Clinically stable disease is associated with a lower risk of both income loss and disability pension for patients with multiple sclerosis

Thor Ameri Chalmer*, Mathias Buron, Zsolt Illes, Viktoria Papp, Asta Theodorsdottir, Jakob Schäfer, Victoria Hansen, Nasrin Asgari, Pernille Bro Skejø, Henrik Boye Jensen, Per Soelberg Sørensen, Melinda Magyari

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Resumé

Objective: To assess the risk of losing income from salaries and risk disability pension for multiple sclerosis patients with a clinically stable disease course 3 years after the start of disease-modifying therapy (DMT). Methods: Data from the Danish Multiple Sclerosis Registry were linked to other Danish nationwide population-based databases. We included patients who started treatment with a DMT between 2001 and 2014. Patients were categorised into a clinically stable group (No Evidence of Disease Activity (NEDA-2)) and a clinically active group (relapse activity or 6-month confirmed Expanded Disability Status Scale worsening). Outcomes were: (1) loss of regular income from salaries and (2) a transfer payment labelled as disability pension. We used a Cox proportional hazards model to estimate confounder-adjusted HRs, and absolute risks were plotted using cumulative incidence curves accounting for competing risks. Results: We included 2406 patients for the income analyses and 3123 patients for the disability pension analysis. Median follow-up from index date was ∼5 years in both analyses. The NEDA-2 group had a 26% reduced rate of losing income (HR 0.74; 95% CI 0.60 to 0.92). HRs were calculated for 5-year intervals in the disability pension analysis: year 0-5: a 57% reduced rate of disability pension for the NEDA-2 group (HR 0.43; 95% CI 0.33 to 0.55) and year 5-10: a 36% reduced rate (HR 0.64; 95% CI 0.40 to 1.01). Conclusion: Clinically stable disease course (NEDA-2) is associated with a reduced risk of losing income from salaries and a reduced risk of disability pension.

OriginalsprogEngelsk
TidsskriftJournal of Neurology, Neurosurgery and Psychiatry
Vol/bind91
Udgave nummer1
Sider (fra-til)67-74
ISSN0022-3050
DOI
StatusUdgivet - jan. 2020

Fingeraftryk

Pensions
Salaries and Fringe Benefits
Proportional Hazards Models
Registries
Databases
Incidence
Population

Citer dette

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title = "Clinically stable disease is associated with a lower risk of both income loss and disability pension for patients with multiple sclerosis",
abstract = "Objective: To assess the risk of losing income from salaries and risk disability pension for multiple sclerosis patients with a clinically stable disease course 3 years after the start of disease-modifying therapy (DMT). Methods: Data from the Danish Multiple Sclerosis Registry were linked to other Danish nationwide population-based databases. We included patients who started treatment with a DMT between 2001 and 2014. Patients were categorised into a clinically stable group (No Evidence of Disease Activity (NEDA-2)) and a clinically active group (relapse activity or 6-month confirmed Expanded Disability Status Scale worsening). Outcomes were: (1) loss of regular income from salaries and (2) a transfer payment labelled as disability pension. We used a Cox proportional hazards model to estimate confounder-adjusted HRs, and absolute risks were plotted using cumulative incidence curves accounting for competing risks. Results: We included 2406 patients for the income analyses and 3123 patients for the disability pension analysis. Median follow-up from index date was ∼5 years in both analyses. The NEDA-2 group had a 26{\%} reduced rate of losing income (HR 0.74; 95{\%} CI 0.60 to 0.92). HRs were calculated for 5-year intervals in the disability pension analysis: year 0-5: a 57{\%} reduced rate of disability pension for the NEDA-2 group (HR 0.43; 95{\%} CI 0.33 to 0.55) and year 5-10: a 36{\%} reduced rate (HR 0.64; 95{\%} CI 0.40 to 1.01). Conclusion: Clinically stable disease course (NEDA-2) is associated with a reduced risk of losing income from salaries and a reduced risk of disability pension.",
author = "Chalmer, {Thor Ameri} and Mathias Buron and Zsolt Illes and Viktoria Papp and Asta Theodorsdottir and Jakob Sch{\"a}fer and Victoria Hansen and Nasrin Asgari and Skej{\o}, {Pernille Bro} and Jensen, {Henrik Boye} and S{\o}rensen, {Per Soelberg} and Melinda Magyari",
year = "2020",
month = "1",
doi = "10.1136/jnnp-2019-321523",
language = "English",
volume = "91",
pages = "67--74",
journal = "Journal of Neurology, Neurosurgery and Psychiatry",
issn = "0022-3050",
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Clinically stable disease is associated with a lower risk of both income loss and disability pension for patients with multiple sclerosis. / Chalmer, Thor Ameri; Buron, Mathias; Illes, Zsolt; Papp, Viktoria; Theodorsdottir, Asta; Schäfer, Jakob; Hansen, Victoria; Asgari, Nasrin; Skejø, Pernille Bro; Jensen, Henrik Boye; Sørensen, Per Soelberg; Magyari, Melinda.

