The impact of increasing neurological disability of multiple sclerosis on health utilities: a systematic review of the literature

Naci, Huseyin; Fleurence, Rachael; Birt, Julie; Duhig, Amy

doi:10.3111/13696990903543085

Cited by 47 publications

(29 citation statements)

References 36 publications

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“…17 Commonly used DMDs have the potential to reduce the activity and progression of MS and thus may improve the utility in MS patients. In fact, a number of studies investi gated their costeffectiveness, however, DMDs such as interferons or glatiramer acetate proved to be only margin ally costeffective (for review see Phillips 18 ).…”

Section: Discussionmentioning

confidence: 99%

Cost of multiple sclerosis in the Czech Republic: The COMS study

et al. 2011

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Section: Discussionmentioning

confidence: 99%

Cost of multiple sclerosis in the Czech Republic: The COMS study

et al. 2011

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“…1–7 Interest is growing in aiming for confirmed disability improvement (CDI), a higher standard for therapeutic efficacy than merely slowing disability accumulation. Because disability is a primary contributor to the burden of MS, 8–10 restoring function in patients with previously acquired neurologic impairments may lead to improved long-term prognosis, greater productivity and quality of life, and reduced economic costs.…”

mentioning

confidence: 99%

Alemtuzumab improves preexisting disability in active relapsing-remitting MS patients

et al. 2016

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Objective:To characterize effects of alemtuzumab treatment on measures of disability improvement in patients with relapsing-remitting multiple sclerosis (RRMS) with inadequate response (≥1 relapse) to prior therapy.Methods:Comparison of Alemtuzumab and Rebif Efficacy in Multiple Sclerosis (CARE-MS) II, a 2-year randomized, rater-blinded, active-controlled, head-to-head, phase 3 trial, compared efficacy and safety of alemtuzumab 12 mg with subcutaneous interferon-β-1a (SC IFN-β-1a) 44 μg in patients with RRMS. Prespecified and post hoc disability outcomes based on Expanded Disability Status Scale (EDSS), Multiple Sclerosis Functional Composite (MSFC), and Sloan low-contrast letter acuity (SLCLA) are reported, focusing on improvement of preexisting disability in addition to slowing of disability accumulation.Results:Alemtuzumab-treated patients were more likely than SC IFN-β-1a–treated patients to show improvement in EDSS scores (p < 0.0001) on all 7 functional systems. Significantly more alemtuzumab patients demonstrated 6-month confirmed disability improvement. The likelihood of improved vs stable/worsening MSFC scores was greater with alemtuzumab than SC IFN-β-1a (p = 0.0300); improvement in MSFC scores with alemtuzumab was primarily driven by the upper limb coordination and dexterity domain. Alemtuzumab-treated patients had more favorable changes from baseline in SLCLA (2.5% contrast) scores (p = 0.0014) and MSFC + SLCLA composite scores (p = 0.0097) than SC IFN-β-1a–treated patients.Conclusions:In patients with RRMS and inadequate response to prior disease-modifying therapies, alemtuzumab provides greater benefits than SC IFN-β-1a across several disability outcomes, reflecting improvement of preexisting disabilities.Classification of evidence:This study provides Class I evidence (based on rater blinding and a balance in baseline characteristics between arms) that alemtuzumab modifies disability measures favorably compared with SC IFN-β-1a.

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“…To date, the reporting of health state values (such as those given by the EQ-5D) for people with MS has been linked only to clinical measures, particularly the EDSS [40].…”

Section: Discussionmentioning

confidence: 99%

“…However, there is a paucity of information regarding the relationships between PROMs and health state values [40] and, in their current form, condition-specific PROMs, such as the MSWS-12, are not amenable for use in policy decisions regarding cost-effectiveness, as they are not preference-based.…”

Section: Discussionmentioning

confidence: 99%

The use of multiple sclerosis condition-specific measures to inform health policy decision-making: mapping from the MSWS-12 to the EQ-5D

et al. 2011

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Background: Walking impairment has a major influence on the quality-of-life of people with multiple sclerosis (MS). The Multiple Sclerosis Walking Scale assesses the impact of MS on walking ability from the patient's perspective, but in its current form, is not amenable for use in many policy decision-making settings.Objectives: Statistical 'mapping' methods were used to convert MSWS-12 scores to EQ-5D health state values. Methods:The relationship between the measures was estimated using cohort data from people with MS in South West England. Regression analyses were conducted, estimation errors assessed, and predictive performance of the best models tested using longitudinal data.Results: Model performance was in line with that of other mapping studies, with the best performing models being an ordinary least squares (OLS) model using MSWS-12 item scores, and an OLS model using the total MSWS-12 score and its squared term.Conclusions: A process has been described whereby data from a patient-reported outcome measure (MSWS-12) can be converted to (EQ-5D) health state values. These values may be used to consider the health-related quality-of-life of people with MS, to estimate quality-adjusted life-years for use in effectiveness and cost-effectiveness analyses, and to inform health policy decisions.

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The impact of increasing neurological disability of multiple sclerosis on health utilities: a systematic review of the literature

Cited by 47 publications

References 36 publications

Cost of multiple sclerosis in the Czech Republic: The COMS study

Cost of multiple sclerosis in the Czech Republic: The COMS study

Alemtuzumab improves preexisting disability in active relapsing-remitting MS patients

The use of multiple sclerosis condition-specific measures to inform health policy decision-making: mapping from the MSWS-12 to the EQ-5D

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