How effective are disease modifying drugs in treating multiple sclerosis?


building blocks with health iconsData access has been approved for the first study designed specifically to investigate both long-term effectiveness and potential adverse drug effects of the full spectrum of disease modifying drugs (DMDs) used to treat multiple sclerosis (MS).

Canada has one of the world's highest rates of multiple sclerosis (MS), a chronic disease of the brain and spinal cord which often starts in young adulthood, and for which there is no cure. In the last two decades, over 10 different drugs have been approved to treat people with MS. DMDs can cost from $20,000 to $40,000 or more, per MS patient, per year, and their combined costs are expected to rise as the choice and availability of DMDs increases.

"We know how well these drugs work in the short-term from randomized clinical trials", says study lead, Professor Helen Tremlett, of the Djavad Mowafaghian Centre for Brain Health, Faculty of Medicine (Neurology), at the University of British Columbia. "In the real world though, people with MS may take these drugs for many years. We do not yet understand all their possible benefits and adverse effects when taken long-term. Few studies as large as ours have looked at the range of possible adverse effects, including cancer, stroke and depression. We will also look at whether the MS drugs have benefits which are often hard to measure, such as fewer hospitalizations or doctors visits."

The research project brings together medical data collected for over 20 years within multiple large health databases in five Canadian provinces, making it the largest ever study of real-world multiple sclerosis drug safety and effectiveness in terms of patient numbers, wealth of data and duration of follow-up.

Our study findings will facilitate much needed evidence informed decision-making surrounding the use of the MS DMDs in clinical practice and may allow for future initiatives, such as a targeted approach to the prevention of specific adverse effects and cost-effectiveness evaluations. Ultimately, we hope to benefit treatment-related outcomes for the 90,000+ people living with MS in Canada, Professor Tremlett concludes.

For the British Columbia (BC) study population, PopData will link five data sets from the BC Ministry of Health with data sets from the BC Vital Statistics Agency, Immigration, Refugees and Citizenship Canada and the BC Multiple Sclerosis Database.

The project is funded by the Canadian Institutes of Health Research (CIHR).