Caila B Vaughn1, Katelyn S Kavak2, Michael G Dwyer3, Aisha Bushra2, Muhammad Nadeem2, Diane L Cookfair4, Murali Ramanathan5, Ralph Hb Benedict6, Robert Zivadinov7, Andrew Goodman8, Lauren Krupp9, Robert W Motl10, Bianca Weinstock-Guttman1. 1. New York State Multiple Sclerosis Consortium, Buffalo, NY, USA/Jacobs MS Center for Treatment and Research, Buffalo, NY, USA/ Department of Neurology, University at Buffalo, Buffalo, NY, USA. 2. New York State Multiple Sclerosis Consortium, Buffalo, NY, USA/Jacobs MS Center for Treatment and Research, Buffalo, NY, USA. 3. Buffalo Neuroimaging Analysis Center, Buffalo, NY, USA. 4. Jacobs MS Center for Treatment and Research, Buffalo, NY, USA/ Department of Neurology, University at Buffalo, Buffalo, NY, USA. 5. Department of Pharmaceutical Sciences, University at Buffalo, Buffalo, NY, USA. 6. Department of Neurology, University at Buffalo, Buffalo, NY, USA. 7. New York State Multiple Sclerosis Consortium, Buffalo, NY, USA/ Department of Neurology, University at Buffalo, Buffalo, NY, USA; Buffalo Neuroimaging Analysis Center, Buffalo, NY, USA. 8. University of Rochester Medical Center, Rochester, NY, USA. 9. NYU Langone Medical Center, New York, NY, USA. 10. Department of Physical Therapy, University of Alabama at Birmingham, Birmingham, AL, USA.
Abstract
BACKGROUND: Fatigue is one of the most common and distressing symptoms among persons with multiple sclerosis (pwMS). OBJECTIVE: The aim of this study is to evaluate fatigue as a predictor for disease worsening among pwMS. METHODS: In this retrospective cohort study of New York State MS Consortium (NYSMSC) registry, MS patients reporting moderate-to-severe fatigue at study enrollment (n = 2714) were frequency matched to less-fatigued subjects (n = 2714) on age, baseline Kurtzke Expanded Disability Status Scale (EDSS), disease duration, and MS phenotype. Change from baseline patient-reported outcomes (PROs), as measured by LIFEware™, categorized participants into two groups: those with stable/improved outcomes and those who worsened. In a subgroup of patients with longitudinal data (n = 1951), sustained EDSS worsening was analyzed using Cox proportional hazards modeling to explore the effect of fatigue. RESULTS: The median survival time from study enrollment to sustained EDSS worsening was 8.7 years (CI: 7.2-10.1). Participants who reported fatigue at baseline were more likely to experience sustained EDSS worsening during follow-up (HR: 1.4, 95% CI: 1.2-1.7). Patients who were fatigued at baseline were also more likely to report worsening psychosocial limitations (all ps ⩽ 0.01). CONCLUSION: In addition to being a common symptom of MS, severe fatigue was a significant predictor for EDSS worsening in the NYSMSC.
BACKGROUND:Fatigue is one of the most common and distressing symptoms among persons with multiple sclerosis (pwMS). OBJECTIVE: The aim of this study is to evaluate fatigue as a predictor for disease worsening among pwMS. METHODS: In this retrospective cohort study of New York State MS Consortium (NYSMSC) registry, MS patients reporting moderate-to-severe fatigue at study enrollment (n = 2714) were frequency matched to less-fatigued subjects (n = 2714) on age, baseline Kurtzke Expanded Disability Status Scale (EDSS), disease duration, and MS phenotype. Change from baseline patient-reported outcomes (PROs), as measured by LIFEware™, categorized participants into two groups: those with stable/improved outcomes and those who worsened. In a subgroup of patients with longitudinal data (n = 1951), sustained EDSS worsening was analyzed using Cox proportional hazards modeling to explore the effect of fatigue. RESULTS: The median survival time from study enrollment to sustained EDSS worsening was 8.7 years (CI: 7.2-10.1). Participants who reported fatigue at baseline were more likely to experience sustained EDSS worsening during follow-up (HR: 1.4, 95% CI: 1.2-1.7). Patients who were fatigued at baseline were also more likely to report worsening psychosocial limitations (all ps ⩽ 0.01). CONCLUSION: In addition to being a common symptom of MS, severe fatigue was a significant predictor for EDSS worsening in the NYSMSC.
Authors: Brian C Healy; Bonnie I Glanz; Elyse Swallow; James Signorovitch; Kaitlin Hagan; Diego Silva; Corey Pelletier; Tanuja Chitnis; Howard Weiner Journal: Mult Scler J Exp Transl Clin Date: 2021-04-11
Authors: Iman Adibi; Mehdi Sanayei; Farinaz Tabibian; Neda Ramezani; Ahmad Pourmohammadi; Kiarash Azimzadeh Journal: J Res Med Sci Date: 2022-03-17 Impact factor: 1.852