Article Dans Une Revue Multiple Sclerosis Journal Année : 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 [EHESP]
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 INSERM U1086
6 CHRU Besançon - Centre Hospitalier Régional Universitaire de Besançon
7 CHU ST-E - Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne]
8 CHU Toulouse - Centre Hospitalier Universitaire de Toulouse
9 UT3 - Université Toulouse III - Paul Sabatier
10 CHU Clermont-Ferrand
11 Centre d’Investigation Clinique Plurithématique (CIC - P) - CIC Strasbourg
12 CHU Nancy - Centre Hospitalier Universitaire de Nancy
13 APEMAC - Adaptation, mesure et évaluation en santé. Approches interdisciplinaires
14 hôpital de Poissy-Saint-Germain-en Laye
15 CHU Montpellier = Montpellier University Hospital
16 U1064 Inserm - CR2TI - Centre de Recherche en Transplantation et Immunologie - Center for Research in Transplantation and Translational Immunology
17 Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Pontchaillou]
18 CHU - Hôpital Pasteur [Nice]
19 CHU Dijon
20 TIMONE - Hôpital de la Timone [CHU - APHM]
21 CIC Bordeaux
22 CHU Nîmes - Hôpital Universitaire Carémeau [Nîmes]
23 IGF - Institut de Génomique Fonctionnelle
24 HCL - Hospices Civils de Lyon
25 OFSEP - Observatoire Français de la Sclérose En Plaques [Lyon]
26 UCBL - Université Claude Bernard Lyon 1
27 LilNCog - Lille Neurosciences & Cognition - U 1172
28 UNICAEN - Université de Caen Normandie
29 CIC - Centre d'Investigation Clinique [Rennes]
Olivier Dejardin
  • Fonction : Auteur
Jerome de Sèze
  • Fonction : Auteur
Thibault Moreau
  • Fonction : Auteur
Aurélie Ruet

Résumé

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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