The following article is part of conference coverage from the 2019 Annual Meeting of the Consortium of Multiple Sclerosis Centers , in Seattle, Washington. Neurology Advisor‘s staff will be reporting breaking news associated with research conducted by leading experts in neurology. Check back for the latest news from CMSC 2019.
SEATTLE — Efforts are currently underway to test the hypothesis that higher efficacy therapies for multiple sclerosis (MS) can improve depressive symptoms among individuals with MS. This research was recently presented at the 33rd Annual Meeting of the Consortium of Multiple Sclerosis Centers, held May 28 to June 1, 2019, in Seattle, Washington.
Researchers of this longitudinal study included data from MS Partners Advancing Technology and Health Solutions, which is currently taking place across 10 sites and includes 1740 individuals with relapsing-remitting MS who are new initiators of disease-modifying therapies (DMTs). All participants completed the Quality of Life in Neurological Disorders depression subscale at study initiation and during follow up. The study researchers compared rates of change in these scores. DMT categories included lower efficacy DMTs (DMT-L) (dimethyl fumarate, fingolimod, glatiramer acetate, interferons) and higher efficacy DMTs (DMT-H) (alemtuzumab, ocrelizumab, rituximab, natalizumab). Rate of change in depression scores in patients initiating different forms of DMT-L and DMT-H were compared using multivariable-adjusted mixed-effects regression models. Interferons within the DMT-L category were excluded in secondary analyses.
The study population was 76% women, with an average age of 45.1±12.3 years and an average follow up of 0.92±0.48 years. Of the total participants, 579 initiated DMT-H, and 922 initiated DMT-L, with DMT-H showing potential association with a 0.58-point/year (95% CI, -1.05 to -0.11) decrease in Quality of Life in Neurological Disorders depression scores compared with DMT-L (P =.01). These results were multivariable adjusted and were sustained when DMT-L interferons were excluded, with depression scores decreasing by 0.63 points/year (95% CI, -1.09 to -0.13; P =.01).
The study researchers conclude that “[initiation] of higher efficacy MS therapies is hypothesized to have favorable effects on depressive symptoms in MS patients; analyses incorporating additional follow up from this cohort are ongoing.”
Author EM Mowry reports associations with Biogen, Genzyme, Sun Pharma (contracted research); Teva (received free medication for clinical trial); UpToDate (royalty).
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Roh YS, Mowry EM, Fitzgerald KC. Initiation of higher-efficacy disease-modifying therapy and depressive symptom evolution in patients with multiple sclerosis. Poster presented at: 33rd Annual Meeting of the Consortium of Multiple Sclerosis Centers; May 28-June 1, 2019; Seattle, WA. Abstract DXT62.