Disease Progression Among Multiple Sclerosis Patients Before and During a Disease-Modifying Drug Program: A longitudinal population-based evaluation

Authors: 
P. J. Veugelers, J. D. Fisk, M. G. Brown, K. Stadnyk, I. S. Sketris, T. J. Murray, V. Bahn
Research Summary: 

Purpose of Study
The purpose of this study was to find if disease-modifying drugs (DMDs) effectively slow MS disability progression using real-world observational evidence from Nova Scotia.

Research Approach/Method
The authors analysed data pre- and post- DMD treatment. They estimated time to disability endpoints using Kaplan-Meier methods, and annual EDSS changes.

Key Overarching Message
Results suggest a publicly funded therapy program, which provides DMDs to all eligible MS patients in Nova Scotia with mandatory annual follow-up, has been effective in slowing the progression of neurological disability in this population.

Key Findings
The authors observed statistically significant increases in the time to reach specific EDSS endpoints. This finding reflects increasing neurologic disability for the clinical populations following introduction of the program. They also noted a reduction in pre-treatment rates of accumulating neurologic disability in patients who were treated with DMDs. They found direct comparisons between estimates of effectiveness (i.e., effect size) for specific DMDs are problematic in observational studies.