpose of the Study:

  • To investigate the association between disease-modifying drugs (DMDs) and survival in a large, population-based cohort of multiple sclerosis (MS) patients.
  • To compare the effects of first-generation and second-generation DMDs on all-cause mortality.
  • To explore the impact of the timing of DMD initiation on patient survival.

Main Methods:

  • Utilized administrative health databases from four Canadian provinces.
  • Identified and followed 35,894 individuals with MS from an index date until December 31, 2017.
  • Employed stratified Cox proportional hazard models to analyze the association between DMD exposure and mortality, considering early, early, and late initiation.

Main Results:

  • Exposure to any DMD or first-generation DMD was associated with a 26% lower hazard of mortality (aHR 0.74).
  • Second-generation DMD exposure showed a 33% lower hazard of mortality (aHR 0.67).
  • Earlier DMD initiation demonstrated a significant survival benefit, but this effect diminished over 15 years.

Conclusions:

  • Disease-modifying drugs (DMDs) are associated with improved survival in multiple sclerosis (MS) patients in a real-world setting.
  • Early initiation of DMDs appears to confer a survival advantage.
  • Further research may be needed to understand the long-term survival dynamics with different DMDs.