Contributions
Abstract: P350
Type: Poster Sessions
Abstract Category: Clinical aspects of MS - Paediatric MS
Background: To date, no studies about factors associated with socio-professional performances in adulthood in patients with juvenile multiple sclerosis (MS) (onset before 18 years of age) have been performed, despite studies showing cognitive impairments in these patients.
Goals: We aimed to assess these associations in two subgroups: patients with juvenile MS, and patients with ´non-juvenile MS´ (aged 18-22 years at MS onset).
Patients and methods. A cross-sectional study nested in the ´Observatoire Français de la Sclérose en Plaques´ (OFSEP) survey was conducted with inclusion of 445 patients with a confirmed MS diagnosis: 211 with juvenile MS (70.1% female) and 234 with non-juvenile MS (75.6 % female). Patients were 25 to 35 years at inclusion in 2015. The variables collected concerned baseline demographic, disease and therapeutic characteristics, social status, academic level, fatigue status (Modified Fatigue Impact Scale 5-item, MFIS5), mental health status (K6 scale), recovery level (Recovery assessment scale), self-esteem status (Rosenberg´s self-esteem scale) and socio-professional performance (´Work and social adjustment scale´, WSAS). The outcome was poor socio-professional performance defined as WSAS≥20. Descriptive analysis was completed by multivariate analysis with logistic regression in the two groups.
Results: In the juvenile MS group, patients were mostly between the ages of 15 and 18 at onset (71.1%), 92.8% had a relapsing-remitting course (92.7% in the non-juvenile group) and 64% were working (69% respectively). In multivariate analysis, Expanded Disability Status Scale (EDSS) at inclusion > 3 (62 patients out of 211 ; odds ratio (OR) : 5.1, 95% confidence interval (95% CI) : 2.1-12.3, p< 0.001), significant fatigue (MFIS5 ≥ 10, 89 patients; OR : 14.9, 95% CI : 5.6-39.5, p< 0.001) and risk of depression (K6≥13, 43 patients; OR : 3.4, 95% CI : 1.3-9.1, p=0.01) were significantly associated with poor socio-professional performances in patients with juvenile MS onset. The same factors were found for non-juvenile MS patients, in addition to a longer disease duration and a lower recovery level. No interaction was found statistically significant for the two groups.
Discussion: For both groups, factors associated with poor socio-professional performances are related to disease severity. Social interventions could be helpful in these patients.
Disclosure: Source of funding for the study from the French ARSEP Foundation
Mikaeloff: nothing to disclose
Rollot: nothing to disclose
Trémolières: nothing to disclose
Leray: reports personal fees as speaker or consultant from Novartis and Sanofi Genzyme, outside the submitted work, and travel grants from Novartis and Roche SAS. Sources of funding in the last year came from the French ARSEP Foundation, the French National Security Agency of Medicines and Health Products, the EDMUS Foundation, and donation from Roche SAS.
Casey: nothing to disclose
Falissard: has been consultant for E. Lilly, BMS, Servier, SANOFI, GSK, HRA, Roche, Boeringer Ingelheim, Bayer, Almirall, Allergan, Stallergene, Genzyme, Pierre Fabre, Astrazeneca, Novartis, Janssen, Astellas, Biotronik, Daiichi-Sankyo, Gilead, MSD, Lundbeck, Stallergene
Abstract: P350
Type: Poster Sessions
Abstract Category: Clinical aspects of MS - Paediatric MS
Background: To date, no studies about factors associated with socio-professional performances in adulthood in patients with juvenile multiple sclerosis (MS) (onset before 18 years of age) have been performed, despite studies showing cognitive impairments in these patients.
Goals: We aimed to assess these associations in two subgroups: patients with juvenile MS, and patients with ´non-juvenile MS´ (aged 18-22 years at MS onset).
Patients and methods. A cross-sectional study nested in the ´Observatoire Français de la Sclérose en Plaques´ (OFSEP) survey was conducted with inclusion of 445 patients with a confirmed MS diagnosis: 211 with juvenile MS (70.1% female) and 234 with non-juvenile MS (75.6 % female). Patients were 25 to 35 years at inclusion in 2015. The variables collected concerned baseline demographic, disease and therapeutic characteristics, social status, academic level, fatigue status (Modified Fatigue Impact Scale 5-item, MFIS5), mental health status (K6 scale), recovery level (Recovery assessment scale), self-esteem status (Rosenberg´s self-esteem scale) and socio-professional performance (´Work and social adjustment scale´, WSAS). The outcome was poor socio-professional performance defined as WSAS≥20. Descriptive analysis was completed by multivariate analysis with logistic regression in the two groups.
Results: In the juvenile MS group, patients were mostly between the ages of 15 and 18 at onset (71.1%), 92.8% had a relapsing-remitting course (92.7% in the non-juvenile group) and 64% were working (69% respectively). In multivariate analysis, Expanded Disability Status Scale (EDSS) at inclusion > 3 (62 patients out of 211 ; odds ratio (OR) : 5.1, 95% confidence interval (95% CI) : 2.1-12.3, p< 0.001), significant fatigue (MFIS5 ≥ 10, 89 patients; OR : 14.9, 95% CI : 5.6-39.5, p< 0.001) and risk of depression (K6≥13, 43 patients; OR : 3.4, 95% CI : 1.3-9.1, p=0.01) were significantly associated with poor socio-professional performances in patients with juvenile MS onset. The same factors were found for non-juvenile MS patients, in addition to a longer disease duration and a lower recovery level. No interaction was found statistically significant for the two groups.
Discussion: For both groups, factors associated with poor socio-professional performances are related to disease severity. Social interventions could be helpful in these patients.
Disclosure: Source of funding for the study from the French ARSEP Foundation
Mikaeloff: nothing to disclose
Rollot: nothing to disclose
Trémolières: nothing to disclose
Leray: reports personal fees as speaker or consultant from Novartis and Sanofi Genzyme, outside the submitted work, and travel grants from Novartis and Roche SAS. Sources of funding in the last year came from the French ARSEP Foundation, the French National Security Agency of Medicines and Health Products, the EDMUS Foundation, and donation from Roche SAS.
Casey: nothing to disclose
Falissard: has been consultant for E. Lilly, BMS, Servier, SANOFI, GSK, HRA, Roche, Boeringer Ingelheim, Bayer, Almirall, Allergan, Stallergene, Genzyme, Pierre Fabre, Astrazeneca, Novartis, Janssen, Astellas, Biotronik, Daiichi-Sankyo, Gilead, MSD, Lundbeck, Stallergene