Early treatment initiation could reduce the need for disability pension

Accessing treatment as early as possible after the onset of multiple sclerosis (MS) symptoms could reduce the likelihood of requiring disability pension, according to a new large-scale study.1

Previous research has shown that people with MS are more likely than the general population to require disability pension (i.e. sickness compensation and early retirement pension). In a retrospective observational study conducted in Sweden, investigators sought to estimate the impact of early treatment on this outcome. The researchers used a nationwide disease-specific register (the Swedish Multiple Sclerosis Registry) to identify 2477 patients who started treatment with a disease-modifying therapy (DMT) between 1 January 2002 and 31 December 2012.1 They then measured the association between time from symptom onset to treatment initiation, and the need for full-time disability pension.

It was reported that patients who accessed treatment within 6 months of symptom onset appeared to have a markedly lower risk of requiring disability pension than those who initiated treatment 12 months after symptom onset. This difference was investigated further, taking into account age, sex, marital status, university education and concurrent illnesses. The researchers showed that patients who commenced treatment within 6 months after onset of symptoms had, on average, a 36% lower risk of permanently leaving the work-force than those who started treatment more than 18 months after symptom onset. For patients who were treated within 6–12 months after symptom onset, the need for disability pension was also lower than for those who initiated treatment after more than 18 months.

The authors pointed out that there were some limitations in the study methodology, hence these results should be interpreted with caution. For example, the retrospective nature of the study meant that it was difficult to account for certain patient factors (such as disease severity), which could have influenced results. Despite such limitations, these findings are supported by previous research, which has shown that early treatment of MS significantly improves physical wel

l-being and reduces relapse rates.2 Whilst more research is needed in this area, the authors of the Swedish study concluded that early treatment with a DMT is associated with a significantly reduced incidence of patients requiring disability pension. The authors also suggested that these findings may have implications for therapeutic decision-making for people with MS.

References

  1. 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. J Neurol. 2018;265:701–7; doi:10.1007/s00415-018-8764-4
  2. Kavaliunas A, Manouchehrinia A, Stawiarz L, et al. Importance of early treatment initiation in the clinical course of multiple sclerosis. Mult Scler. 2017;23:1233–40; doi:10.1177/1352458516675039

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