Huah Shin Ng1, Feng Zhu1, Elaine Kingwell1, Yinshan Zhao1, Shenzhen Yao2,3, Okechukwu Ekuma4, Lawrence W Svenson5,6,7, Charity Evans2, John D Fisk8, Ruth Ann Marrie9, Helen Tremlett1. 1. Department of Medicine, Division of Neurology and the Djavad Mowafaghian Centre for Brain Health, University of British Columbia , Vancouver, BC, Canada. 2. College of Pharmacy and Nutrition, University of Saskatchewan , Saskatoon, SK, Canada. 3. Health Quality Council , Saskatoon, SK, Canada. 4. Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba , Winnipeg, MB, Canada. 5. Alberta Health , Edmonton, AB, Canada. 6. Division of Preventive Medicine & School of Public Health, University of Alberta , Edmonton, AB, Canada. 7. Community Health Sciences, Cumming School of Medicine, University of Calgary , Calgary, AB, Canada. 8. Nova Scotia Health Authority and the Departments of Psychiatry, Psychology and Neuroscience, and Medicine, Dalhousie University , Halifax, NS, Canada. 9. Departments of Internal Medicine and Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba , Winnipeg, MB, Canada.
Abstract
Background: Relatively little is known about the use of disease-modifying drugs (DMDs) for multiple sclerosis (MS) in the population-based universal healthcare setting. This study aimed to describe the characteristics of a population-based cohort with MS and their DMD exposure in four Canadian provinces. Methods: We identified all adults (aged ≥18 years) with MS using linked population-based health administrative data. Individuals were followed from the most recent of their first MS or demyelinating event or 1 January 1996(study entry), to the earliest of death, emigration, or 31 March 2018(study end). Cohort characteristics examined included sex, age, socioeconomic status, and comorbidity burden. Results: Overall, 10,418/35,894 (29%) of MS cases filled a DMD prescription during the 22-year study period. Most were women (n = 7,683/10,418;74%), and 17% (n = 1,745/10,418) had some comorbidity (Charlson Comorbidity Index≥1) at study entry. Nearly 20% (n = 1,745/10,418) were aged ≥50 when filling their first DMD; the mean age was 39.6 years. Conclusions: Almost 1 in 6 people with MS had at least some comorbidity, and nearly 1 in 6 were ≥50 years old at the time of their first DMD. As these individuals are typically excluded from clinical trials, findings illustrate the need to understand the harms and benefits of DMD use in these understudied groups.
Background: Relatively little is known about the use of disease-modifying drugs (DMDs) for multiple sclerosis (MS) in the population-based universal healthcare setting. This study aimed to describe the characteristics of a population-based cohort with MS and their DMD exposure in four Canadian provinces. Methods: We identified all adults (aged ≥18 years) with MS using linked population-based health administrative data. Individuals were followed from the most recent of their first MS or demyelinating event or 1 January 1996(study entry), to the earliest of death, emigration, or 31 March 2018(study end). Cohort characteristics examined included sex, age, socioeconomic status, and comorbidity burden. Results: Overall, 10,418/35,894 (29%) of MS cases filled a DMD prescription during the 22-year study period. Most were women (n = 7,683/10,418;74%), and 17% (n = 1,745/10,418) had some comorbidity (Charlson Comorbidity Index≥1) at study entry. Nearly 20% (n = 1,745/10,418) were aged ≥50 when filling their first DMD; the mean age was 39.6 years. Conclusions: Almost 1 in 6 people with MS had at least some comorbidity, and nearly 1 in 6 were ≥50 years old at the time of their first DMD. As these individuals are typically excluded from clinical trials, findings illustrate the need to understand the harms and benefits of DMD use in these understudied groups.
Authors: Huah Shin Ng; Jonas Graf; Feng Zhu; Elaine Kingwell; Orhan Aktas; Philipp Albrecht; Hans-Peter Hartung; Sven G Meuth; Charity Evans; John D Fisk; Ruth Ann Marrie; Yinshan Zhao; Helen Tremlett Journal: Front Immunol Date: 2022-01-13 Impact factor: 7.561
Authors: Jonas Graf; Huah Shin Ng; Feng Zhu; Yinshan Zhao; José Ma Wijnands; Charity Evans; John D Fisk; Ruth Ann Marrie; Helen Tremlett Journal: Mult Scler Date: 2022-03-01 Impact factor: 5.855
Authors: Huah Shin Ng; Feng Zhu; Elaine Kingwell; Yinshan Zhao; Shenzhen Yao; Okechukwu Ekuma; Lawrence W Svenson; Charity Evans; John D Fisk; Ruth Ann Marrie; Helen Tremlett Journal: Mult Scler Date: 2021-12-24 Impact factor: 6.312