Contributions
Abstract: P871
Type: Poster
Abstract Category: Clinical aspects of MS - MS symptoms
Background: The effect of multiple sclerosis (MS) on physical functioning has been well studied, and the Expanded Disability Status Scale (EDSS) shows strong correlation with costs and health-related quality of life (HRQoL). The additional effect of mental and psychological factors on overall well-being is less well documented.
Objectives: The main study objective was to collect current information on the burden of illness of MS across Europe. Here we investigate cognition and fatigue in MS and their effect on HRQoL at all disease stages.
Methods: 16,400 patients from 16 countries provided cross-sectional data on demographics, disease severity, relapses, disease symptoms and their impact on productivity, resource use and HRQoL. Cognition and fatigue were assessed using visual analogue scales (VAS; 0=no problems, 10=extreme problems). The impact of MS on productivity was assessed with descriptive questions. HRQoL was measured with the EQ-5D and responses were evaluated for the individual domains and translated to utility weights (1=perfect health, 0=death).
Results: In the first 13,844 patients from 10 countries, mean age was 52±12 years, 74% women, 42/35/21% had EDSS 0-3/4-6.5/7-9, and 12% overall had experienced a relapse in the last 3 months. Cognitive problems and fatigue were present at all disease severity levels. 73% of patients reported cognitive problems, with mean VAS scores of 4.4±2.1 at EDSS 0-3, 4.9±2.1 at EDSS 4-6.5 and 5.3±2.3 at EDSS 7-9. Mean VAS scores for fatigue within the last 48 hours, reported by 98%, were 5.0±2.5, 5.9±2.2, and 6.0±2.4, respectively. A VAS score of ≥5 was reported by 40% for cognitive problems and by 69% for fatigue. Among employed patients, 79% felt that their productivity at work was reduced, with fatigue being the most common reason (81%); cognition was mentioned by 42%. The most affected HRQoL dimensions were pain/discomfort (77% reporting problems), usual activities (74%) and mobility (72%). Mean utility ranged from 0.9±0.1 at EDSS 0 to -0.2±0.2 at EDSS 9. Both fatigue and cognitive problems showed moderate negative correlations with utility (r=-0.385 and -0.335, p< 0.001, respectively).
Conclusion: In this large European sample of MS patients covering the entire disease severity spectrum a majority experienced fatigue and cognitive problems. While HRQoL deteriorated with advancing disease, fatigue and cognitive problems were present at all disease severity levels and impacted HRQoL significantly.
Disclosure: The study is funded by Biogen Inc.
Gisela Kobelt: received consulting fees from Biogen, Genzyme/Sanofi, Merck Serono, Novartis, Roche and Teva
Jenny Berg: working for consultancy performing projects for pharmaceutical companies
Mia Gannedahl: working for consultancy performing projects for pharmaceutical companies
Jennifer Eriksson: working for consultancy performing projects for pharmaceutical companies
Alan Thompson: received honoraria/support for travel for consultancy from Eisai, Excemed, MedDay, support for travel from the International Progressive MS Alliance (chair, Scientific Steering Committee), from the National MS Society (USA) (member, Research Programs Advisory Committee), and an honorarium from SAGE Publishers (Editor-in-Chief for Multiple Sclerosis Journal)
Abstract: P871
Type: Poster
Abstract Category: Clinical aspects of MS - MS symptoms
Background: The effect of multiple sclerosis (MS) on physical functioning has been well studied, and the Expanded Disability Status Scale (EDSS) shows strong correlation with costs and health-related quality of life (HRQoL). The additional effect of mental and psychological factors on overall well-being is less well documented.
Objectives: The main study objective was to collect current information on the burden of illness of MS across Europe. Here we investigate cognition and fatigue in MS and their effect on HRQoL at all disease stages.
Methods: 16,400 patients from 16 countries provided cross-sectional data on demographics, disease severity, relapses, disease symptoms and their impact on productivity, resource use and HRQoL. Cognition and fatigue were assessed using visual analogue scales (VAS; 0=no problems, 10=extreme problems). The impact of MS on productivity was assessed with descriptive questions. HRQoL was measured with the EQ-5D and responses were evaluated for the individual domains and translated to utility weights (1=perfect health, 0=death).
Results: In the first 13,844 patients from 10 countries, mean age was 52±12 years, 74% women, 42/35/21% had EDSS 0-3/4-6.5/7-9, and 12% overall had experienced a relapse in the last 3 months. Cognitive problems and fatigue were present at all disease severity levels. 73% of patients reported cognitive problems, with mean VAS scores of 4.4±2.1 at EDSS 0-3, 4.9±2.1 at EDSS 4-6.5 and 5.3±2.3 at EDSS 7-9. Mean VAS scores for fatigue within the last 48 hours, reported by 98%, were 5.0±2.5, 5.9±2.2, and 6.0±2.4, respectively. A VAS score of ≥5 was reported by 40% for cognitive problems and by 69% for fatigue. Among employed patients, 79% felt that their productivity at work was reduced, with fatigue being the most common reason (81%); cognition was mentioned by 42%. The most affected HRQoL dimensions were pain/discomfort (77% reporting problems), usual activities (74%) and mobility (72%). Mean utility ranged from 0.9±0.1 at EDSS 0 to -0.2±0.2 at EDSS 9. Both fatigue and cognitive problems showed moderate negative correlations with utility (r=-0.385 and -0.335, p< 0.001, respectively).
Conclusion: In this large European sample of MS patients covering the entire disease severity spectrum a majority experienced fatigue and cognitive problems. While HRQoL deteriorated with advancing disease, fatigue and cognitive problems were present at all disease severity levels and impacted HRQoL significantly.
Disclosure: The study is funded by Biogen Inc.
Gisela Kobelt: received consulting fees from Biogen, Genzyme/Sanofi, Merck Serono, Novartis, Roche and Teva
Jenny Berg: working for consultancy performing projects for pharmaceutical companies
Mia Gannedahl: working for consultancy performing projects for pharmaceutical companies
Jennifer Eriksson: working for consultancy performing projects for pharmaceutical companies
Alan Thompson: received honoraria/support for travel for consultancy from Eisai, Excemed, MedDay, support for travel from the International Progressive MS Alliance (chair, Scientific Steering Committee), from the National MS Society (USA) (member, Research Programs Advisory Committee), and an honorarium from SAGE Publishers (Editor-in-Chief for Multiple Sclerosis Journal)