Contributions
Abstract: EP1450
Type: ePoster
Abstract Category: Clinical aspects of MS - 11 Comorbidity
Background: Studies have shown that comorbidities impact health outcomes and quality of life (QoL) in the multiple sclerosis (MS) population. However, less is known about how use of disease modifying treatment (DMT) mitigates the impact of comorbidity on QoL.
Objective: To determine which specific comorbidities impact QoL and if DMT use reduces the impact of comorbidities on QoL among participants in the Pacific Northwest Multiple Sclerosis Registry (PNWMSR).
Methods: PNWMSR participant survey data from 2011 to 2016 was used. Participants who had relapsing disease were included. Those who had progressive MS, reported use of more than one DMT, were on their reported DMT for less than six months, or had not reported duration of DMT were excluded. Comorbidities included were cardiovascular disease, respiratory disease, smoking, cancer, thyroid disease, gastrointestinal (GI) disease, depression and obesity. Chi-square tests were used to determine differences in the prevalence of comorbidities among those who used and did not use DMT. Physical and psychological QoL was measured using the Multiple Sclerosis Impact Scale (MSIS), with higher scores indicating more severe impact. Multiple linear regression, adjusting for participant characteristics, was used to determine the impact of comorbidities and DMT use on physical and psychological QoL scores. Interactions between DMT use and comorbidities that significantly impacted MSIS were tested using Type III F-tests to determine whether DMT use moderated the effect of comorbidities on QoL.
Results: Survey data from 1,163 participants were included in the final analysis. Cancer, thyroid and GI disease were significantly more prevalent among participants not on DMT. Depression was significantly more prevalent among those on a DMT. Physical MSIS scores worsened with depression (β=3.26; p< .001), respiratory diseases (β=2.59; p=.001), and thyroid diseases (β=2.55; p=0.04). Psychological MSIS scores worsened with depression (β=4.37; p< .001), thyroid disease (β=2.17; p=.002), and smoking (β=1.12; p=0.04). All interactions between DMT use and comorbidities were not significant.
Conclusions: The prevalence of comorbidities differed based on DMT use. Depression was highly prevalent among DMT users and had the largest impact on psychological and physical QoL in this regional cohort. The use of DMT had no significant moderating effect on the impact of comorbidities on physical or psychological QoL.
Disclosure:
T. Stuchiner, L. Lucas, E. Baraban and C. Chen have no conflict of interest to report.
S. Cohan has either served on advisory boards or steering committees for Biogen, Novartis, Sanofi Genzyme, and Mallinckrodt; have received research support from Biogen, Novartis, Sanofi Genzyme, Opexa, Teva, Mallinckrodt, and Roche; have received speaker honoraria from Biogen Idec, Novartis, Sanofi Genzyme and Acorda.
Abstract: EP1450
Type: ePoster
Abstract Category: Clinical aspects of MS - 11 Comorbidity
Background: Studies have shown that comorbidities impact health outcomes and quality of life (QoL) in the multiple sclerosis (MS) population. However, less is known about how use of disease modifying treatment (DMT) mitigates the impact of comorbidity on QoL.
Objective: To determine which specific comorbidities impact QoL and if DMT use reduces the impact of comorbidities on QoL among participants in the Pacific Northwest Multiple Sclerosis Registry (PNWMSR).
Methods: PNWMSR participant survey data from 2011 to 2016 was used. Participants who had relapsing disease were included. Those who had progressive MS, reported use of more than one DMT, were on their reported DMT for less than six months, or had not reported duration of DMT were excluded. Comorbidities included were cardiovascular disease, respiratory disease, smoking, cancer, thyroid disease, gastrointestinal (GI) disease, depression and obesity. Chi-square tests were used to determine differences in the prevalence of comorbidities among those who used and did not use DMT. Physical and psychological QoL was measured using the Multiple Sclerosis Impact Scale (MSIS), with higher scores indicating more severe impact. Multiple linear regression, adjusting for participant characteristics, was used to determine the impact of comorbidities and DMT use on physical and psychological QoL scores. Interactions between DMT use and comorbidities that significantly impacted MSIS were tested using Type III F-tests to determine whether DMT use moderated the effect of comorbidities on QoL.
Results: Survey data from 1,163 participants were included in the final analysis. Cancer, thyroid and GI disease were significantly more prevalent among participants not on DMT. Depression was significantly more prevalent among those on a DMT. Physical MSIS scores worsened with depression (β=3.26; p< .001), respiratory diseases (β=2.59; p=.001), and thyroid diseases (β=2.55; p=0.04). Psychological MSIS scores worsened with depression (β=4.37; p< .001), thyroid disease (β=2.17; p=.002), and smoking (β=1.12; p=0.04). All interactions between DMT use and comorbidities were not significant.
Conclusions: The prevalence of comorbidities differed based on DMT use. Depression was highly prevalent among DMT users and had the largest impact on psychological and physical QoL in this regional cohort. The use of DMT had no significant moderating effect on the impact of comorbidities on physical or psychological QoL.
Disclosure:
T. Stuchiner, L. Lucas, E. Baraban and C. Chen have no conflict of interest to report.
S. Cohan has either served on advisory boards or steering committees for Biogen, Novartis, Sanofi Genzyme, and Mallinckrodt; have received research support from Biogen, Novartis, Sanofi Genzyme, Opexa, Teva, Mallinckrodt, and Roche; have received speaker honoraria from Biogen Idec, Novartis, Sanofi Genzyme and Acorda.