Contributions
Abstract: EP1845
Type: ePoster
Abstract Category: Therapy - symptomatic - 34 Quality of life
Background: Multiple sclerosis (MS) affects negatively quality of life. The Short Form Health Survey (SF36) measures various aspects of health‐related‐quality of life (QoL), including physical and mental health. Physical disability and emotional problems seem to have a negative impact on QoL in patients with MS, but their relative importance at different stages could differ.
Goals: To identify the main factors influencing QoL in patients with MS and to compare the contributors to low QoL soon after the first MS relapse and later on the disease.
Methods: We included 160 MS patients (mean age 43.6±11.2 years, 72.3% women) and 35 healthy controls (HC, age 41.4±10.9 years, 60% women) who completed the SF36. Eight QoL subscales and two composite scores, physical (PCS) and mental (MCS), were calculated. Participants were also evaluated with the Hospital Anxiety and Depression Scale (HADS), Modified Fatigue Impact Scale (MFIS), Pittsburgh Sleep Quality Assessment and Cognitive Reserve. Clinical information including disease duration, Expanded Disability Status Scale (EDSS), 25-feet walk test (25FWT), 6-minutes walk test (6MWT), Paced Auditory Serial Addition test and Symbol Digit Modalities test were recorded in patients.
Results: Patients had 11.7±10.5 years of disease duration, median EDSS of 2.0 (range 0-6.5). They presented worse scores in all SF36 metrics compared to HC (p< 0.01). EDSS, walk ability measured with 25FWT and 6WT, HADS, fatigue, sleep and cognitive reserve correlated with most subscales of SF36 (p< 0.01). In a multivariate model the main predictors of low PCS were worse MFIS, 6MWT and Pittsburgh score (corrected r2=0.52), and the main predictors of low MCS were worse HADS and shorter disease duration (corrected r2=0.41).
Patients with less than 2 years of disease duration (n=43), compared to those with more than 15 years (n=50), presented better physical QoL, but showed greater loss in QoL in the last year and worse mental QoL scores (p< 0.01) despite their HADS values were similar (11.9±7.4 vs. 10.7±7.4, p=0.47).
Conclusion: Fatigue, walk impairment, low quality of sleep, anxiety and depression symptoms are key elements influencing low QoL in patients with MS, although their relative impact changes along the disease. In early phases, when disability is mild, QoL is already impaired, mainly due to worse perception of their mental health probably related to the recent diagnosis.
Disclosure:
MS received speaker honoraria from Genzyme and Novartis.
ES received travel reimbursement from TEVA.
EMH declares nothing to disclose.
NSV receives funding from the Spanish Government (Instituto de Salud Carlos III, Spain and Fondo Europeo de Desarrollo Regional (FEDER, FI16/00251), and a Predoctoral Grant for Health Research.
YB received speaking honoraria from Biogen, Novartis and Genzyme.
AS received compensation for consulting services and speaker honoraria from Bayer-Schering, Merck-Serono, Biogen-Idec, Sanofi-Aventis, TEVA and Novartis, and funding from the Spanish Government (PI15/00587, RD16/0015/0002, RD16/0015/0003, RD12/0032/0002, RD12/0060/01-02).
SL received speaker honoraria from Biogen Idec, Novartis, Teva, Genzyme and Merck, and research support from a Juan Rodes grant from the Instituto de Salud Carlos III (JR14/00016) and the Spanish Government (PI15/00587).
Funding: This work was funded by a Proyecto de Investigacion en Salud (FIS 2015. PI15/00587, S.L., A.S.) integrated in the Plan Estatal de Investigación Científica y Técnica de Innovación I+D+I and co-funded by the Instituto de Salud Carlos III-Subdirección General de Evaluación and the Fondo Europeo de Desarrollo Regional (FEDER, 'Otra manera de hacer Europa'); Red Española de Esclerosis Múltiple (REEM) (RD16/0015/0002, RD16/0015/0003, RD12/0032/0002, RD12/0060/01-02). MS receives funding from the Generalitat de Catalunya (SLT002/16/00354).
