Which treatment makes my multiple sclerosis patient happiest? (Predictors of quality of life ratings, self-reported fatigue and psychiatric comorbidities in relapsing-remitting multiple sclerosis)

Multiple sclerosis (MS) is a common cause of neurological impairment in younger adults and has a major impact on quality of life and the ability to be active professionally and socially.

MS not only reduces psychosocial functioning, but it also increases the risk of psychiatric problems, including depression and suicide.Several treatments are approved to reduce inflammation and worsening in MS, but it is unknown how they affect quality of life and psychiatric comorbidities, even though this is ranked as the most important issue by MS patients.

One promising MS treatment is rituximab, the most commonly prescribed MS treatment in Sweden, despite not being approved for MS but for rheumatoid arthritis and some B-cell related cancers.

Several studies have shown that rituximab is more tolerable and effective while considerably cheaper than all other approved MS treatments.

The purpose of my project is to investigate how quality of life and psychological well-being are affected in relation to a variety of treatments and epidemiological factors.

In preliminary data, I have seen that the risk of depression or antidepressant treatment is halved for those starting treatment with rituximab compared to recommended first-line drugs.

In future studies, I will have access to high quality information from the world´s largest observational MS drug study, which is conducted in Sweden and will give me a unique opportunity to generate knowledge about how MS treatments affect quality of life and psychological well-being in relation to traditional measures of illness.

If we can show that rituximab is equal or better than other drugs, this might become the first line of treatment not just in Sweden but also in countries with restricted access to costly treatments.