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Socioeconomic impact of initial high vs. moderate efficacy disease-modifying therapy in multiple sclerosis: Effects
Rolf Pringler Holm1, Elisabeth Framke1, Luigi Pontieri1
1Danish Multiple Sclerosis Registry, Department of Neurology, Copenhagen University Hospital - Rigshospitalet, 2600 Glostrup, Denmark.
Background:
The clinical effects of disease-modifying therapies (DMTs) on relapsing-remitting multiple sclerosis (RRMS) are well understood. However, evidence of DMTs' impact on socioeconomic outcomes, such as working capacity, is limited.
Objectives:
We hypothesised that patients initiating high-efficacy (he)DMTs as their first DMT have a lower risk of disability pension and a lower risk of employment in a protected employment scheme than patients initiating moderate-efficacy (me)DMTs as their first DMT.
Methods:
We performed a nationwide registry-based, propensity score-matched cohort study including 1064 patients (532 pairs) newly diagnosed with RRMS who initiated heDMT or meDMT, and we followed the development in their labour market affiliation. For analyses, we used Cox proportional hazards models.
Results:
The two groups were comparable at baseline. Initiating heDMT was associated with a hazard ratio (HR) of 0.9 (95 % confidence interval (CI) 0.6-1.3) for disability pensions and an HR of 0.6 (95 % CI: 0.4-0.9) for becoming employed in a protected employment scheme compared with initiating meDMT.
Conclusion:
Initiating heDMT as the first DMT was associated with a lower risk of becoming employed in a protected employment scheme. The two DMT groups did not differ in their risk of receiving disability pensions.
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