Abstract: EP1845
Type: ePoster
Abstract Category: Therapy - symptomatic - 34 Quality of life
Background: Multiple sclerosis (MS) affects negatively quality of life. The Short Form Health Survey (SF36) measures various aspects of health‐related‐quality of life (QoL), including physical and mental health. Physical disability and emotional problems seem to have a negative impact on QoL in patients with MS, but their relative importance at different stages could differ.
Goals: To identify the main factors influencing QoL in patients with MS and to compare the contributors to low QoL soon after the first MS relapse and later on the disease.
Methods: We included 160 MS patients (mean age 43.6±11.2 years, 72.3% women) and 35 healthy controls (HC, age 41.4±10.9 years, 60% women) who completed the SF36. Eight QoL subscales and two composite scores, physical (PCS) and mental (MCS), were calculated. Participants were also evaluated with the Hospital Anxiety and Depression Scale (HADS), Modified Fatigue Impact Scale (MFIS), Pittsburgh Sleep Quality Assessment and Cognitive Reserve. Clinical information including disease duration, Expanded Disability Status Scale (EDSS), 25-feet walk test (25FWT), 6-minutes walk test (6MWT), Paced Auditory Serial Addition test and Symbol Digit Modalities test were recorded in patients.
Results: Patients had 11.7±10.5 years of disease duration, median EDSS of 2.0 (range 0-6.5). They presented worse scores in all SF36 metrics compared to HC (p< 0.01). EDSS, walk ability measured with 25FWT and 6WT, HADS, fatigue, sleep and cognitive reserve correlated with most subscales of SF36 (p< 0.01). In a multivariate model the main predictors of low PCS were worse MFIS, 6MWT and Pittsburgh score (corrected r2=0.52), and the main predictors of low MCS were worse HADS and shorter disease duration (corrected r2=0.41).
Patients with less than 2 years of disease duration (n=43), compared to those with more than 15 years (n=50), presented better physical QoL, but showed greater loss in QoL in the last year and worse mental QoL scores (p< 0.01) despite their HADS values were similar (11.9±7.4 vs. 10.7±7.4, p=0.47).
Conclusion: Fatigue, walk impairment, low quality of sleep, anxiety and depression symptoms are key elements influencing low QoL in patients with MS, although their relative impact changes along the disease. In early phases, when disability is mild, QoL is already impaired, mainly due to worse perception of their mental health probably related to the recent diagnosis.
Disclosure:
MS received speaker honoraria from Genzyme and Novartis.
ES received travel reimbursement from TEVA.
EMH declares nothing to disclose.
NSV receives funding from the Spanish Government (Instituto de Salud Carlos III, Spain and Fondo Europeo de Desarrollo Regional (FEDER, FI16/00251), and a Predoctoral Grant for Health Research.
YB received speaking honoraria from Biogen, Novartis and Genzyme.
AS received compensation for consulting services and speaker honoraria from Bayer-Schering, Merck-Serono, Biogen-Idec, Sanofi-Aventis, TEVA and Novartis, and funding from the Spanish Government (PI15/00587, RD16/0015/0002, RD16/0015/0003, RD12/0032/0002, RD12/0060/01-02).
SL received speaker honoraria from Biogen Idec, Novartis, Teva, Genzyme and Merck, and research support from a Juan Rodes grant from the Instituto de Salud Carlos III (JR14/00016) and the Spanish Government (PI15/00587).
Funding: This work was funded by a Proyecto de Investigacion en Salud (FIS 2015. PI15/00587, S.L., A.S.) integrated in the Plan Estatal de Investigación Científica y Técnica de Innovación I+D+I and co-funded by the Instituto de Salud Carlos III-Subdirección General de Evaluación and the Fondo Europeo de Desarrollo Regional (FEDER, 'Otra manera de hacer Europa'); Red Española de Esclerosis Múltiple (REEM) (RD16/0015/0002, RD16/0015/0003, RD12/0032/0002, RD12/0060/01-02). MS receives funding from the Generalitat de Catalunya (SLT002/16/00354).