Abstract
BackgroundEarly initiation of disease-modifying treatment (DMT) is associated with better disability outcomes in multiple sclerosis (MS). However, little is known of how treatment decisions affect socio-economic outcomes.ObjectiveTo estimate the long-term impact of early initiation of DMT on the income of MS patients.MethodsIn total, 3610 MS patients were included in this register-based cohort study. We measured the association between the time to treatment and the outcome, defined as time from treatment initiation to a 95% decrease in annual earnings compared to each patient´s baseline level. Additionally, the association between time to treatment and increase of social benefits (sickness absence, disability pension) was investigated. A Cox model was adjusted for sex, onset age, education, family situation, country of birth, living area, and disability.ResultsMS patients initiating treatment later had a higher risk of reaching the outcome- those who started treatment after 2 years from MS onset lost 95% of their earnings sooner (HR, 1.19; 95% CI, 1.04–1.37). Furthermore, risk to receive an annual compensation of SEK 100,000 (≈EUR 10,500) was higher for the delayed treatment group.ConclusionEarly treatment initiation in MS is associated with better socioeconomic outcome, adding to previous studies showing benefits regarding disability.
Highlights
Multiple sclerosis (MS) continues to be a challenging and disabling condition, predominantly affecting individuals in their early life, and has an impact functionally, financially, and on quality of life.[1]
The emergence of effective diseasemodifying treatments (DMT) has created an impetus to diagnose as early as possible and the plethora of new agents poses challenges in selecting the right drug for the right person at the right time.[1,4] there is a clear association between health and income,[9] and multiple sclerosis (MS) is associated with lower productivity at work, and higher levels of sickness absence and disability pension,[10,11,12] little is known of how treatment decisions affect socio-economic outcomes in MS patients
In these analyses sex was not significantly associated with the outcomes (HRs 1.03 and 1.14; p > 0.5; for earnings and benefits, respectively). In this register-based cohort study we investigated how early or delayed treatment initiation was associated with the income of MS patients
Summary
Multiple sclerosis (MS) continues to be a challenging and disabling condition, predominantly affecting individuals in their early life, and has an impact functionally, financially, and on quality of life.[1]. The aim of this study was to estimate the long-term impact of early treatment initiation on the income of MS patients. Initiation of disease-modifying treatment (DMT) is associated with better disability outcomes in multiple sclerosis (MS). Objective: To estimate the long-term impact of early initiation of DMT on the income of MS patients. We measured the association between the time to treatment and the outcome, defined as time from treatment initiation to a 95% decrease in annual earnings compared to each patients baseline level. Conclusion: Early treatment initiation in MS is associated with better socioeconomic outcome, adding to previous studies showing benefits regarding disability. Landfeldt E, Castelo-Branco A, Svedbom A, et al The long-term impact of early treatment of multiple sclerosis on the risk of disability pension.
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