Impact of Early-stage Relapsing Remitting Multiple Sclerosis on Quality of Life
Tamara Castillo-Trivino1, Rocío Gómez-Ballesteros2, Mónica Borges3, Jesús Martín-Martínez4, Javier Sotoca5, Ana Alonso6, Ana B Caminero7, Laura Borrega8, José L Sánchez-Menoyo9, Francisco J Barrero-Hernández10, Carmen Calles11, Luis Brieva12, María R Blasco-Quílez13, Julio Dotor Garcia-Soto3, María del Campo-Amigo14, Laura Navarro-Cantó15, Eduardo Agüera16, Moisés Garcés-Redondo17, Olga Carmona18, Laura Gabaldón-Torres19, Lucía Forero20, Mariona Hervás21, Paloma López-Laiz2, Jorge Maurino2, Susana Sainz de la Maza22
1Hospital Universitario Donostia, 2Medical Department, Roche Farma, 3Hospital Universitario Virgen Macarena, 4Hospital Universitario Miguel Servet, 5Hospital Universitari Mútua Terrassa, 6Hospital Regional Universitario de Málaga, 7Complejo Asistencial de Ávila, 8Hospital Universitario Fundación Alcorcón, 9Hospital de Galdakao-Usansolo, 10Hospital Universitario Clínico San Cecilio, 11Hospital Universitari Son Espases, 12Hospital Universitari Arnau de Vilanova, 13Hospital Universitario Puerta de Hierro, 14Complexo Hospitalario Universitario de Pontevedra, 15Hospital General Universitario de Elche, 16Hospital Universitario Reina Sofía, 17Hospital Clínico Universitario Lozano Blesa, 18Fundació Salut Empordà, 19Hospital Francesc de Borja, 20Hospital Universitario Puerta del Mar, 21Consorci Corporació Sanitària Parc Taulí, 22Hospital Universitario Ramón y Cajal
Objective:
The study’s aim was to assess the impact of early-stage relapsing remitting multiple sclerosis (RRMS) on health-related quality of life (HRQoL).
Background:
Number of relapses, disability progression, and symptomatology can reduce RRMS patients’ HRQoL. However, limited information is available in early-stage patients.
Design/Methods:
A multicentre, non-interventional study was conducted. Adult patients with RRMS diagnosis, disease duration ≤3 years, and Expanded Disability Status Scale (EDSS) score between 0-5.5 were included. The 29-item Multiple Sclerosis Impact Scale (MSIS-29), SymptoMScreen (SyMS), 8-item Stigma Scale for Chronic Illness (SSCI-8), Hospital Anxiety and Depression Scale (HADS), Modified Fatigue Impact Scale (MFIS), 23-item Multiple Sclerosis Work Difficulties Questionnaire (MSWDQ-23), and EDSS were used to assess HRQoL, symptom severity, perception of stigma, depression and anxiety, fatigue, workplace barriers, and disability, respectively. Outcome measures associations were analyzed using Pearson correlation.
Results:
A total of 189 patients were included (mean age: 36.1±9.4 years, 71.4% female, mean disease duration: 1.4±0.8 years, median EDSS: 1.0 [IQR: 0-2]).
Mean physical and psychological MSIS-29 sub-scores were 29.2±11.3 and 17.2±6.6, respectively. Mean SyMS score was highest for fatigue (1.6±1.4). Stigma prevalence was 56.6% (n=107/189) and 24.9% (n=47/189) of patients were probable anxiety cases. Physical and psychological MSIS-29 showed a significant correlation between them (rho=0.702, p<0.0001). Physical MSIS-29 subscale showed strong significant correlations with symptom severity, fatigue, and workplace barriers (rho=0.822, 0.778, 0.725, respectively, all p<0.0001). Psychological MSIS-29 subscale showed strong significant correlations with anxiety, depression, symptom severity, workplace barriers, and fatigue (rho=0.817, 0.791, 0.759, 0.722, 0.716, respectively, all p<0.0001). Symptom severity and workplace barriers were both strongly correlated with fatigue (rho=0.800, 0.774, respectively, p<0.0001). Stigma was moderately correlated with both MSIS-29 subscales (p<0.0001).
Conclusions:
RRMS can affect patients’ HRQoL even in early stages of the disease. Evaluating symptomatology impact at disease onset can help clinicians discerning when to apply early interventions, improving patient care and patients’ well-being.