I: Journal of Neurology, Neurosurgery and Psychiatry, Bind 91, Nr. 1, 01.2020, s. 67-74.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Clinically stable disease is associated with a lower risk of both income loss and disability pension for patients with multiple sclerosis

AU - Chalmer, Thor Ameri

AU - Buron, Mathias

AU - Illes, Zsolt

AU - Papp, Viktoria

AU - Theodorsdottir, Asta

AU - Schäfer, Jakob

AU - Hansen, Victoria

AU - Asgari, Nasrin

AU - Skejø, Pernille Bro

AU - Jensen, Henrik Boye

AU - Sørensen, Per Soelberg

AU - Magyari, Melinda

PY - 2020/1

Y1 - 2020/1

N2 - Objective: To assess the risk of losing income from salaries and risk disability pension for multiple sclerosis patients with a clinically stable disease course 3 years after the start of disease-modifying therapy (DMT). Methods: Data from the Danish Multiple Sclerosis Registry were linked to other Danish nationwide population-based databases. We included patients who started treatment with a DMT between 2001 and 2014. Patients were categorised into a clinically stable group (No Evidence of Disease Activity (NEDA-2)) and a clinically active group (relapse activity or 6-month confirmed Expanded Disability Status Scale worsening). Outcomes were: (1) loss of regular income from salaries and (2) a transfer payment labelled as disability pension. We used a Cox proportional hazards model to estimate confounder-adjusted HRs, and absolute risks were plotted using cumulative incidence curves accounting for competing risks. Results: We included 2406 patients for the income analyses and 3123 patients for the disability pension analysis. Median follow-up from index date was ∼5 years in both analyses. The NEDA-2 group had a 26% reduced rate of losing income (HR 0.74; 95% CI 0.60 to 0.92). HRs were calculated for 5-year intervals in the disability pension analysis: year 0-5: a 57% reduced rate of disability pension for the NEDA-2 group (HR 0.43; 95% CI 0.33 to 0.55) and year 5-10: a 36% reduced rate (HR 0.64; 95% CI 0.40 to 1.01). Conclusion: Clinically stable disease course (NEDA-2) is associated with a reduced risk of losing income from salaries and a reduced risk of disability pension.

AB - Objective: To assess the risk of losing income from salaries and risk disability pension for multiple sclerosis patients with a clinically stable disease course 3 years after the start of disease-modifying therapy (DMT). Methods: Data from the Danish Multiple Sclerosis Registry were linked to other Danish nationwide population-based databases. We included patients who started treatment with a DMT between 2001 and 2014. Patients were categorised into a clinically stable group (No Evidence of Disease Activity (NEDA-2)) and a clinically active group (relapse activity or 6-month confirmed Expanded Disability Status Scale worsening). Outcomes were: (1) loss of regular income from salaries and (2) a transfer payment labelled as disability pension. We used a Cox proportional hazards model to estimate confounder-adjusted HRs, and absolute risks were plotted using cumulative incidence curves accounting for competing risks. Results: We included 2406 patients for the income analyses and 3123 patients for the disability pension analysis. Median follow-up from index date was ∼5 years in both analyses. The NEDA-2 group had a 26% reduced rate of losing income (HR 0.74; 95% CI 0.60 to 0.92). HRs were calculated for 5-year intervals in the disability pension analysis: year 0-5: a 57% reduced rate of disability pension for the NEDA-2 group (HR 0.43; 95% CI 0.33 to 0.55) and year 5-10: a 36% reduced rate (HR 0.64; 95% CI 0.40 to 1.01). Conclusion: Clinically stable disease course (NEDA-2) is associated with a reduced risk of losing income from salaries and a reduced risk of disability pension.

U2 - 10.1136/jnnp-2019-321523

DO - 10.1136/jnnp-2019-321523

M3 - Journal article

C2 - 31727727

AN - SCOPUS:85075174422

VL - 91

SP - 67

EP - 74

JO - Journal of Neurology, Neurosurgery and Psychiatry

JF - Journal of Neurology, Neurosurgery and Psychiatry

SN - 0022-3050

IS - 1

ER -