Quality of life in 1000 patients with early relapsing-remitting multiple sclerosis.
OBJECTIVE
To examine the quality of life (QoL) in a large cohort of untreated patients with relapsing-remitting multiple sclerosis (RRMS) and to investigate the impact of intramuscular (IM) interferon beta-1a (IFNbeta-1a) treatment.


METHODS
Prospective, observational, open-label, multicentre study conducted in Germany. Untreated patients with RRMS who initiated treatment with IM IFNbeta-1a were included and followed for 12 months. QoL was measured using the EQ-5D questionnaire. Clinical response was assessed by relapse rate and disability (Expanded Disability Status Scale; EDSS).


RESULTS
A total of 1157 patients were included [mean age 37.6 years, median disease duration 13 months, mean relapse rate 1.7 (95%CI: 1.58-1.73), median EDSS score 2.0]. Relapse rate was reduced to 0.6 at 12 months (95%CI: 0.51-0.69, P < 0.0001). EDSS did not change significantly. At baseline, QoL was considerably lower in MS patients compared with the general German population, but was improved after treatment initiation [utilities of EQ-5D: 0.77 (95%CI: 0.75-0.78) vs. 0.75 (95%CI: 0.74-0.76) at baseline, 95%CI for difference: 0.01-0.03, P = 0.0046]. Higher disease activity and inability to work were negative predictors of QoL. 14.7% of patients were incapable of working for MS-related reasons.


CONCLUSIONS
Quality of life is considerably impaired in early stages of MS. Treatment initiation with IM IFNbeta attenuates MS disease activity and improves QoL. Inability to work early during the disease is a major challenge for the social security systems.
Putzki
N
N
Department of Neurology, University Clinic Essen, University of Duisburg-Essen, Germany. norman.putzki@uni-due.de
Fischer
J
J
Gottwald
K
K
Reifschneider
G
G
Ries
S
S
Siever
A
A
Hoffmann
F
F
Käfferlein
W
W
Kausch
U
U
Liedtke
M
M
Kirchmeier
J
J
Gmünd
S
S
Richter
A
A
Schicklmaier
P
P
Niemczyk
G
G
Wernsdörfer
C
C
Hartung
H P
HP
D000223:Adaptation, Psychological; D000276:Adjuvants, Immunologic / Q000008:administration & dosage; D000328:Adult; D015331:Cohort Studies; D004185:Disability Evaluation; D005260:Female; D005858:Germany; D017048:Health Care Costs / Q000706:statistics & numerical data; D006304:Health Status; D006801:Humans; D000068556:Interferon beta-1a; D016899:Interferon-beta / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000188:drug therapy* / Q000523:psychology*; D017063:Outcome Assessment, Health Care; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology*; D012008:Recurrence; D012720:Severity of Illness Index; D018582:Sick Leave / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D013997:Time Factors
D000276:Adjuvants, Immunologic; D016899:Interferon-beta; D000068556:Interferon beta-1a