Tysabri infusion improves working ability for RRMS patients: Study
New TITAN data show less missed work time, better efficiency with treatment
One year of Tysabri (natalizumab) improves working ability among people with relapsing-remitting multiple sclerosis (RRMS), according to new data from TITAN, an observational study launched by researchers in France to assess the impact of the approved infusion therapy.
Treatment also lessened missed work time, reduced work efficiency, and overall work impairment due to multiple sclerosis (MS), according to the researchers. TITAN participants whose condition improved with treatment tended to work more hours than those who remained stable or worsened, the data showed.
Tysabri infusion also was found to improve life quality for the RRMS patients taking part in the study.
“Overall work impairment and overall activity impairment decreased with [Tysabri] treatment, and people with MS on [Tysabri] reported reduced physical and psychologic impact of MS,” the researchers wrote.
Their study, “Impact of Natalizumab on Productivity and Ability to Work in Patients with Multiple Sclerosis in France: The TITAN Study,” was published in the journal Neurology and Therapy.
Significant improvements seen for patients at 6, 12 and 18 months
MS is an inflammatory condition marked by damage to certain parts of the brain and spinal cord, resulting in neurological symptoms such as walking difficulties, numbness and tingling, pain, excessive fatigue, and vision problems.
While the condition can arise at any age, MS most commonly manifests in people between the ages of 20 and 40, a time when most adults are working. Accordingly, most MS patients in France — 8 of every 10 in one study in the country — reported that the condition negatively impacted their work productivity.
In recent years, disease-modifying therapies, known as DMTs, have positively impacted the working ability of people with MS.
Now, a team of researchers in France specifically launched TITAN to gauge the impact of the DMT Tysabri on the work productivity of employed adults with RRMS. Biogen, the company that markets the medicine, sponsored the study.
All 162 RRMS patients in the study were receiving Tysabri for the first time or had been given no more than one treatment infusion before the study. The mean age of the participants was 36.8, and slightly more than three-quarters were women.
In the year before starting Tysabri, most patients (80.6%) experienced relapses, with about half (48.1%) reporting one relapse.
According to the researchers, “significant improvement was seen in overall activity impairment” — meaning impairments were lessened — at six months, one year, and 1.5 years after starting treatment.
Psychological impact of RRMS seen to ease with Tysabri infusion
The team noted that the number of working hours markedly dropped from Tysabri initiation through one year of treatment, during the time of the COVID-19 lockdown in the country (mean 1,224.9 vs. 808.3 hours), demonstrating a drop in “annual mean … productivity.”
“Work productivity after the lockdown was substantially decreased, suggesting that this reduction in productivity at 12 months [the primary outcome] may be related to the lockdown,” the researchers wrote.
In patients with stable disease, as assessed by scores on the Expanded Disability Status Scale (EDSS), working hours per year decreased by 76.9 after one year of Tysabri and by 315 hours among those with worsening disability. Conversely, patients with less disability worked 190.7 hours more per year after starting Tysabri.
In patients with sick leave related to MS in the year before Tysabri, the annual productivity remained stable the year after (mean 1,298 vs. 1,247 hours). At 12 months, the proportion of patients who took at least one period of sick leave was similar to before treatment (64.2% vs. 66%), but was higher among those who took at least three sick leave periods (19.1% vs. 10.5%).
One year of Tysabri significantly attenuated time missed from work (mean 25.3% vs. 17%), reduced work efficiency (mean 25.2% vs. 18.4%), overall work impairment (mean 26.4% vs. 19.1%), and overall activity impairment (mean 37% vs. 26.3%), as measured by the WPAI-MS questionnaire.
These findings suggest that early treatment with [Tysabri] may improve the work function of patients with MS, thereby decreasing the economic burden of the disease and improving patient quality of life.
In quality of life measures, the psychological impact of RRMS lessened after 12 months of Tysabri, as indicated by a drop in scores on the Multiple Sclerosis Impact Scale (mean 31.8 vs. 26.7 points). Physical impact scores also improved (mean 19.4 vs. 16.7 points). As assessed with the EQ-5D-3L, quality of life scores remained stable.
In clinical measures, the number of relapses per year significantly decreased before and after Tysabri (1.2 vs. 0.1). While EDSS scores for disability improved overall with Tysabri, there was no change in EDSS scores for most patients (77.4%) after one year of treatment.
According to the researchers, within six months of starting on Tysabri infusion, “patients in France reported improved work function, as noted by decreases in absenteeism, … overall work impairment, and overall activity impairment. … These improvements were maintained at 18 months of follow-up.”
Overall, the team concluded, “these findings suggest that early treatment with [Tysabri] may improve the work function of patients with MS, thereby decreasing the economic burden of the disease and improving patient quality of life.”
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