Abstract: P940
Type: Poster
Abstract Category: Clinical aspects of MS - 11 Comorbidity
Background: People with MS frequently experience depression as a symptom of MS. Although prior research has shown anti-depressant (AD) use is common in MS, the association between AD use and depression severity has not been well studied in MS.
Objective: To characterize AD use in MS patients and determine how depression severity and its predictors vary by AD use.
Methods: Patients who participated in MS PATHS, a collaborative network of ten healthcare institutions in the US and Europe which aims to enrol over 10,000 patients, were identified. During routine clinic visits, all patients use the Multiple Sclerosis Performance Test (MSPT), an iPad-based device, to complete a standardized MS history and 12 scales of the Quality of Life in Neurologic Disorders (Neuro-QoL) instrument, including depression. Patients with an active prescription for ADs in their EMR on the date they completed the MSPT were classified as using ADs. Patients were classified as meeting the screening criterion for major depressive disorder (MDD) if their Neuro-QoL depression t-score ≥53.6 (Amtmann D et al. J Psychosom Res, 2015). Patterns of MDD and AD use were examined by sociodemographic and clinical characteristics using chi-square tests. Multivariate logistic regression was used to evaluate the independent effect of AD use and patient characteristics on MDD. With high participation rates (>90%), it is likely the MS PATHS cohort is representative of MS patients seeking care at these institutions.
Results: The sample comprised 1353 patients, mean (SD) age 48.9 years (12), mean (SD) disease duration 12.2 years (9.4), 72% female and 85% white. At initial assessment, 40% of patients were AD users and 23% met the criterion for MDD. Of AD users, 31% met the MDD criterion, and of AD non-users, 18% met the MDD criterion. MDD and AD use varied significantly with age, gender, employment status, living situation, number of relapses and disability. Logistic regression analysis showed that of AD users, patients with >3 relapses in the past 12 months were 3 times (p=0.005) more likely to meet the MDD criterion. Among AD non-users, unemployed patients were 8 times (p=0.007) more likely to meet the MDD criterion.
Conclusions: AD use was relatively common in MS patients. Nearly a third of AD users and 18% of AD non-users met the criterion for MDD, indicating a high degree of unmet need in MS patients. These results suggest MS patients should be screened routinely for symptoms of depression.
Disclosure: Project funded by Biogen, Inc.
Author disclosures:
Deborah Miller has received consulting fees from Hoffmann-Roche and Biogen.
Carrie Hersh has received speaking and consulting fees from Genzyme and Teva, and grant funding from Genentech.
Lauren Krupp has received consultant fees from EMD Serono, Projects in Knowledge, Novartis, Pfizer (for serving on a DSMB), Biogen, PK Law and Teva Neurosciences; Royalty payments from Abbvie Inc. and Grifols World Wide Services; and research grant support from Novartis, Teva Neurosciences, Biogen, NIH, National Multiple Sclerosis Society, Department of Defense and the Lourie Foundation.
Carl de Moor, Glenn A. Phillips, James R. Williams, Himanshu Pandya, Nate Mockler and Richard Rudick are employees of, and stockholders in, Biogen.
Abstract: P940
Type: Poster
Abstract Category: Clinical aspects of MS - 11 Comorbidity
Background: People with MS frequently experience depression as a symptom of MS. Although prior research has shown anti-depressant (AD) use is common in MS, the association between AD use and depression severity has not been well studied in MS.
Objective: To characterize AD use in MS patients and determine how depression severity and its predictors vary by AD use.
Methods: Patients who participated in MS PATHS, a collaborative network of ten healthcare institutions in the US and Europe which aims to enrol over 10,000 patients, were identified. During routine clinic visits, all patients use the Multiple Sclerosis Performance Test (MSPT), an iPad-based device, to complete a standardized MS history and 12 scales of the Quality of Life in Neurologic Disorders (Neuro-QoL) instrument, including depression. Patients with an active prescription for ADs in their EMR on the date they completed the MSPT were classified as using ADs. Patients were classified as meeting the screening criterion for major depressive disorder (MDD) if their Neuro-QoL depression t-score ≥53.6 (Amtmann D et al. J Psychosom Res, 2015). Patterns of MDD and AD use were examined by sociodemographic and clinical characteristics using chi-square tests. Multivariate logistic regression was used to evaluate the independent effect of AD use and patient characteristics on MDD. With high participation rates (>90%), it is likely the MS PATHS cohort is representative of MS patients seeking care at these institutions.
Results: The sample comprised 1353 patients, mean (SD) age 48.9 years (12), mean (SD) disease duration 12.2 years (9.4), 72% female and 85% white. At initial assessment, 40% of patients were AD users and 23% met the criterion for MDD. Of AD users, 31% met the MDD criterion, and of AD non-users, 18% met the MDD criterion. MDD and AD use varied significantly with age, gender, employment status, living situation, number of relapses and disability. Logistic regression analysis showed that of AD users, patients with >3 relapses in the past 12 months were 3 times (p=0.005) more likely to meet the MDD criterion. Among AD non-users, unemployed patients were 8 times (p=0.007) more likely to meet the MDD criterion.
Conclusions: AD use was relatively common in MS patients. Nearly a third of AD users and 18% of AD non-users met the criterion for MDD, indicating a high degree of unmet need in MS patients. These results suggest MS patients should be screened routinely for symptoms of depression.
Disclosure: Project funded by Biogen, Inc.
Author disclosures:
Deborah Miller has received consulting fees from Hoffmann-Roche and Biogen.
Carrie Hersh has received speaking and consulting fees from Genzyme and Teva, and grant funding from Genentech.
Lauren Krupp has received consultant fees from EMD Serono, Projects in Knowledge, Novartis, Pfizer (for serving on a DSMB), Biogen, PK Law and Teva Neurosciences; Royalty payments from Abbvie Inc. and Grifols World Wide Services; and research grant support from Novartis, Teva Neurosciences, Biogen, NIH, National Multiple Sclerosis Society, Department of Defense and the Lourie Foundation.
Carl de Moor, Glenn A. Phillips, James R. Williams, Himanshu Pandya, Nate Mockler and Richard Rudick are employees of, and stockholders in, Biogen.