Importance of early treatment decisions on future income of multiple sclerosis patients

Background Early initiation of disease-modifying treatment (DMT) is associated with better disability outcomes in multiple sclerosis (MS). However, little is known of how treatment decisions affect socio-economic outcomes. Objective To estimate the long-term impact of early initiation of DMT on the income of MS patients. Methods In total, 3610 MS patients were included in this register-based cohort study. We measured the association between the time to treatment and the outcome, defined as time from treatment initiation to a 95% decrease in annual earnings compared to each patients baseline level. Additionally, the association between time to treatment and increase of social benefits (sickness absence, disability pension) was investigated. A Cox model was adjusted for sex, onset age, education, family situation, country of birth, living area, and disability. Results MS patients initiating treatment later had a higher risk of reaching the outcome- those who started treatment after 2years from MS onset lost 95% of their earnings sooner (HR, 1.19; 95% CI, 1.04-1.37). Furthermore, risk to receive an annual compensation of SEK 100,000 (approximate to EUR 10,500) was higher for the delayed treatment group. Conclusion Early treatment initiation in MS is associated with better socioeconomic outcome, adding to previous studies showing benefits regarding disability.