Abstract: P778
Type: Poster
Abstract Category: Therapy - symptomatic - Quality of life
Background: The Timed 25-Foot Walk (T25FW) is a simple and quick walking test that is frequently used as a quantitative mobility performance test for multiple sclerosis (MS) patients. Studies have reported that a 20% increase in T25FW is indicative of significant gait and disease worsening.
Objective: To identify predictors of T25FW worsening in an ageing MS sample.
Methods: This is a retrospective study of subjects enrolled in the New York State MS Consortium (NYSMSC), a 20-year longitudinal, population-based registry of MS patients. In this study, patients 60 years or over at their most recent follow-up and with a disease duration of ≥15 years were analysed. Time to complete the T25FW test was compared between baseline and a follow-up visit 5 years later. Worsening was defined as a 20% increase in time to complete the test. Independent samples t-tests and chi-square tests were used to investigate group differences. Logistic regression analyses were carried out to adjust for covariates.
Results: Of the 272 patients in our database with complete data, 119 (43.8%) had a 20% increase in time it took to complete the T25FW. At year 5, those who worsened had a mean score of 20.7±20.8 seconds, while subjects who did not worsen had a mean score of 8.3±6.3 seconds, and baseline scores were similar between the groups (9.1±7.0 seconds vs 9.2±7.9 seconds, respectively). There were no differences in age, sex, disease duration, DMT use, or self-reported physical difficulties between subjects with a worsening in T25FW compared to those who did not. Patients who worsened had higher Kurtzke Expanded Disability Status Scale (EDSS) scores at baseline (3.9±1.6 vs 3.4±1.7, p=.023) and were more likely to report feeling lonely (12.6% vs 4.7%, p=.017) and pessimistic (25.2% vs 14.6%, p=.028). Furthermore, patients who had worsened T25FW scores also had higher EDSS scores at year 5 (5.3±15 vs 3.8±1.7, p< .001). Results remained significant after adjusting for age, disease duration, and marital status.
Conclusion: Loneliness and pessimism, a hallmark of neuroticism, in addition to higher EDSS scores at study enrolment were predictive of T25FW worsening over 5 years in a sample of MS patients with a disease duration of 15 years or longer supporting the need for neurobehavioural evaluation and counselling.
Disclosure:
Bianca Weinstock-Guttman: received personal compensation for consulting, speaking and serving on a scientific advisory board for Biogen Idec, Teva Neuroscience, EMD Serono, Novartis, Questcor and Genzyme& Sanofi and has received financial support for research activities from NMSS, NIH (not for the present study), ITN, Teva Neuroscience, Biogen Idec, EMD Serono, Aspreva, Novartis, Genzyme.
Katelyn Kavak: nothing to disclose.
Aisha Bushra: nothing to disclose.
Katia Noyes: nothing to disclose.
Patricia Coyle: receives consulting fees from AbbVie, Accordant, Acorda, Bayer, Biogen, Genentech/Roche, Genzyme/Sanofi, Mallinckrodt, Novartis, Serono, and Teva. She also receives research support from Actelion, Genentech/Roche, NINDS, Novartis, and Opexa.
Lauren Krupp: received either consulting fees, honoraria, or royalty payments from the following: Biogen, Pfizer, Teva Neurosciences, EMD Serono, Janseen, Biogen, Novartis, Abbvie.
Andrew Goodman: received personal compensation for consulting from the following commercial entities: Abbvie, Acorda Therapeutics, Atara, Bayer, Biogen Idec, Genentech, Sanofi Genzyme, Novartis, Purdue, Teva. Dr. Goodman´s employer, the University of Rochester, received research support for conducting clinical trials from the following commercial entities: Acorda Therapeutics, Avanir, Biogen-Idec, EMD-Serono, Novartis, Ono, Roche, Sanofi Genzyme, Sun Pharma, Teva.
Burk Jubelt: received Clinical Trial Grants from: Sanofi-Aventis (Relapsing MS/Teriflunomide), Genzyme (MS/Alemtuzumab), Novartis (Secondary Progressive MS/Fingolimod/Siponimod), Grifols (Post Polio Syndrome/Flebogamma), Receptos (MS/RPC1063), NY Stem Cell Program (Secondary Progressive MS), NIH/NINDS (SUNY Next Clinical Site), Clinical Studies: Biogen-Idec, Continuing Medical Education Speaker:CMEducation Resources LLC,Prime Education, Inc., Patient Education Speaker: National Multiple Sclerosis Society, Multiple Sclerosis Resources of Central New York.
Keith Edwards: Consulting services: Biogen, Genzyme. Speaker bureaus: Biogen, Genzyme. Research support: Actelion, Biogen, Eisai, Eli Lilly, Forum Pharmaceuticals, Genentech, Genzyme/Sanofi, Hoffmann-La Roche, Merz Pharmaceuticals, Novartis, Pfizer, Vaccinex.Malcolm Gottesman: has served as a consultant for Biogen, Teva, and Genzyme.
Ralph Benedict: receives research support from Biogen, Novartis, Genzyme, Acorda and Mallinckrodt, provides consultation for Biogen, Genentech, Teva, Novartis, and Sanofi, and conducts CME for EMD Serono.
Caila Vaughn: nothing to disclose.
