Contributions
Abstract: P411
Type: Poster Sessions
Abstract Category: Clinical aspects of MS - Comorbidity
Introduction: Among people with MS, comorbid conditions can diminish quality of life (QoL). Disease modifying therapy (DMT) for MS may moderate this effect.The relationship between DMT type and comorbidities, and its impact on QoL, has not been studied to date.
Aims: Determine the impact of DMT types and comorbidities on QoL in participants in the Pacific Northwest Multiple Sclerosis Registry in the USA.
Methods: The study used self-reported data from participants registering between 2011 and 2016. Comorbidities included cardiovascular disease (CVD), diabetes, cancer, depression, smoking, and respiratory, thyroid, and gastrointestinal disease. QoL was assessed using physical and psychological scores from the Multiple Sclerosis Impact Scale. DMT users were grouped by self- injectable therapy (beta interferons, glatiramer acetate), oral therapy (teriflunomide, dimethyl fumarate, and fingolimod), and infusion (IV) therapy (alemtuzumab, rituximab, natalizumab, and ocrelizumab). Those not on a DMT were excluded. Multiple linear regression was used to analyse the impact of comorbidity and DMT type on physical and psychological QoL, adjusting for participant characteristics. Interactions between DMT type and each comorbidity were tested and post-hoc comparisons between DMT types for participants with the comorbidity were analysed.
Results: Of 908 participants included, 55.3% (n=502) were on self-injectable 34.1% (n=310) on oral, and 10.6% (n=96) on IV therapy. Physical QoL scores were significantly worse for those with CVD (regression coefficient [B]=1.86, P=0.006) and depression (B=2.94, P≤0.001), and suggestive for respiratory disease (B=1.67, P=0.051). Psychological QoL scores were significantly worse for depression (B=4.40, P< 0.001) and suggestive for diabetes (B=1.32, P=0.078). There was a trend toward significance for interactions between DMT type and diabetes (P=0.069) for physical score, and DMT type and CVD (P=0.061), cancer (P=0.079), and diabetes (P=0.061) for psychological score. Among participants with comorbidities, post-hoc analyses showed no differences by DMT type for QoL scores.
Conclusion: There was suggestive evidence for moderating effects of DMT type on the impact of comorbidities on QoL, but scores did not differ significantly by DMT type for those with comorbidities. Cohort sizes may have impacted results. These results emphasise the need for clinicians to maintain awareness of the overriding impact of comorbidities on QoL of MS patients.
Disclosure: EB, TS, LL, and CC: Nothing to disclose. LH, AR and AS: Employees of Sanofi. SLC: Advisory boards or steering committees (Biogen, Mallinckrodt, Novartis, and Sanofi); research support and/or speaker honoraria (Acorda, Biogen, Genentech, IMS Health, Mallinckrodt, Novartis, Roche, and Sanofi). STUDY SUPPORT: Sanofi.
Abstract: P411
Type: Poster Sessions
Abstract Category: Clinical aspects of MS - Comorbidity
Introduction: Among people with MS, comorbid conditions can diminish quality of life (QoL). Disease modifying therapy (DMT) for MS may moderate this effect.The relationship between DMT type and comorbidities, and its impact on QoL, has not been studied to date.
Aims: Determine the impact of DMT types and comorbidities on QoL in participants in the Pacific Northwest Multiple Sclerosis Registry in the USA.
Methods: The study used self-reported data from participants registering between 2011 and 2016. Comorbidities included cardiovascular disease (CVD), diabetes, cancer, depression, smoking, and respiratory, thyroid, and gastrointestinal disease. QoL was assessed using physical and psychological scores from the Multiple Sclerosis Impact Scale. DMT users were grouped by self- injectable therapy (beta interferons, glatiramer acetate), oral therapy (teriflunomide, dimethyl fumarate, and fingolimod), and infusion (IV) therapy (alemtuzumab, rituximab, natalizumab, and ocrelizumab). Those not on a DMT were excluded. Multiple linear regression was used to analyse the impact of comorbidity and DMT type on physical and psychological QoL, adjusting for participant characteristics. Interactions between DMT type and each comorbidity were tested and post-hoc comparisons between DMT types for participants with the comorbidity were analysed.
Results: Of 908 participants included, 55.3% (n=502) were on self-injectable 34.1% (n=310) on oral, and 10.6% (n=96) on IV therapy. Physical QoL scores were significantly worse for those with CVD (regression coefficient [B]=1.86, P=0.006) and depression (B=2.94, P≤0.001), and suggestive for respiratory disease (B=1.67, P=0.051). Psychological QoL scores were significantly worse for depression (B=4.40, P< 0.001) and suggestive for diabetes (B=1.32, P=0.078). There was a trend toward significance for interactions between DMT type and diabetes (P=0.069) for physical score, and DMT type and CVD (P=0.061), cancer (P=0.079), and diabetes (P=0.061) for psychological score. Among participants with comorbidities, post-hoc analyses showed no differences by DMT type for QoL scores.
Conclusion: There was suggestive evidence for moderating effects of DMT type on the impact of comorbidities on QoL, but scores did not differ significantly by DMT type for those with comorbidities. Cohort sizes may have impacted results. These results emphasise the need for clinicians to maintain awareness of the overriding impact of comorbidities on QoL of MS patients.
Disclosure: EB, TS, LL, and CC: Nothing to disclose. LH, AR and AS: Employees of Sanofi. SLC: Advisory boards or steering committees (Biogen, Mallinckrodt, Novartis, and Sanofi); research support and/or speaker honoraria (Acorda, Biogen, Genentech, IMS Health, Mallinckrodt, Novartis, Roche, and Sanofi). STUDY SUPPORT: Sanofi.