Trajectories of disease-modifying therapies and associated sickness absence and disability pension among 1923 people with multiple sclerosis in Sweden

Teni, Fitsum Sebsibe; Machado, Alejandra; Murley, Chantelle; He, Anna; Fink, Katharina; Gyllensten, Hanna; Glaser, Anna; Alexanderson, Kristina; Hillert, Jan; Friberg, Emilie

doi:10.1016/j.msard.2022.104456

Cited by 2 publications

(17 citation statements)

References 43 publications

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“…Furthermore, the increased use of high-efficacy DMTs more recently relates to the increased availability and use of high-efficacy DMTs in Sweden, particularly the highly increased use of rituximab in the treatment of MS since early 2010s as well as the availability of other high-efficacy DMTs in late 2000s and 2010s including natalizumab, alemtuzumab, ocrelizumab, and others. 16,28 Our findings had common features also with a study from France which reported four clusters where the first-line DMTs cluster roughly compares with the long-term non-high-efficacy cluster in our study. The second-line DMTs cluster had similarities with the long-term high-efficacy and escalation clusters in our study.…”

Section: Discussionsupporting

confidence: 89%

“…16 This could be because early use of highefficacy DMTs was lower in the previous study which has increased more recently and such sequences were previously grouped mainly as part of the escalation cluster. 16 The decreasing benefits of high-efficacy DMTs over non-high-efficacy ones among older PwMS have been highlighted in the literature. 30 Progressive forms of MS were associated with escalating to (secondary progressive), being on high-efficacy DMTs, or discontinuing/not being on DMT similar to our previous study.…”

Section: Discussionmentioning

confidence: 96%

“…It included PwMS with onset during 2007-2010. 16 This study, however, included PwMS with recent treatment initiation while making a long-term observation.…”

Section: Discussionmentioning

confidence: 99%

“…30 Progressive forms of MS were associated with escalating to (secondary progressive), being on high-efficacy DMTs, or discontinuing/not being on DMT similar to our previous study. 16 The pattern reflects the limited DMT options to treat progressive MS, potentially associated with the relatively limited understanding of their pathology than relapsing MS. 31 Specific DMTs approved for progressive MS are ocrelizumab for primary and siponimod for secondary progressive MS. 32 Higher EDSS scores around treatment start were also associated with belonging in the DMT use clusters other than long-term non-high-efficacy, similar to our previous study. 16 The higher odds of initiating highefficacy DMTs are seemingly in line with the increasingly common induction approach.…”

Section: Discussionmentioning

confidence: 99%

“…16 The pattern reflects the limited DMT options to treat progressive MS, potentially associated with the relatively limited understanding of their pathology than relapsing MS. 31 Specific DMTs approved for progressive MS are ocrelizumab for primary and siponimod for secondary progressive MS. 32 Higher EDSS scores around treatment start were also associated with belonging in the DMT use clusters other than long-term non-high-efficacy, similar to our previous study. 16 The higher odds of initiating highefficacy DMTs are seemingly in line with the increasingly common induction approach. 10,11,28 Similarly, the higher odds of escalation among PwMS with higher EDSS score also show switch to high-efficacy DMTs among those who initiated non-high-efficacy DMTs and have not had the desired effect.…”

Section: Discussionmentioning

confidence: 99%

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Recent trends in disease-modifying therapy use and associated sickness absence and disability pension among people with multiple sclerosis in Sweden

Teni,

Machado,

Fink

et al. 2024

Mult Scler

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Background: Disease-modifying therapies (DMTs) have led to improved health and work productivity among people with multiple sclerosis (PwMS). Objectives: To describe trajectories of recent DMT use and their association with sickness absence and/or disability pension (SADP) among PwMS in Sweden. Methods: A longitudinal register–based study was conducted among 1395 PwMS with treatment start in 2014/2015. While DMT use over 5 years was assessed using sequence analysis resulting in four clusters, a 7-year (Y−2 toY4) trend of SADP was analyzed using zero-inflated negative binomial regression. Results: Four clusters of DMT use trajectories were identified: long-term non-high-efficacy (483, 34.6%), long-term high-efficacy (572, 41%), escalation (221, 15.8%), and discontinuation (119, 8.5%). Progressive MS and higher expanded disability status scale scores were associated with the escalation, long-term high-efficacy, or discontinuation clusters. PwMS in the long-term high-efficacy and escalation clusters had higher likelihood of being on SADP. However, PwMS initiating high-efficacy DMTs demonstrated steeper decline in SADP than others. Conclusion: Using sequence analysis, this study showed recent DMT use trajectories among PwMS where initiation of high-efficacy DMTs has become more common. The trend of SADP was stable and lower in those using non-high-efficacy DMTs and larger improvements were shown in those initiating high-efficacy DMTs.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 96%

“…It included PwMS with onset during 2007-2010. 16 This study, however, included PwMS with recent treatment initiation while making a long-term observation.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Recent trends in disease-modifying therapy use and associated sickness absence and disability pension among people with multiple sclerosis in Sweden

Teni,

Machado,

Fink

et al. 2024

Mult Scler

Self Cite

View full text Add to dashboard Cite

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Coronavirus disease 2019 infection among working-aged people with multiple sclerosis and the impact of disease-modifying therapies

Murley,

Pettersson,

Hillert

et al. 2024

Multiple Sclerosis Journal - Experimental, Translational and Cl

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Background The risk of coronavirus disease 2019 among people with multiple sclerosis with different disease-modifying therapies is not well established. Objective To investigate the occurrence of coronavirus disease 2019 and the remaining symptoms among people with multiple sclerosis and the associations with different disease-modifying therapies. Methods Individuals aged 20–50 listed in the Swedish Multiple Sclerosis Registry were invited to participate in a survey in 2021. Information on reported coronavirus disease 2019 infection and remaining symptoms were linked to individual-level register data. The risks by disease-modifying therapy of having coronavirus disease 2019 or having remaining symptoms were estimated with logistic regression. Results Of the 4393 participants, 1030 (23.4%) self-reported coronavirus disease 2019 (749 confirmed and 281 suspected). The observed odds for coronavirus disease 2019 did not differ by disease-modifying therapy ( p-values <0.05). The majority reporting coronavirus disease 2019 had fully recovered (68.5%), 4.2% were currently/recently sick, and 27.0% had symptoms remaining after 2 months. The most frequently reported remaining symptoms involved one's sense of smell or taste (37.0%), fatigue (20.0%), and breathing (12.0%). No statistically significant associations were observed between having remaining symptoms and the disease-modifying therapy. Conclusion Despite the initial concerns of differing infection risks by MS treatments, we observed no differences in coronavirus disease 2019 occurrence or remaining symptoms among those who had coronavirus disease 2019. Nonetheless, exercising caution in interpreting our findings, it remains implicit that people with multiple sclerosis are particularly susceptible to infection and that lingering symptoms may persist beyond the initial infection.

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Trajectories of disease-modifying therapies and associated sickness absence and disability pension among 1923 people with multiple sclerosis in Sweden

Cited by 2 publications

References 43 publications

Recent trends in disease-modifying therapy use and associated sickness absence and disability pension among people with multiple sclerosis in Sweden

Recent trends in disease-modifying therapy use and associated sickness absence and disability pension among people with multiple sclerosis in Sweden

Coronavirus disease 2019 infection among working-aged people with multiple sclerosis and the impact of disease-modifying therapies

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