Contributions
Abstract: EP1295
Type: ePoster
Abstract Category: Clinical aspects of MS - 2 MS Variants
Objective: To evaluate prevalence of pain syndromes and depression as well as their effects on the activities of daily life (ADL) and quality of life (QoL) among patients with neuromyelitis optica spectrum disorder (NMOSD).
Methods: All NMOSD patients of one academic centre were contacted. Detailed characterisation of pain syndromes was done based on McGill, PainDetect and Brief Pain Inventory. Effects of symptomatic and immune therapies on pain severity were evaluated retrospectively. Using the Beck Depression Inventory (BDI), depression was classified into severe, moderate or minimal. QoL was evaluated with the SF-36 questionnaire.
Results: We achieved a high response rate of 93% (42 of 45 patients). 83% were female, the mean age was 44.1±12.4 years, 79% were antibody (ab)-seropositive: 26 AQP4-ab, 7 MOG-ab. The majority (79%) of patients reported NMOSD-associated pain syndromes, 70% had neuropathic pain and 64% painful tonic spasms. The mean pain intensity was moderate (3.8±1.5, scale 0-10). Almost half of the pain sufferers (49%) had chronic pain. There were no differences between seronegative and seropositive patients, as well as between those with AQP4- and MOG-abs. 70% took pain relieving medications, however, they had still a pain intensity of 4.3±1.3 (scale 0-10). Among those with painful spasms, 33.3% only had antispastic medication. Tocilizumab was the only immune therapy with probable pain relieving effect: 3 of 4 patients reported improvement after a switch to tocilizumab. Pain syndromes were associated with a substantial reduction of ADL (4.1±2.0, scale 0-10) and the health related QoL (34.2 vs. 46.0 in pain free patients, p=0.015). Pain intensity significantly correlated with the following SF-36 items: physical and social role functioning, general health perception and bodily pain. 45% of patients had BDI scores indicative of depressive disorder (BDI>13), 32% of them moderate or severe (BDI>19). The BDI score was significantly higher in patients with chronic pain compared to episodic pain (15.1 vs. 8.1, p=0.02). Depressive disorder was clearly undertreated, only two patients, both with mild depression, took antidepressants.
Conclusion: Pain syndromes and depression are highly prevalent, undertreated and associated with reduced QoL and ADL in NMOSD. It is crucial for an adequate targeted therapy to differentiate between the following 3 pain patterns: neuropathic pain, painful tonic spasms and chronic pain associated with depression.
Disclosure:
I.Ayzenberg has nothing to disclose
E.Henke has nothing to disclose
I.Kleiter has nothing to disclose
This study has received funding from Chugai Pharmaceutical Co.
Abstract: EP1295
Type: ePoster
Abstract Category: Clinical aspects of MS - 2 MS Variants
Objective: To evaluate prevalence of pain syndromes and depression as well as their effects on the activities of daily life (ADL) and quality of life (QoL) among patients with neuromyelitis optica spectrum disorder (NMOSD).
Methods: All NMOSD patients of one academic centre were contacted. Detailed characterisation of pain syndromes was done based on McGill, PainDetect and Brief Pain Inventory. Effects of symptomatic and immune therapies on pain severity were evaluated retrospectively. Using the Beck Depression Inventory (BDI), depression was classified into severe, moderate or minimal. QoL was evaluated with the SF-36 questionnaire.
Results: We achieved a high response rate of 93% (42 of 45 patients). 83% were female, the mean age was 44.1±12.4 years, 79% were antibody (ab)-seropositive: 26 AQP4-ab, 7 MOG-ab. The majority (79%) of patients reported NMOSD-associated pain syndromes, 70% had neuropathic pain and 64% painful tonic spasms. The mean pain intensity was moderate (3.8±1.5, scale 0-10). Almost half of the pain sufferers (49%) had chronic pain. There were no differences between seronegative and seropositive patients, as well as between those with AQP4- and MOG-abs. 70% took pain relieving medications, however, they had still a pain intensity of 4.3±1.3 (scale 0-10). Among those with painful spasms, 33.3% only had antispastic medication. Tocilizumab was the only immune therapy with probable pain relieving effect: 3 of 4 patients reported improvement after a switch to tocilizumab. Pain syndromes were associated with a substantial reduction of ADL (4.1±2.0, scale 0-10) and the health related QoL (34.2 vs. 46.0 in pain free patients, p=0.015). Pain intensity significantly correlated with the following SF-36 items: physical and social role functioning, general health perception and bodily pain. 45% of patients had BDI scores indicative of depressive disorder (BDI>13), 32% of them moderate or severe (BDI>19). The BDI score was significantly higher in patients with chronic pain compared to episodic pain (15.1 vs. 8.1, p=0.02). Depressive disorder was clearly undertreated, only two patients, both with mild depression, took antidepressants.
Conclusion: Pain syndromes and depression are highly prevalent, undertreated and associated with reduced QoL and ADL in NMOSD. It is crucial for an adequate targeted therapy to differentiate between the following 3 pain patterns: neuropathic pain, painful tonic spasms and chronic pain associated with depression.
Disclosure:
I.Ayzenberg has nothing to disclose
E.Henke has nothing to disclose
I.Kleiter has nothing to disclose
This study has received funding from Chugai Pharmaceutical Co.