Characteristics Affecting Health-Related Quality of Life in RRMS, Progressive MS

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In patients with relapsing remitting multiple sclerosis, the symptom with the greatest effect on health-related QoL was gait problems.
In patients with relapsing remitting multiple sclerosis, the symptom with the greatest effect on health-related QoL was gait problems.

Depression, spasticity, and problems with balance most frequently affect quality of life in relapsing-remitting forms of multiple sclerosis, but paralysis, pain, weakness, and spasticity make the largest impacts in progressive forms of multiple sclerosis, according to a study published in Multiple Sclerosis and Related Disorders.

The study included 244 individuals with a progressive form of multiple sclerosis and 611 with a relapsing-remitting form. Those in the relapsing-remitting group showed the most significant EuroQol 5-Dimension EQ-5D-index (EQ-5D-index) reductions in problems with balance (-5.1%) and gait (-6.5%), which also proved important at the population level (frequencies 52% and 45%). The population disease burden was also affected by depression (31%), spasticity (38%), and fatigue (74.1%). 

Those with progressive multiple sclerosis were most affected by paralysis, bowel problems, and spasticity, according to the EQ-5D-index among both individuals and the population. In terms of the EQ-Visual Analogue Scale (EQ-VAS), depression, spasticity, dizziness, and problems with balance made the biggest impacts on the relapsing-remitting group, and the progressive group was most affected by paralysis, pain, and weakness.

Participants in this study were Swiss and had either relapsing-remitting or progressive forms of multiple sclerosis. Their health-related quality of life was measured using scales from 0 to 100% on the EQ-VAS and EQ-5D-index. Participants were assessed with median regression models for sociodemographic characteristics, clinical details, and relations with 20 symptoms.

The study researchers conclude that, "[although] [health-related quality of life] at [the] population level is most affected by balance problems, spasticity, and depression in [relapsing-remitting multiple sclerosis], the biggest [health-related quality of life] losses in [progressive multiple sclerosis] are caused by spasticity, paralysis, weakness, and pain. Many symptoms with the largest effects in individuals substantially contribute to the population disease burden."

Reference

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.

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