Journal Articles Multiple Sclerosis Journal Year : 2025

Association between education level and access to disease-modifying treatment in patients with multiple sclerosis in France

1 EHESP - École des Hautes Études en Santé Publique
2 METIS - Département Méthodes quantitatives en santé publique
3 ARENES - Arènes: politique, santé publique, environnement, médias
4 RSMS - Recherche sur les services et le management en santé
5 ANTICIPE - Unité de recherche interdisciplinaire pour la prévention et le traitement des cancers
6 CHRU Besançon - Centre Hospitalier Régional Universitaire de Besançon
7 CHU ST-E - Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne]
8 CRC-SEP Toulouse - Centre Ressources et Compétences sclérose en plaques (CRC-SEP) [CHU Toulouse]
9 Infinity - Institut Toulousain des Maladies Infectieuses et Inflammatoires
10 CHU Clermont-Ferrand
11 Neuro-Dol - Neuro-Dol
12 Centre d’Investigation Clinique Plurithématique (CIC - P) - CIC Strasbourg
13 APEMAC - Adaptation, mesure et évaluation en santé. Approches interdisciplinaires
14 Service de neurologie [CHRU Nancy]
15 Centre hospitalier intercommunal de Poissy/Saint-Germain-en-Laye - CHIPS [Poissy]
16 CHU Montpellier = Montpellier University Hospital
17 UM - Université de Montpellier
18 U1064 Inserm - CR2TI - Centre de Recherche en Transplantation et Immunologie - Center for Research in Transplantation and Translational Immunology
19 Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Pontchaillou]
20 UR2CA URRIS - UR2CA - URRIS - Unité de Recherche sur le syndrome Radiologique ISolé et maladies apparentées
21 CHU Dijon - Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand
22 TIMONE - Hôpital de la Timone [CHU - APHM]
23 CIC Bordeaux
24 U1215 Inserm - UB - Neurocentre Magendie : Physiopathologie de la Plasticité Neuronale
25 CHU Nîmes - Hôpital Universitaire Carémeau [Nîmes]
26 IGF - Institut de Génomique Fonctionnelle
27 HCL - Hospices Civils de Lyon
28 OFSEP - Observatoire Français de la Sclérose En Plaques [Lyon]
29 UCBL - Université Claude Bernard Lyon 1
30 Fondation Eugène Devic EDMUS
31 LilNCog - Lille Neurosciences & Cognition - U 1172
32 UNICAEN - Université de Caen Normandie
33 CHU Caen Normandie - CHU Caen Normandie – Centre Hospitalier Universitaire de Caen Normandie
34 CIC - Centre d'Investigation Clinique [Rennes]

Abstract

Background: We hypothesized that differences in access to disease-modifying treatments (DMTs) could explain the association between socioeconomic status and disability progression in multiple sclerosis (MS). Objective: This study aimed to analyze the association between education level and DMT use in France. Methods: All patients from OFSEP network with MS onset over 1996–2014 and aged ⩾ 25 years at onset were included. Three time-to-event outcomes were investigated using flexible parametric survival regression models: time from MS onset to first DMT (any) and to platform therapy, and time from platform therapy to switch to high-efficacy therapy. Results: Overall, 7563 patients were included (mean follow-up 12.6 ± 5.9 years). The percentages of patients aged less than 40 years at MS onset and who initiated treatment before the age of 40 years were significantly higher in the groups with a higher education level. The time-to-event outcomes showed no major difference in DMT practices according to education level, except for women who had a significantly shorter time to DMT initiation in medium to very high education level groups versus low, at 5 years from MS clinical onset. Conclusion: Our results suggest that the association between education level and MS disability progression does not solely reflect different therapeutic practices, particularly in men.

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hal-04826502 , version 1 (30-01-2025)

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Mathilde Lefort, Olivier Dejardin, Eric Berger, Jean-Philippe Camdessanché, Jonathan Ciron, et al.. Association between education level and access to disease-modifying treatment in patients with multiple sclerosis in France. Multiple Sclerosis Journal, 2025, 31 (1), pp.69-80. ⟨10.1177/13524585241289276⟩. ⟨hal-04826502⟩
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