[Paradigm shift in multiple sclerosis patient care at the Center of Neuro-immunology, Semmelweis University - data of...

In the last two decades, the quality of life and life expectancy of multiple sclerosis (MS) patients have improved, related to the growing number and efficacy of disease-modifying drugs (DMD). Due to multifactorial causes, the prevalence of MS has also increased. Our aim was to assess and quantify the changes of patient management in clinical practice in the last 17 years.

Of all out- and inpatients seen at the Department of Neurology, Semmelweis University, we have screened those who have at least once received the diagnostic code of MS (G35 in ICD-10) in calendar years of 2006, 2012, 2016, and 2022. After reviewing their medical documents, we have validated the MS diagnosis and examined the duration of inpatient stays, the number of outpatient consultations and type of DMD.

The yearly number of MS patients seen at the Department has grown from 139 in 2006 to 514 in 2022. The proportion of patients who have received at least one type of DMD in the given year has changed from 21.6% to 76.8% respectively. While in 2006, 54.7% of patients had to be hospitalized at least once in relation with MS, in 2022 only a minority (6%) needed inpatient care, but with a difference between treated and untreated patients (3.8% vs 13.4%). Regarding outpatient consultations, not only its absolute yearly number, but also the yearly number per patient has grown (from 1.7 in 2006 to 5.1 in 2022), especially among treated subjects.

In accordance with international and Hungarian guidelines, the ratio of MS-patients receiving DMD has greatly increased, and - probably not independently of this trend - the need for hospitalization has diminished. Paralelly, the outpatient management load multiplied. These changes should be considered when allocating resources.