Department of Neurology, Telemark Hospital Trust, Skien 3710, Norway; Institute of Clinical Medicine, University of Oslo, Norway.
Institute of Clinical Medicine, University of Oslo, Norway; Department of Neurology, Vestre Viken Hospital Trust, Drammen, Norway.
Mult Scler Relat Disord. 2022 May;61:103759. doi: 10.1016/j.msard.2022.103759. Epub 2022 Mar 24.
Several studies report an impact of socioeconomic factors on access to disease modifying treatment (DMT) in multiple sclerosis (MS), with a trend of less access to more deprived persons. We investigated the impact of socioeconomic status (SES) on access to treatment in a well-defined Norwegian MS cohort.
This is a study of a population-based Norwegian MS cohort. We collected detailed information on disease development, progression, and DMT administered. Socioeconomic data was obtained from Statistics Norway and a questionnaire.
We included 1314 persons with relapsing remitting MS at the prevalence date 01/01/2018. The population ever treated with DMTs is younger at onset, has shorter time from onset to diagnosis and lower expanded disability status score (EDSS) at diagnosis. The persons with MS (pwMS) with the highest levels of education, and those who are married are more likely to be ever treated with DMT. In the subgroup treated with a high efficacy DMT as a first drug, the pwMS are younger at prevalence date (39.9 years (SD 12.1)) compared with those who are not treated with a high efficacy DMT as first drug (43.8 years (SD 10.3)). The subgroup treated with a high efficacy DMT as a first drug has a 0.5 point higher EDSS at diagnosis compared to those not treated with a high efficacy DMT as a first drug. The level of education, household income and marital status are inversely related to access to high efficacy DMT as a first drug. None of the above differences persist when analyzing the subgroup diagnosed within the last six years (2012-2017).
Since 2012, the pwMS in this Norwegian cohort are treated equally with DMT in terms of different measures of socioeconomic position.
多项研究报告称，社会经济因素对多发性硬化症（MS）患者获得疾病修正治疗（DMT）有影响，且经济条件较差的患者获得治疗的机会较少。我们研究了挪威 MS 患者队列中社会经济地位（SES）对治疗的影响。
这是一项基于人群的挪威 MS 队列研究。我们收集了疾病进展、DMT 治疗方案等详细信息。社会经济数据来自挪威统计局和问卷调查。
我们纳入了 1314 名在 2018 年 1 月 1 日发病的复发缓解型 MS 患者。曾经接受过 DMT 治疗的患者起病年龄较小，从起病到确诊的时间较短，确诊时扩展残疾状态量表（EDSS）评分较低。受教育程度最高和已婚的 MS 患者（pwMS）更有可能接受过 DMT 治疗。在作为一线药物首次接受高效 DMT 治疗的亚组中，pwMS 在发病日期时的年龄较小（39.9 岁（SD 12.1）），而未作为一线药物接受高效 DMT 治疗的 pwMS 年龄较大（43.8 岁（SD 10.3））。作为一线药物接受高效 DMT 治疗的亚组在诊断时的 EDSS 评分比未接受高效 DMT 治疗的亚组高 0.5 分。受教育程度、家庭收入和婚姻状况与作为一线药物接受高效 DMT 的机会呈负相关。当分析在最近六年（2012-2017 年）内确诊的亚组时，上述差异均不存在。
自 2012 年以来，挪威队列中的 pwMS 患者在接受 DMT 治疗方面，根据 SES 的不同衡量标准，机会均等。
