Impact of natalizumab on quality of life in a real-world cohort of patients with multiple sclerosis: Results from MS PATHS

Carrie M. Hersh, Bernd Kieseier, Carl de Moor, Deborah M. Miller, Denise Campagnolo, James R. Williams, Kathryn C. Fitzgerald, Kuangnan Xiong, Marisa P. McGinley, Megan Hyland, Richard A. Rudick, Tjalf Ziemssen, Irene Koulinska

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Optimizing multiple sclerosis treatment warrants understanding of changes in physical, mental, and social health. Objective: To assess the impact of natalizumab on Quality of Life in Neurological Disorders (Neuro-QoL) scores. Methods: Annualized change in T-scores and likelihood of ≥5-point improvement over baseline were calculated for each Neuro-QoL domain after natalizumab initiation. Comparisons with ocrelizumab-treated patients were conducted after propensity score weighting and adjustment for relevant co-medications, year, and drug-year interaction. Results: Among 164 natalizumab patients analyzed, 8 of 12 Neuro-QoL domains improved significantly, with greater improvement in patients with abnormal baseline Neuro-QoL. In the subgroup comparison of natalizumab-treated (n = 145) and ocrelizumab-treated (n = 520) patients, significant improvement occurred in 9 of 12 and 4 of 12 domains, respectively. The difference between groups was statistically significant for positive affect and well-being (p = 0.02), sleep (p = 0.003), and satisfaction with social roles and activities (SRA) (p = 0.03) in the overall population and for emotional and behavioral dyscontrol (p = 0.01), participation in SRA (p = 0.0001), and satisfaction with SRA (p = 0.02) in patients with abnormal baseline Neuro-QoL. Conclusions: Natalizumab can produce clinically meaningful improvements in mental and social health. Such improvements are unlikely to be primarily driven by expectation bias, as their magnitude exceeded improvements with another high-efficacy therapy, ocrelizumab.

Original languageEnglish (US)
JournalMultiple Sclerosis Journal - Experimental, Translational and Clinical
Volume7
Issue number2
DOIs
StatePublished - 2021

Keywords

  • Natalizumab
  • Neuro-QoL
  • depression
  • fatigue
  • multiple sclerosis
  • sleep

ASJC Scopus subject areas

  • Clinical Neurology
  • Cellular and Molecular Neuroscience

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