Subcutaneous natalizumab administration in relapsing-remitting multiple sclerosis: results of EASIER 2 study

EASIER 2 is a multicenter, observational, cross-sectional study conducted in 14 Italian multiple sclerosis (MS) centers to evaluate patient and healthcare professional (HCP) time, healthcare resource consumption, costs, and patient quality of life (QoL) associated with subcutaneous (SC) administration of natalizumab compared to intravenous (IV) administration as measured in the earlier EASIER study.

The study included: (1) time-and-motion analysis using a mobile application to collect real-world data during SC administration; (2) structured HCP questionnaire assessing organizational impacts; (3) patient survey capturing experience, preferences, and QoL. The comparison between SC and IV was conducted using a random-intercept regression model adjusted for patient history.

A total of 265 SC procedures were analyzed. Compared to IV administration, SC reduced patient center time by 77%, HCP active time by 35%, and chair time by 74%. Hospital costs per administration decreased by 60%, with a reduction of about 33 and 14% from the perspectives of the Society and patient, respectively. Among patients, 86% preferred SC administration, mainly due to shorter center time, less physical discomfort, and lower emotional burden. QoL scores (scale 0-100) were higher on SC days (mean 70.4) than IV days (mean 56.9) administration, corresponding to a 13-point improvement (p < 0.001). All HCPs reported a favorable opinion on SC administration, with 82% expecting simplifications in MS center organization and shorter patient waiting lists.

SC natalizumab administration significantly reduces dispensation procedure times, healthcare resource consumption, and associated costs, while improving patient experience and QoL.