Yesterday someone was asking about life expectancy, giving a list of personalities that did badly due to their MS. Clearly there are some people with very aggressive MS, but I made the point that all of the personalities mentioned didn’t live in a time when there were treatments and not in a time when the treatments work well for most people. I exclude the first generation CRAB drugs from my mind set. As I’m not a neuro I do this as I don’t have the weigh-up the pros and cons of each agent for each individidual.
However the point is that it is apt that this paper was just published as it supports the view that in the age of treatments you do better than doing nothing. If you take a DMT there is a survival advantage and the quicker you start the better. In addition if you take a more highly efficacious DMT, it is even better, supporting my mind set. After all it is simple biologcal sense
Ng HS, Zhu F, Kingwell E, Yao S, Ekuma O, Evans C, Fisk JD, Marrie RA, Zhao Y, Tremlett H. Disease-Modifying Drugs for Multiple Sclerosis and Association With Survival. Neurol Neuroimmunol Neuroinflamm. 2022 Jun 14;9(5):e200005. doi: 10.1212/NXI.0000000000200005.
Background and objectives: We examined the association between the disease-modifying drugs (DMDs) for multiple sclerosis (MS) and survival in a multiregion population-based study (4 Canadian provinces).
Results: We identified 35,894 persons with MS; 72% were female. The mean age at index date was 44.5 years (SD = 13.6)…… Compared with no exposure, exposure to any DMD or to any first-generation DMD was associated with a 26% lower hazard of mortality (both aHRs 0.74; 95% CI 0.56-0.98), while any second-generation DMD exposure was associated with a 33% lower hazard (aHR 0.67; 95% CI 0.46-0.98). Earlier DMD initiation (beta-interferon or glatiramer acetate vs no exposure) was associated with a significant mortality effect (p < 0.05), while later initiation was not (95% CIs included 1). However, the survival advantage with earlier initiation diminished over time, no longer reaching statistical significance at 15 years postindex date.
Discussion: Our study demonstrates an association between the DMDs for MS and improved survival in the real-world setting.
Disclaimer. These are the vews of the author and dobody else