Contributions
Abstract: P307
Type: Poster
Abstract Category: Clinical aspects of MS - Epidemiology
Background: Socioeconomic status (SES) plays an important role in various chronic or severe diseases including neurological ones, where delays stand as relevant care quality markers. To measure social inequalities in health issues a recent European Deprivation Index (EDI), has proved to be a pertinent comparative tool. Diagnostic and disease modifying treatments (DMTs) delays tend to be reduced by evolution of MS diagnosis criteria especially McDonald 2001 criteria and the evidence of early DMT initiation benefit in Relapsing Remitting Multiple Sclerosis (RRMS).
Objective: To identify the influence of SES on the delay between first and second line DMTs in RRMS patients.
Methods: 933 patients "files with an initial RRMS diagnosis (Poser and 2001 McDonald criteria) during the period [1982-2011] were extracted for the study from the database of Lower-Normandy MS network part of the French Observatory of MS (OFSEP). Cut-off date was fixed at the end of February 2015. Cyclophosphamide, mitoxantrone, natalizumab, and fingolimod were retained as second line DMTs. We performed Cox multivariate proportional hazard model adjusted on clinical variables to assessed association between social deprivation (measured by EDI) and delay to access a second line DMT.
Results: Mean age at second line DMTs initiation was 39.49 years (SD ±10,08). Median time to access second line DMTs was 10.83 years for patients diagnosed from 1982 to 2000 compared to 5.00 years for patients diagnosed from 2001 to 2011. No significant influence of SES was observed on delay to access a second line DMT if first line DMT exposure time was less than 5 years. After 5 years of first line DMT exposure, risk to access a second line DMT was 3 times higher for RRMS patients with the lowest EDI (socially favoured patients) HR=3.14 95% IC [1,72-5,72] compared to patients with higher EDIs.
Conclusion: In MS social inequalities seem to influence with a time dependent effect access to second line DMTs.
Disclosure:
Calocer: nothing to disclosure
Dejardin: nothing to disclosure
Droulon: nothing to disclosure
Derache: nothing to disclosure
Defer: nothing to disclosure
Abstract: P307
Type: Poster
Abstract Category: Clinical aspects of MS - Epidemiology
Background: Socioeconomic status (SES) plays an important role in various chronic or severe diseases including neurological ones, where delays stand as relevant care quality markers. To measure social inequalities in health issues a recent European Deprivation Index (EDI), has proved to be a pertinent comparative tool. Diagnostic and disease modifying treatments (DMTs) delays tend to be reduced by evolution of MS diagnosis criteria especially McDonald 2001 criteria and the evidence of early DMT initiation benefit in Relapsing Remitting Multiple Sclerosis (RRMS).
Objective: To identify the influence of SES on the delay between first and second line DMTs in RRMS patients.
Methods: 933 patients "files with an initial RRMS diagnosis (Poser and 2001 McDonald criteria) during the period [1982-2011] were extracted for the study from the database of Lower-Normandy MS network part of the French Observatory of MS (OFSEP). Cut-off date was fixed at the end of February 2015. Cyclophosphamide, mitoxantrone, natalizumab, and fingolimod were retained as second line DMTs. We performed Cox multivariate proportional hazard model adjusted on clinical variables to assessed association between social deprivation (measured by EDI) and delay to access a second line DMT.
Results: Mean age at second line DMTs initiation was 39.49 years (SD ±10,08). Median time to access second line DMTs was 10.83 years for patients diagnosed from 1982 to 2000 compared to 5.00 years for patients diagnosed from 2001 to 2011. No significant influence of SES was observed on delay to access a second line DMT if first line DMT exposure time was less than 5 years. After 5 years of first line DMT exposure, risk to access a second line DMT was 3 times higher for RRMS patients with the lowest EDI (socially favoured patients) HR=3.14 95% IC [1,72-5,72] compared to patients with higher EDIs.
Conclusion: In MS social inequalities seem to influence with a time dependent effect access to second line DMTs.
Disclosure:
Calocer: nothing to disclosure
Dejardin: nothing to disclosure
Droulon: nothing to disclosure
Derache: nothing to disclosure
Defer: nothing to disclosure