Clinical Outcome Measures Poster Presentation

P0042 - Clinical evolution of spasticity in adults with multiple sclerosis: systematic review (ID 1615)

Speakers
  • L. Crathorne
Authors
  • T. Jones-Hughes
  • C. Vila Silván
  • J. Campbell
  • D. Ortin Sulbaran
  • R. Stork
  • L. Crathorne
Presentation Number
P0042
Presentation Topic
Clinical Outcome Measures

Abstract

Background

Spasticity is a common symptom for people with multiple sclerosis (MS), occurring in >80% of MS patients and increasing in prevalence and severity throughout the disease course. Worsening spasticity is associated with pain, sleep disorders, further impaired mobility, bladder dysfunction and other symptoms, impacting negatively on quality of life and increasing health resource utilization and costs. Data showing evolution of spasticity over time appear limited and, when reported, often use non-validated categorical scales.

Objectives

To conduct a systematic review of published evidence on the prevalence and clinical evolution of MS-related spasticity.

Methods

Searches were conducted in bibliographic databases. Two reviewers selected articles according to pre-defined inclusion criteria. Data were extracted to describe the frequency of spasticity, and progression of spasticity severity.

Results

Four studies were eligible for inclusion including a total of 29,196 patients. Study design was either retrospective (n=3), or longitudinal (n=1). Study duration ranged from approximately three to 30 years. Study population, timeframe for evaluation and method of assessment of spasticity within the included studies were heterogeneous which precluded meta-analysis. Two studies reported symptom prevalence and severity (measured using categorical mild/moderate/severe scales) over time. Results demonstrated an increased proportion of patients with severe symptoms, despite treatment. A continuous decrease in the proportion of participants with milder severity was also reported. The remaining two studies reported the clinical evolution of spasticity over time. Both studies used the 0–10 numeric rating scale (NRS) (0 no spasticity to 10 worst possible spasticity) to measure change in spasticity: one compared symptoms pre- vs post-MS diagnosis split by relapse- and progressive-onset disease, and the other in patients with treatment-resistant (≤1 prior therapy) MS-related spasticity, indicated a deterioration in spasticity over time (1 to 3 years [mean 2.1 years], mean NRS 5.7 [1.9] to 5.9 [2.1]).

Conclusions

Few studies consider the evolution of MS spasticity over the longer term. While there was a high degree of variation between the included studies, all indicated a deterioration in MS spasticity symptoms over time despite available treatments. Tracking MS spasticity seems necessary in MS to inform clinical management.

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