Highlights
- •The prevalence of cognitive impairment (CI) in Chinese patients with MS is above 40% at the stage of relapsing-remitting multiple sclerosis (RRMS) and could further increase to over 80% after the progression to secondary-progressive multiple sclerosis (SPMS).
- •Based on the simulations for both disease progression and development of CI in Chinese with newly diagnosed RRMS, over 85% of RRMS patients could develop to CI over their lifetime.
- •The developed CI could make the major contribution to the disease burden of RRMS by substantially increasing mortality, impairing quality of life, and increasing both direct medical costs and indirect costs.
- •The projected heavy disease burden associated with CI in Chinese RRMS patients suggests that routine cognitive function assessment and CI management should be implemented in the management of RRMS.
Abstract
Background
Cognitive impairment (CI) is prevalent in Chinese patients with relapsing-remitting
multiple sclerosis (RRMS).
Methods
A decision analytic model was constructed to simulate Chinese patients with newly
diagnosed RRMS and their matched control cohort without MS for the risks of developing
CI, developing secondary progressive MS (SPMS), and mortality. Both English and Chinese
bibliographic databases were searched for evidence to estimate model inputs. Base
case analysis and sensitivity analysis were conducted for the point estimations and
uncertainty of the measured burden outcomes.
Results
Model simulations estimated that the lifetime cumulative risk of CI in newly diagnosed
RRMS patients was 85.2%. Relative to the matched control cohort, newly diagnosed RRMS
patients were associated with a lower life expectancy (33.2 years vs. 41.7 years,
difference: -8.5 years), lower quality-adjusted life years (QALY) (18.4 QALY vs. 38.4
QALY, difference: -19.9 QALY), and higher lifetime medical costs (¥613,883 vs. ¥202,726,
difference: ¥411,157) and indirect costs (¥1,099,021 vs. ¥94,612, difference: ¥1,004,410).
Patients who developed CI accounted for at least half of the measured burden. The
disease burden outcomes were mainly driven by the risk of developing CI, progression
risk from RRMS to SPMS, hazard ratios of mortality associated with CI relative to
no CI, utility of patients with RRMS, annual relapse risk, and annual costs of personal
care.
Conclusion
Most Chinese patients with newly diagnosed RRMS are likely to develop CI in their
lifetime, and such patients that develop CI could significantly contribute to the
disease burden of RRMS.
Keywords
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Article info
Publication history
Published online: March 20, 2023
Accepted:
March 18,
2023
Received in revised form:
February 2,
2023
Received:
October 11,
2022
Footnotes
☆This study has been accepted for poster presentation at the ECTRIMS 2022 Congress.
Identification
Copyright
© 2023 Elsevier B.V. All rights reserved.
