Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

MS Disease Burden: Which Symptoms Matter Most?

Mult Scler Relat Disord; 2018 Oct; Barin, et al

While health-related quality of life (HRQoL) at population level is most affected by balance problems, spasticity, and depression in relapsing-remitting multiple sclerosis (RRMS), the biggest HRQoL losses in progressive MS (PMS) are caused by spasticity, paralysis, weakness, and pain, according to a recent study. Researchers included 855 MS registry participants with RRMS or PMS. HRQoL was measured with the EuroQol 5-Dimension EQ-5D-index and EQ-Visual Analogue Scale (EQ-VAS) on 0–100% scales. They found:

  • 611 participants with RRMS and 244 with PMS were included.
  • In RRMS, gait (−6.5%) and balance problems (−5.1%) had the largest EQ-5D-index reductions, and were also important at the population level (frequencies 45% and 52%).
  • Fatigue, depression, and spasticity (frequencies 74.1%, 31%, 38%) also contributed to the population disease burden.
  • In PMS, spasticity, paralysis, and bowel problems had the largest impact on EQ-5D-index, both at the individual and population levels.
  • The largest impact on EQ-VAS at population level was associated in RRMS with balance problems, depression, dizziness, and spasticity, while in PMS with weakness, pain, and paralysis.

Barin L, Salmen A, Disanto G, et al. The disease burden of multiple sclerosis from the individual and population perspective: Which symptoms matter most? Mult Scler Relat Disord. 2018;25:112–121. doi:10.1016/j.msard.2018.07.013.