Work Productivity Outcomes Associated with Ocrelizumab Compared with Other Disease-Modifying Therapies for Multiple Sclerosis

Abstract

Objective: This study evaluated work and activity impairment in patients with multiple sclerosis (MS) treated with ocrelizumab (OCR) versus other disease-modifying therapies (DMTs). Methods: Data were obtained from the Adelphi Real World Disease Specific Programme for Multiple Sclerosis. Patients with relapsing-remitting or secondary progressive MS who completed surveys in 2018 and 2019 and received C 6 months of an eligible therapy, including OCR, injectable therapy, and oral therapy, were included. Outcomes were assessed using the patient-reported Work Productivity and Activity Impairment questionnaire. Doubly robust estimation, which combined propensity score weighting and regression modeling, was used to compare treatments, controlling for baseline clinical and demographic characteristics. Results: This study included 630 patients (OCR, n = 90; injectable DMT, n = 224; oral DMT, n = 316) with a mean (standard deviation) age of 42 (11) years. A greater proportion of OCR-treated patients had an Expanded Disability Status Scale score of C 3 at treatment initiation compared with those receiving oral and injectable DMTs (51 vs. 15% and 15%, respectively), and a smaller proportion of OCRtreated patients received treatment for C 1 year (43 vs. 90% and 92%, respectively). OCR-treated patients had higher odds of employment [odds ratio (95% confidence interval) 3.4 (1.5-7.7) vs. oral DMT, 5.6 (2.6-12.0) vs. injectable DMT], lower overall work productivity loss [difference (95% confidence interval)-10.0% (-6.1 to-15.0%) vs. oral DMT,-13.0% (-8.5 to-17.0%) vs. injectable DMT] and lower activity impairment [difference (95% confidence interval)-11% (-7.1 to-16.0%) vs. oral DMT,-9.7% (-5.0 to-14.0%) vs. injectable DMT]. Conclusion: This real-world evidence suggests that patients with MS treated with OCR experience lower work and activity impairment than patients treated with other DMTs.

Spatial and temporal distribution of the prevalence of unemployment and early retirement in people with multiple sclerosis: A systematic review with meta-analysis

“…In addition, there is a lack of evidence addressing the reintegration of the worker with MS into the workforce so that nowadays unemployment usually means an irreversible outcome [ 181 ], even though almost one-third feel they are still able to work [ 84 ]. Regarding specifically early retirement, the results also reinforce the role of MS therapeutic improvement over the years [ 162 ]. In addition, aggressive disease characteristics were associated with worse effect estimates of early retirement, which is also consistent with the findings of previous results [ 182 , 183 ].…”

“…Forty percent of patients did not even communicate the diagnosis of MS to their occupational physician [ 181 ]. Many of the reasons for work withdrawal are associated with the workplace and could be potentially managed by occupational health multidisciplinary teams [ 44 , 84 , 162 ]. In addition, there is a lack of evidence addressing the reintegration of the worker with MS into the workforce so that nowadays unemployment usually means an irreversible outcome [ 181 ], even though almost one-third feel they are still able to work [ 84 ].…”

“…The accurate interpretation of every single result must consider the complexity and particularity of each country’s socio-economic characteristics. A lower unemployment rate at a national level may be associated with larger effects of poor health on not entering employment [ 162 ]. Moreover, countries with a high prevalence of unemployment in the general population may also influence the outcomes of PwMS.…”

Cost-effectiveness Analysis of Ocrelizumab for the Treatment of Relapsing and Primary Progressive Multiple Sclerosis in Portugal

“…Despite the aforementioned limitations, there is valuable information about the utilisation of ocrelizumab in real-world conditions that may complement and support the daily decision-making process about the value of different DMT for MS. An accumulating body of evidence supports the effectiveness outcomes and the impact of ocrelizumab in suppressing disease activity with a favourable and consistent safety profile [ 55 ], superior persistence and adherence to treatment [ 56 ], lower work and activity impairment versus patients treated with other DMTs [ 57 ] and predictability and lower treatment costs relative to other infused disease-modifying therapies [ 58 ].…”

Clinical Evaluation of Siponimod for the Treatment of Secondary Progressive Multiple Sclerosis: Pathophysiology, Efficacy, Safety, Patient Acceptability and Adherence

“…Ocrelizumab was found to positively impact employment in MS and this outcome should be evaluated in other trials. 84 Patient-centred outcomes in SPMS trials will help to shape future care of this population. Future studies may include a consensus-driven definition of active SPMS and also focus on patient’s goals and expectations to enhance long-term quality of life of those living with MS.…”