Impact of Natalizumab on Productivity and Ability to Work in Patients with Multiple Sclerosis in France: The TITAN Study.

Background: The TITAN study examined changes in productivity, ability to work, and quality of life (QoL) before and after treatment with the high-efficacy therapy natalizumab (TYSABRI®) in patients with multiple sclerosis (MS) in France.

Methods: Patients, aged ≥ 18 and < 65 years with relapsing-remitting MS, either naïve to natalizumab or with ≤ 1 prior natalizumab infusion, with paid employment, were evaluated for productivity (number of working hours) in the 12 months prior to and after natalizumab initiation. Changes in annualized relapse rate and Expanded Disability Status Scale (EDSS) score were assessed. Changes in work status, working ability, physical and psychologic functioning, and QoL were also evaluated.

Results: Of 185 enrolled patients, the primary analysis population comprised 162 patients with a mean (SD) age of 36.8 (9.6) years and a baseline mean (SD) EDSS score of 1.9 (1.4). Annual mean (SD) productivity (n = 160) decreased from 1284.4 (503.3) h before natalizumab to 1208.0 (575.3) h (p = 0.05) in the year after natalizumab initiation. Significant improvement was seen in overall activity impairment at 6, 12, and 18 months of natalizumab treatment (p < 0.001). Decreases in annualized relapse rate (p < 0.0001) and EDSS score (p < 0.05) were observed during this period. In addition, treatment-related improvements were observed in presenteeism (reduced work efficiency), overall work impairment, and absenteeism (p < 0.05); significant improvements in psychological and physical impact (p ≤ 0.01) of MS were reported.

Conclusions: These findings suggest that early treatment with natalizumab may improve the work function of patients with MS, thereby decreasing the economic burden of the disease and improving patient quality of life.