University of Tasmania
Menzies Institute For Medical Research. College of Health and medicine

Author Of 3 Presentations

Clinical Outcome Measures Poster Presentation

P0104 - Long term disability trajectories in multiple sclerosis: a group-based trajectory analysis of the AusLong cohort (ID 1920)

Speakers
Presentation Number
P0104
Presentation Topic
Clinical Outcome Measures

Abstract

Background

Understanding progression of disability in multiple sclerosis (MS) is essential to design preventive and therapeutic strategies.

Objectives

We analyzed data from the Ausimmune Longitudinal (AusLong) Study to investigate the existing heterogeneity in long-term disability accumulation in a prospective cohort of People with MS (PwMS) followed over 10 years from the date of their first clinical diagnosis (FCD) and identify clinical and demographic factors associated with these trajectories.

Methods

We used a group-based trajectory model (GBTM) to measure the heterogeneity in the disability trajectories based on Expanded Disability Status Scale (EDSS) in a prospective cohort of 263 participants followed from FCD.

Results

We identified three distinct clinically meaningful disability trajectories: no or mild, moderate and severe disability trajectories. Those in the minimal disability trajectory did not show any appreciable progression of disability (median EDSS ~ 1 at 10-year review), those in moderate and severe disability trajectories experienced disability worsening (median EDSS~ 2.5 and 6, respectively). The relative probability of being in a worsening disability trajectory was higher for older age at onset, those experiencing a higher number of relapses within five-year post FCD and those having a shorter interval between the first two attacks. High annual relapse rate was associated with an upward shift in moderate disability trajectory, whereas non-smoking status was associated with reducing the EDSS score in minimal and severe disability trajectories.

Conclusions

Those at highest risk of rapid disability progression can be identified based on their early clinical information with potential therapeutic implications.

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Epidemiology Poster Presentation

P0471 - Intra-individual variations in multiple sclerosis symptoms are associated with changes in work productivity of people living with multiple sclerosis (ID 1721)

Speakers
Presentation Number
P0471
Presentation Topic
Epidemiology

Abstract

Background

Multiple sclerosis (MS) symptoms are associated with MS-related work productivity loss. But it is unknown whether changes in MS symptoms would lead to changes in work productivity in people living with MS (PwMS).

Objectives

To determine whether intra-individual variations in MS symptoms over time are associated with corresponding changes in work productivity in PwMS.

Methods

Study participants were employed Australian MS Longitudinal Study (AMSLS) participants followed from 2015 to 2019 with at least two repeated measures (n=2121). We used mixed effect models to examine if the within-individual variations in MS symptoms are associated with changes in work productivity.

Results

The mean annual change in work productivity between 2015 and 2019 was -0.23% (SD = 18.68%), with 39% experiencing no change, 31% decreasing in work productivity and 30% increasing in work productivity. Our analysis showed that disability and symptom scores at the start of the year were not associated with subsequent annual change in work productivity. However, the annual change in disability and annual change in symptom severity clusters were associated with the annual change in work productivity in the same year. In a multivariable model, annual change in ‘pain and sensory symptoms’, ‘feelings of anxiety and depression’, and ‘fatigue and cognitive symptom’ were independently associated with annual change in work productivity. Every unit increase in mean annual change of the symptom clusters were associated with 2.44%, 1.57% and 1.01% annual reduction in work productivity, respectively.

Conclusions

Individual change in work productivity seems to be driven by the changes in symptom severity rather than the absolute severity. To improve work productivity, management should focus on stabilising or improving symptoms.

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Epidemiology Poster Presentation

P0513 - Work productivity trajectories in Australians living with multiple sclerosis: a group-based modelling approach (ID 1737)

Speakers
Presentation Number
P0513
Presentation Topic
Epidemiology

Abstract

Background

Studies have documented loss of work capacity and work productivity loss in multiple sclerosis (MS). Little is known about the longitudinal trajectories of work productivity in MS.

Objectives

To explore trajectories of work productivity in people living with multiple sclerosis (PwMS) and examine the baseline factors associated with assignment to the trajectories group.

Methods

Study participants were from the Australian MS Longitudinal Study (AMSLS) from 2015 to 2019 who were employed and had more than two follow-ups (n=2121). We used group-based trajectory modelling to identify unique work productivity trajectories in PwMS. Multinomial logistic regression was used to assess associations with the work productivity trajectories.

Results

We identified three distinct trajectories of work productivity: ‘moderately worsened’ (16.7% of participants) with a mean work productivity of 47.6% in 2015, ‘mildly worsened’ (50.1%) with a mean work productivity of 86.3% in 2015 and ‘normal’ (33.2%) with a mean work productivity of 99.7% in 2015. The relative probability of being in a moderately or mildly worsened work productivity trajectory were higher for those with a higher education level, baseline work productivity, and high MS symptom severity. For example, the relative probability of being in ‘moderately worsened’ rather than ‘normal’ work productivity trajectory increased by 36% (RRR:1.36 ; 95% confidence interval:1.09 –1.71) for each unit increase in ‘fatigue and cognitive symptoms’ cluster.

Conclusions

Higher education level, and MS symptom severity increased the relative probability of following a low work productivity trajectory. Work productivity interventions should target MS symptoms severity and disability reduction.

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Presenter Of 1 Presentation

Clinical Outcome Measures Poster Presentation

P0104 - Long term disability trajectories in multiple sclerosis: a group-based trajectory analysis of the AusLong cohort (ID 1920)

Speakers
Presentation Number
P0104
Presentation Topic
Clinical Outcome Measures

Abstract

Background

Understanding progression of disability in multiple sclerosis (MS) is essential to design preventive and therapeutic strategies.

Objectives

We analyzed data from the Ausimmune Longitudinal (AusLong) Study to investigate the existing heterogeneity in long-term disability accumulation in a prospective cohort of People with MS (PwMS) followed over 10 years from the date of their first clinical diagnosis (FCD) and identify clinical and demographic factors associated with these trajectories.

Methods

We used a group-based trajectory model (GBTM) to measure the heterogeneity in the disability trajectories based on Expanded Disability Status Scale (EDSS) in a prospective cohort of 263 participants followed from FCD.

Results

We identified three distinct clinically meaningful disability trajectories: no or mild, moderate and severe disability trajectories. Those in the minimal disability trajectory did not show any appreciable progression of disability (median EDSS ~ 1 at 10-year review), those in moderate and severe disability trajectories experienced disability worsening (median EDSS~ 2.5 and 6, respectively). The relative probability of being in a worsening disability trajectory was higher for older age at onset, those experiencing a higher number of relapses within five-year post FCD and those having a shorter interval between the first two attacks. High annual relapse rate was associated with an upward shift in moderate disability trajectory, whereas non-smoking status was associated with reducing the EDSS score in minimal and severe disability trajectories.

Conclusions

Those at highest risk of rapid disability progression can be identified based on their early clinical information with potential therapeutic implications.

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