Contributions
Abstract: P305
Type: Poster
Abstract Category: Clinical aspects of MS - Natural course
Background and Objective: Fatigue is a common symptom in MS, reported by more than 75% of MS patients. In an earlier study we showed that fatigue is not only a common symptom in patients at time of CIS (46%), but also predicts a subsequent diagnosis of CDMS and is associated with a shorter time to a next attack after CIS. Furthermore, in another study, fatigue in patients with MS has been found predictive of disease progression. The first aim of this study was to explore the longitudinal course of fatigue during follow-up after CIS. The second aim was to study the association of fatigue at time of CIS and disability when reaching MS diagnosis.
Methods: In this study 235 CIS patients, aged between 18 and 50 years, were prospectively followed. CIS patients with comorbidities other than depression, which are likely to cause fatigue, were excluded from the analysis. Patients filled in the Krupp"s Fatigue Severity Scale (FSS) at baseline and annually. When they reached CDMS diagnosis, EDSS was also obtained annually. Mixed effects models were used to analyse the longitudinal FSS measurements and to evaluate the association between the baseline FSS and EDSS during follow-up.
Results: In this prospective study 89 out of 235 CIS patients were diagnosed with CDMS (mean follow up 53.1 months (SD ±29.5)). Fatigue at baseline was validated as an independent predictor for CDMS (HR 2.9, 95% CI:1.8-4.9). At time of CIS, patients who were diagnosed with CDMS during follow-up had a significantly higher FSS score than monophasic CIS patients. We found a nonlinear average longitudinal evolution of FSS in time and this evolution was not altered after CDMS diagnosis (p=0.44). However, we found a significant increase of FSS score by 0.86 units when patients experienced a second attack after CIS (p=0.01). Additionally, we found that a high FSS score at baseline (>5.0) showed a trend towards a higher EDSS during follow-up (0.9 points higher EDSS) (p=0.1).
Conclusions: Fatigue, which is often present at time of CIS, persists over time and may increase after a second attack. A high FSS score at CIS might be associated with disability after CDMS diagnosis.
Disclosure:
RM van der Vuurst de Vries: nothing to disclose
JJA van den Dorpel: nothing to disclose
JY Mescheriakova: nothing to disclose
TF Runia: nothing to disclose
N Jafari: nothing to disclose
DAM Siepman: nothing to disclose
D Rizopoulos: nothing to disclose
EW Steyerberg: nothing to disclose
RQ Hintzen: nothing to disclose
Funding
The study was supported by the Dutch MS research Foundation.
Abstract: P305
Type: Poster
Abstract Category: Clinical aspects of MS - Natural course
Background and Objective: Fatigue is a common symptom in MS, reported by more than 75% of MS patients. In an earlier study we showed that fatigue is not only a common symptom in patients at time of CIS (46%), but also predicts a subsequent diagnosis of CDMS and is associated with a shorter time to a next attack after CIS. Furthermore, in another study, fatigue in patients with MS has been found predictive of disease progression. The first aim of this study was to explore the longitudinal course of fatigue during follow-up after CIS. The second aim was to study the association of fatigue at time of CIS and disability when reaching MS diagnosis.
Methods: In this study 235 CIS patients, aged between 18 and 50 years, were prospectively followed. CIS patients with comorbidities other than depression, which are likely to cause fatigue, were excluded from the analysis. Patients filled in the Krupp"s Fatigue Severity Scale (FSS) at baseline and annually. When they reached CDMS diagnosis, EDSS was also obtained annually. Mixed effects models were used to analyse the longitudinal FSS measurements and to evaluate the association between the baseline FSS and EDSS during follow-up.
Results: In this prospective study 89 out of 235 CIS patients were diagnosed with CDMS (mean follow up 53.1 months (SD ±29.5)). Fatigue at baseline was validated as an independent predictor for CDMS (HR 2.9, 95% CI:1.8-4.9). At time of CIS, patients who were diagnosed with CDMS during follow-up had a significantly higher FSS score than monophasic CIS patients. We found a nonlinear average longitudinal evolution of FSS in time and this evolution was not altered after CDMS diagnosis (p=0.44). However, we found a significant increase of FSS score by 0.86 units when patients experienced a second attack after CIS (p=0.01). Additionally, we found that a high FSS score at baseline (>5.0) showed a trend towards a higher EDSS during follow-up (0.9 points higher EDSS) (p=0.1).
Conclusions: Fatigue, which is often present at time of CIS, persists over time and may increase after a second attack. A high FSS score at CIS might be associated with disability after CDMS diagnosis.
Disclosure:
RM van der Vuurst de Vries: nothing to disclose
JJA van den Dorpel: nothing to disclose
JY Mescheriakova: nothing to disclose
TF Runia: nothing to disclose
N Jafari: nothing to disclose
DAM Siepman: nothing to disclose
D Rizopoulos: nothing to disclose
EW Steyerberg: nothing to disclose
RQ Hintzen: nothing to disclose
Funding
The study was supported by the Dutch MS research Foundation.