MS Progresses, Income Drops, Swedes Find

Without treatment, the course of relapsing-remitting multiple sclerosis (RRMS) is generally downward, as RRMS converts to more serious forms of the disease.

A study of MS patients in Sweden found that the deterioration steadily takes patients’ income levels down with it.

Writing in PLOS One, Andrius Kavaliunas and colleagues said they looked at patients in the nationwide Swedish Multiple Sclerosis Register to get information about people diagnosed with MS, their age at on set, and the clinical course of their illness.

They cross-referenced this information with data on socio-demographic variables, and income.

In Sweden all residents have a unique personal identification number, so it was possible to link the data.

They found that the more serious their form of MS, the lower patients’ incomes were.

Of the 6,890 patients in their study, 5,018 (72.8%) had RRMS, 1,410 (20.5%) had secondary progressive MS (SPMS), and 462 (6.7%) had primary progressive MS (PPMS).

There were relatively few younger patients with PPMS or SPMS, so to see if there was a difference in outcomes based on income the team looked only at a cohort of older patients (40 to 60 years old).

“It is clearly seen, that in this age interval RRMS and SPMS patients’ earnings were very different,” the researchers said.

The overall mean among MS patients of 40—60 years was SEK (Swedish Krona) 221,857 and SEK 88,782 for RRMS and SPMS patients, respectively), while PPMS patients´ earnings with age became more similar to those of SPMS patients (the mean among MS patients of 40–60 years was SEK 130,831). Using the exchange rate at the time of the study, one US dollar equaled 7.2 SEK.

The study also showed that as the MS progressed, patients’ incomes were not only lower but a greater portion of them came from government benefits as opposed to earnings.

Patients with SPMS, the most serious form of the disease, had the lowest proportion of income from earnings (41.9% or a median SEK 79,800) and that patients with RRMS, the least serious form, earned almost twice as much as PPMS and SPMS patients.

The numbers were adjusted for age, gender, education and other covariates.

“Altogether this study contributes with the insight on MS patients’ financial situation and to our knowledge, this is the first study to examine how MS patients’ income is associate with different disease phenotypes,” the team concluded.

The findings “highlight the socioeconomic importance of preventing RRMS patients [converting] to SPMS.

The PLOS study is called “Income in Multiple Sclerosis Patients with Different Disease Phenotypes.”