Abstract: P778
Type: Poster
Abstract Category: Therapy - symptomatic - Quality of life
Background: The Timed 25-Foot Walk (T25FW) is a simple and quick walking test that is frequently used as a quantitative mobility performance test for multiple sclerosis (MS) patients. Studies have reported that a 20% increase in T25FW is indicative of significant gait and disease worsening.
Objective: To identify predictors of T25FW worsening in an ageing MS sample.
Methods: This is a retrospective study of subjects enrolled in the New York State MS Consortium (NYSMSC), a 20-year longitudinal, population-based registry of MS patients. In this study, patients 60 years or over at their most recent follow-up and with a disease duration of ≥15 years were analysed. Time to complete the T25FW test was compared between baseline and a follow-up visit 5 years later. Worsening was defined as a 20% increase in time to complete the test. Independent samples t-tests and chi-square tests were used to investigate group differences. Logistic regression analyses were carried out to adjust for covariates.
Results: Of the 272 patients in our database with complete data, 119 (43.8%) had a 20% increase in time it took to complete the T25FW. At year 5, those who worsened had a mean score of 20.7±20.8 seconds, while subjects who did not worsen had a mean score of 8.3±6.3 seconds, and baseline scores were similar between the groups (9.1±7.0 seconds vs 9.2±7.9 seconds, respectively). There were no differences in age, sex, disease duration, DMT use, or self-reported physical difficulties between subjects with a worsening in T25FW compared to those who did not. Patients who worsened had higher Kurtzke Expanded Disability Status Scale (EDSS) scores at baseline (3.9±1.6 vs 3.4±1.7, p=.023) and were more likely to report feeling lonely (12.6% vs 4.7%, p=.017) and pessimistic (25.2% vs 14.6%, p=.028). Furthermore, patients who had worsened T25FW scores also had higher EDSS scores at year 5 (5.3±15 vs 3.8±1.7, p< .001). Results remained significant after adjusting for age, disease duration, and marital status.
Conclusion: Loneliness and pessimism, a hallmark of neuroticism, in addition to higher EDSS scores at study enrolment were predictive of T25FW worsening over 5 years in a sample of MS patients with a disease duration of 15 years or longer supporting the need for neurobehavioural evaluation and counselling.
Disclosure:
Bianca Weinstock-Guttman: received personal compensation for consulting, speaking and serving on a scientific advisory board for Biogen Idec, Teva Neuroscience, EMD Serono, Novartis, Questcor and Genzyme& Sanofi and has received financial support for research activities from NMSS, NIH (not for the present study), ITN, Teva Neuroscience, Biogen Idec, EMD Serono, Aspreva, Novartis, Genzyme.
Katelyn Kavak: nothing to disclose.
Aisha Bushra: nothing to disclose.
Katia Noyes: nothing to disclose.
Patricia Coyle: receives consulting fees from AbbVie, Accordant, Acorda, Bayer, Biogen, Genentech/Roche, Genzyme/Sanofi, Mallinckrodt, Novartis, Serono, and Teva. She also receives research support from Actelion, Genentech/Roche, NINDS, Novartis, and Opexa.
Lauren Krupp: received either consulting fees, honoraria, or royalty payments from the following: Biogen, Pfizer, Teva Neurosciences, EMD Serono, Janseen, Biogen, Novartis, Abbvie.
Andrew Goodman: received personal compensation for consulting from the following commercial entities: Abbvie, Acorda Therapeutics, Atara, Bayer, Biogen Idec, Genentech, Sanofi Genzyme, Novartis, Purdue, Teva. Dr. Goodman´s employer, the University of Rochester, received research support for conducting clinical trials from the following commercial entities: Acorda Therapeutics, Avanir, Biogen-Idec, EMD-Serono, Novartis, Ono, Roche, Sanofi Genzyme, Sun Pharma, Teva.
Burk Jubelt: received Clinical Trial Grants from: Sanofi-Aventis (Relapsing MS/Teriflunomide), Genzyme (MS/Alemtuzumab), Novartis (Secondary Progressive MS/Fingolimod/Siponimod), Grifols (Post Polio Syndrome/Flebogamma), Receptos (MS/RPC1063), NY Stem Cell Program (Secondary Progressive MS), NIH/NINDS (SUNY Next Clinical Site), Clinical Studies: Biogen-Idec, Continuing Medical Education Speaker:CMEducation Resources LLC,Prime Education, Inc., Patient Education Speaker: National Multiple Sclerosis Society, Multiple Sclerosis Resources of Central New York.
Keith Edwards: Consulting services: Biogen, Genzyme. Speaker bureaus: Biogen, Genzyme. Research support: Actelion, Biogen, Eisai, Eli Lilly, Forum Pharmaceuticals, Genentech, Genzyme/Sanofi, Hoffmann-La Roche, Merz Pharmaceuticals, Novartis, Pfizer, Vaccinex.Malcolm Gottesman: has served as a consultant for Biogen, Teva, and Genzyme.
Ralph Benedict: receives research support from Biogen, Novartis, Genzyme, Acorda and Mallinckrodt, provides consultation for Biogen, Genentech, Teva, Novartis, and Sanofi, and conducts CME for EMD Serono.
Caila Vaughn: nothing to disclose.