Author Of 2 Presentations
P0484 - Prevalence of fatigue in multiple sclerosis (ID 1003)
Abstract
Background
Fatigue is considered to be one of the main causes of impaired quality of life among patients with multiple sclerosis (MS). It affects family life, social activities, and education. Fatigue is one of the main reasons why many patients with MS are unable to work. To our knowledge there have been no larger studies on the prevalence of fatigue in MS in almost 20 years. Previous studies have reported a prevalence ranging between 50-90 %. We assumed that the prevalence of fatigue has changed due to changes in diagnostic criteria and the great change in treatment possibilities over these years.
Objectives
Our objective was to determine the prevalence of fatigue in a contemporary MS population in Norway, and to assess the association between fatigue and sex, age, disease course, disease severity and duration.
Methods
This is a cross-sectional study from a registry comprising MS patients in the counties Buskerud, Oslo and Telemark in Norway. Clinical, demographic and socio-economic data were obtained from the registry. Questionnaires were distributed by postal mail to all living subjects. Self-reported fatigue was assessed with the Fatigue Scale for Motor and Cognitive Functions (FSMC), and anxiety and depression was measured with the Hospital Anxiety and Depression Scale (HADS). We used the Epworth sleepiness scale (ESS) to assess daytime sleepiness.
Results
The response rate was 62.3 % (1599/2566). The prevalence of fatigue was 81.3 %. There was a significantly higher prevalence of fatigue in women than in men (82.9 % vs 77.6 %, p = 0.017). The prevalence was higher in patients aged ≥ 50 years compared with those aged < 50 years (85.7 % vs 75.4 %, p < 0.001). There was also a higher prevalence of fatigue in the group with progressive MS (87.6 % vs 80.0 % in the RR-MS group). 30 % of the patients with fatigue had concomitant anxiety/depression, versus 2.6 % in the non-fatigue group (p<0.001). Daytime sleepiness was more prevalent in patients with fatigue than in patients without fatigue (35 % versus 8 %, p<0.001).
Conclusions
Fatigue is prevalent in contemporary patients with MS and is associated with symptoms of anxiety, depression and daytime sleepiness. Fatigue was more prevalent in women, and in patients older than 50 years of age. Anxiety/depression and daytime sleepiness occurred more often in patients with fatigue.
P0502 - The Natural Course of Multiple Sclerosis Rewritten: A Population Based Study on Disease Demographics and Progression (ID 758)
Abstract
Background
Over the past few decades there has been an improvement in the rate of disability progression in multiple sclerosis (MS) patients, and most studies relate this evolvement to the introduction of disease modifying therapies. However, several other factors have changed over this period, including access to improved MRI and newer diagnostic criteria
Objectives
To investigate changes in the natural course of MS over time in a near-complete and geographically well-defined population from the south-east of Norway.
Methods
This is a registry-based study. We examined disease progression over two decades and assessed the effect of disease modifying therapies using linear mixed-effect models.
Results
In a cohort of 2097 patients we found a significant improvement in disability as measured by the Expanded Disability Status Scale (EDSS) stratified by age, and the improvement remained significant after adjusting for time on disease modifying medications, gender and progressive MS at onset. The time from disease onset to EDSS 6 in the total cohort was 29.8 years (95% CI 28.5-31.1) and was significantly longer in patients diagnosed after 2006 compared to patients diagnosed before. In addition, we found significant differences between patient demographics, as well as time to EDSS 6 in the near-complete, geographically well-defined population compared to the rest of the cohort from Oslo and its affluent suburbs.
Conclusions
The natural course of MS is improving, but the improvement seen in disease progression in the modern MS patient may have multifaceted explanations. This is supported by our findings of changing population demographics with patients being diagnosed earlier in the disease course, but also at an older age and with less severe disease. Our study underlines the fact that historical cohorts are unsuitable for comparison with modern cohorts in MS studies. We also found significant differences in demographics and time to EDSS 6 between our geographically near-complete population and the rest of the database with the cohort from Oslo and its wealthy suburbs, which means that studies done on incomplete populations should be interpreted with caution.
Presenter Of 1 Presentation
P0502 - The Natural Course of Multiple Sclerosis Rewritten: A Population Based Study on Disease Demographics and Progression (ID 758)
Abstract
Background
Over the past few decades there has been an improvement in the rate of disability progression in multiple sclerosis (MS) patients, and most studies relate this evolvement to the introduction of disease modifying therapies. However, several other factors have changed over this period, including access to improved MRI and newer diagnostic criteria
Objectives
To investigate changes in the natural course of MS over time in a near-complete and geographically well-defined population from the south-east of Norway.
Methods
This is a registry-based study. We examined disease progression over two decades and assessed the effect of disease modifying therapies using linear mixed-effect models.
Results
In a cohort of 2097 patients we found a significant improvement in disability as measured by the Expanded Disability Status Scale (EDSS) stratified by age, and the improvement remained significant after adjusting for time on disease modifying medications, gender and progressive MS at onset. The time from disease onset to EDSS 6 in the total cohort was 29.8 years (95% CI 28.5-31.1) and was significantly longer in patients diagnosed after 2006 compared to patients diagnosed before. In addition, we found significant differences between patient demographics, as well as time to EDSS 6 in the near-complete, geographically well-defined population compared to the rest of the cohort from Oslo and its affluent suburbs.
Conclusions
The natural course of MS is improving, but the improvement seen in disease progression in the modern MS patient may have multifaceted explanations. This is supported by our findings of changing population demographics with patients being diagnosed earlier in the disease course, but also at an older age and with less severe disease. Our study underlines the fact that historical cohorts are unsuitable for comparison with modern cohorts in MS studies. We also found significant differences in demographics and time to EDSS 6 between our geographically near-complete population and the rest of the database with the cohort from Oslo and its wealthy suburbs, which means that studies done on incomplete populations should be interpreted with caution.