Contributions
Abstract: EP1556
Type: ePoster
Abstract Category: Therapy - disease modifying - Others
Background: In the UK, the use of disease modifying therapies (DMT) for multiple sclerosis (MS) is governed by National Health Service regulators who have adopted the Association of British Neurologists" (ABN) criteria for restricting the use of DMT to those patients relapsing more frequently than twice in a two year period. This leaves patients with infrequent relapses off DMT.
Objective: To compare the impact of MS and quality of life in patients receiving or not receiving DMT.
Method: The MS Impact Scale (MSIS) and the WHO QOL Bref were administered in a large cross-sectional survey of patients with clinically definite MS, as part of the TONiC study, a multicentre, UK study of factors affecting quality of life (QOL) in MS. Summed raw scores were converted to interval level data by application of the Rasch measurement model. MSIS and QOL were plotted against disease duration, over 40 years, for patients with relapsing remitting MS (RRMS) either on or off DMT. Non-linear relationships were visualised with local polynomial regression fit and differences confirmed by ANOVA, using disease duration as a covariate.
Results: 857 records were available for analysis. 78% were female, 67% were on a licensed DMT. Physical impact for those on DMT was higher than those off DMT at diagnosis and improved in the first few years but then increased steadily with longer disease duration. Physical impact for those off DMT worsened a little to a level comparable to the DMT group but then remained broadly stable (F13.3, p< 0.001). Psychological impact of MS for those on DMT again improved initially but after a few years steadily increased, whereas, for those off DMT, psychological impact generally improved with disease duration although the difference was non-significant. Physical QOL remained significantly better for those off DMT (F10.6, p=0.001), otherwise there was no difference in psychological, social or environmental QOL.
Conclusion: RRMS patients on DMT have worse physical disease impact and physical QOL at any time of disease duration, when compared to those off DMT. Of course, those patients not on DMT are an auto-selecting population but the guidelines determining that selection would appear to be broadly correct and so to "watch and wait" in patients with relatively inactive disease and treat when MS becomes active would seem to be a valid strategy.
Disclosure: C.A. Young has received honoraria and travel expenses for scientific meetings and advisory boards, or grants from Bayer, Biogen Idec, Merck Serono, Genzyme, Motor Neurone Disease Association, MS Trust, National Institute for Health Research, Novartis, Roche, Teva, and Wellcome Trust.
R.J. Mills has received conference expenses from Biogen Idec, Novartis and Teva.
A. Tennant has nothing to declare.
Abstract: EP1556
Type: ePoster
Abstract Category: Therapy - disease modifying - Others
Background: In the UK, the use of disease modifying therapies (DMT) for multiple sclerosis (MS) is governed by National Health Service regulators who have adopted the Association of British Neurologists" (ABN) criteria for restricting the use of DMT to those patients relapsing more frequently than twice in a two year period. This leaves patients with infrequent relapses off DMT.
Objective: To compare the impact of MS and quality of life in patients receiving or not receiving DMT.
Method: The MS Impact Scale (MSIS) and the WHO QOL Bref were administered in a large cross-sectional survey of patients with clinically definite MS, as part of the TONiC study, a multicentre, UK study of factors affecting quality of life (QOL) in MS. Summed raw scores were converted to interval level data by application of the Rasch measurement model. MSIS and QOL were plotted against disease duration, over 40 years, for patients with relapsing remitting MS (RRMS) either on or off DMT. Non-linear relationships were visualised with local polynomial regression fit and differences confirmed by ANOVA, using disease duration as a covariate.
Results: 857 records were available for analysis. 78% were female, 67% were on a licensed DMT. Physical impact for those on DMT was higher than those off DMT at diagnosis and improved in the first few years but then increased steadily with longer disease duration. Physical impact for those off DMT worsened a little to a level comparable to the DMT group but then remained broadly stable (F13.3, p< 0.001). Psychological impact of MS for those on DMT again improved initially but after a few years steadily increased, whereas, for those off DMT, psychological impact generally improved with disease duration although the difference was non-significant. Physical QOL remained significantly better for those off DMT (F10.6, p=0.001), otherwise there was no difference in psychological, social or environmental QOL.
Conclusion: RRMS patients on DMT have worse physical disease impact and physical QOL at any time of disease duration, when compared to those off DMT. Of course, those patients not on DMT are an auto-selecting population but the guidelines determining that selection would appear to be broadly correct and so to "watch and wait" in patients with relatively inactive disease and treat when MS becomes active would seem to be a valid strategy.
Disclosure: C.A. Young has received honoraria and travel expenses for scientific meetings and advisory boards, or grants from Bayer, Biogen Idec, Merck Serono, Genzyme, Motor Neurone Disease Association, MS Trust, National Institute for Health Research, Novartis, Roche, Teva, and Wellcome Trust.
R.J. Mills has received conference expenses from Biogen Idec, Novartis and Teva.
A. Tennant has nothing to declare.