There is only little knowledge regarding the comparative effectiveness of different types of disease-modifying therapies (DMTs) on patient-reported outcomes among multiple sclerosis patients. In a study whose findings were published in the Journal of Neurology, Neurosurgery & Psychiatry, the researchers compared the effects of treatment with natalizumab versus other DMTs, based on real-world data. The variables tested included the severity of symptoms following multiple sclerosis, quality of life, disability, disease progression and occupational outcomes.
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A total of 2,817 observations were collected from 2015, 2016 and 2017 on 1,382 participants from the Australian MS Longitudinal Study. The researchers used questionnaires to collect prospective information on treatment, health and employment outcomes. The researchers used marginal structural models with interaction terms for DMT×time in order to compare the treatment with natalizumab and other comparator treatment groups.
The results of the study show that treatment with natalizumab is associated with improvements over time, or with general improvement trends, in the severity of many symptoms and loss of productivity at work. Compared with all other DMTs, treatment with natalizumab was associated with better effects over time for 8 of 23 patient-reported outcomes, with similar directions of effect observed for an additional 6, demonstrating consistency. No differences were found in the effect on spasticity, fatigue, pain, feelings of depression, disability, the European quality of life five dimension index, ineffective presence (presenteeism) and employment status. Also, the performance of natalizumab did not significantly decline over time compared with any other DMTs for any of the outcomes.
In conclusion, treatment with natalizumab, compared to other DMTs, has been associated with better outcomes over time regarding several patient-reported health and employment outcomes. The researchers’ findings may influence the choice of treatment in clinical practice, as well as in future therapeutic cost-benefit analyses.
source:
Chen, J., Diouf, I., Taylor, B. V., Kalincik, T., & van der Mei, I. (2022). Superior effects of natalizumab versus other DMTs on patient-reported outcomes in people with multiple sclerosis. Journal of neurology, neurosurgery, and psychiatry, jnnp-2022-329223. Advance online publication.