The clinical and socioeconomic impact of relapses in multiple sclerosis

Wynford-Thomas, Rachael 2024. The clinical and socioeconomic impact of relapses in multiple sclerosis. PhD Thesis, Cardiff University. Item availability restricted.

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Abstract

Relapses are a primary outcome measure in multiple sclerosis (MS) and help guide treatment with disease-modifying therapies (DMTs). Given the increasing availability of DMTs over the last 20 years, there is need for contemporary clinical and socioeconomic data on how DMT use has affected relapse patterns, to help inform patients in decision-making, key stakeholders, and the cost-effectiveness of DMTs. Using prospectively collected 20-year longitudinal population data, alongside a more in-depth prospective analysis of those presenting with a relapse, we aimed to describe the correlation between relapse patterns and DMT use, the contribution of relapses to sustained accumulation of disability and disutility in MS, explore predictors of relapse severity and recovery, and determine the costs associated with a relapse in the current era. Our research shows that although there is a notable decline in relapse rates over time, relapses continue to lead to an accumulation of disability and disutility that often persist after medium-term follow-up. This change in ability results in a substantial economic burden to the patient, National Health Service and social services. Despite their expense and side-effects, our findings support the use of DMTs, which in our 20-year study appear to be associated with a higher chance of complete recovery from relapse, and reduced frequency of relapses. Our findings will have value for clinical practice and economic valuation studies. Clinicians should be encouraged by the evidence supporting DMTs in improving patient outcomes. Additionally, our findings suggest that multi-disciplinary team management strategies are essential to tackle the multifaceted impact of relapses. Our research highlights the potential cost-effectiveness of DMTs which may lower overall healthcare costs and productivity losses. This information is useful for policymakers and healthcare providers when making decisions about resource allocation and funding for MS treatments.

Item Type:	Thesis (PhD)
Date Type:	Completion
Status:	Unpublished
Schools:	Schools > Medicine
Funders:	Novartis
Date of First Compliant Deposit:	26 February 2025
Last Modified:	26 Feb 2025 09:47
URI:	https://orca.cardiff.ac.uk/id/eprint/176486

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