A 10-year study of four multiple sclerosis (MS) disease modifying therapies (DMTs) - Avonex, Rebif, Betaferon and Copaxone – has found them to be cost effective and successful at reducing disease progression in MS patients, particularly those with relapsing remitting multiple sclerosis (RRMS).
The short-term effects of DMTs are reported in randomised controlled trials, but less is known about their long-term effects. This prospective observational study of disability outcomes spans 10 years and was set up to investigate the issue.
The outcomes of the UK treated patients were compared with a modelled untreated control group on the British Columbia MS data set to assess the long-term effectiveness of treatments.
At six years, all four medications effectively reduced the rate of disability in patients with RRMS and were meeting the pre-specified cost-effectiveness target of £36,000 per quality-adjusted life-year projected out for 20 years.
At 10 years, the final results of the 4,862 patients who took part in the study showed that all four drugs were cost effective and provided a stable and clinically significant reduction in disability progression.
However, the long term benefits seem to decrease over time. This study suggests that better outcomes are achieved when patients are treated earlier and have less disability.
The drugs also showed a meaningful delay to an Expanded Disability Status Scale score of six, where someone may begin needing more assistance, of around four years in people with walking difficulties at the start of treatment.
The researchers concluded that this study supports a beneficial effect on long-term disability with first-line MS disease-modifying treatments, which is clinically meaningful. However the waning effect noted requires further study.
Source: MS-UK 02/10/2018