Employment has many benefits beyond the financial, playing an important role in improving quality of life. Being in work can provide opportunities for social interaction and a sense of purpose – just two of the reasons that employment features among MSIF’s seven principles to improve quality of life.
In the past, studies have shown that people with MS are much more likely to drop out of employment than people with other chronic conditions, and the general public more broadly. However, recent studies have shown that this gap is beginning to close, with employment outcomes improving for people with MS.
New research, conducted by staff at the Menzies Institute for Medical Research, Australia, has used data from MS Research Australia’s Australian MS Longitudinal Study to explore whether the use of disease-modifying therapies has played a role in this improvement in employment retention for people with MS.
The results, published in the Journal of Neurology, Neurosurgery, and Psychiatry, showed that people taking high-efficacy disease-modifying therapies were 2-3 times more likely to report improved employment outcomes than those on the lower-efficacy first generation MS treatments.
The research was led by Ms Jing Chen, Associate Professor Ingrid van der Mei and other colleagues at the Menzies Institute. Participating in the study were 874 individuals who had previously contributed to the Australian MS Longitudinal Study. This group was a representative cohort of Australian people with MS who regularly answer longitudinal surveys. For this study, participants were asked about their use of disease-modifying therapies in the previous 5 years and about any changes in work-related outcomes over that period.
Disease-modifying therapies were classified into three groups based on their clinical efficacy: β-interferons and glatiramer acetate as category 1; teriflunomide and dimethyl fumarate as category 2; and fingolimod, natalizumab, alemtuzumab and mitoxantrone as category 3. These category 3 medications are considered to be more efficacious based on the clinical trial results, which showed strong suppression of relapses, MRI lesions and disability accumulation.
Impact on employment
The results showed that, whilst many participants did not report any changes to their employment outcomes, those who took the category 3 therapies (mainly represented by fingolimod and natalizumab) were 2.84 times more likely to report an increased amount of work, 3.14 times more likely to report an increased work attendance and 2.5 times more likely to report improved work productivity, compared to those who used β-interferons and glatiramer acetate.
It is important to note that these results examined groups of people taking disease-modifying therapies, as opposed to individual cases of people taking disease-modifying therapies. Many individuals did respond very well to therapies categorised here as ‘lower efficacy’, which reflects the fact that MS can be a very varied disease and each individual with MS can respond differently to different medications. For each individual, many personal factors need to be taken into consideration when choosing a medication, so it is important for people with MS to discuss with a neurologist the most appropriate medication for their circumstances.
With thanks to MS Research Australia – the lead provider of research summaries on our website.