Does DMF Cut Multiple Sclerosis-Related Workplace Productivity Decline?

VANCOUVER, BC—Delayed-release dimethyl fumarate (DMF) is associated with better control of multiple sclerosis (MS)-associated declines in work productivity than the injectable platform therapies, such as interferon-β and glatiramer acetate, a study reported at the 68^th AAN Annual Meeting.

“Compared with patients receiving platform therapy, patients on DMF had a significantly lower work productivity loss as measured by WPAI-MS [Work Productivity and Activity Impairment questionnaire],” reported lead study author Ravi G. Iyer, MD, of Biogen in Cambridge, MA.

“Initiating patients with relapsing-remitting MS on DMF may be associated with a reduced patient burden compared with patients initiated on platform therapy,” he stated.

The study objective was “to compare real-world work productivity impairment in patients with MS initiated on DMF vs. interferon-β (1a/b) or glatiramer acetate platform therapy in routine clinical practice.”

Dr. Iyer and coauthors analyzed data from the Adelphi MS Disease Specific Programme, a cross-sectional study of patients with MS in five EU countries and U.S., to identify those with relapsing-remitting MS who were administered DMF or platform therapies for longer than 12 months.

They compared work productivity for 160 patients and daily activity impairment for 243 patients, as measured by WPAI-MS, across treatment arms.

Regression models were adjusted for age, gender, Expanded Disability Status Scale score at current treatment initiation, body mass index, duration of current treatment, line of therapy, time since MS diagnosis, and number of comorbid conditions.

“Overall work impairment due to MS was significantly lower in the DMF cohort (7.0%) compared with patients on platform therapy (20.92%; average treatment effect [ATE] -13.92%, P<0.001),” the researchers stated. In addition, “impairment due to MS while working (“presenteeism”) was significantly lower in the DMF cohort vs. the platform therapy cohort (6.45% vs. 19.45%; ATE -12.97%, P<0.001).”

Work missed, or “absenteeism,” was 0% in the DMF cohort compared with 2.06% for the platform therapy cohort (ATE -2.06%, P=0.012).

They also found that daily activity impairment was significantly lower in the DMF cohort, 8.04%, compared with platform therapy, 25.31% (ATE -17.26%; P<0.001).