title: The impact of a recent relapse on patient-reported outcomes in subjects with multiple sclerosis.
abstract: OBJECTIVE
  In this study, we estimate the impact of a recent relapse on physical and mental health in subjects with relapsing-remitting multiple sclerosis (RRMS) using validated patient-reported outcome (PRO) measures.
  
  
  METHODS
  Subjects enrolled in the Comprehensive Longitudinal Investigation of MS at the Brigham and Women's Hospital with RRMS were eligible for enrollment. Subjects with a clinical visit within 45 days of a relapse were identified and divided into groups based on whether the relapse occurred before (recent relapse) (n = 59) or after the visit (pre-relapse) (n = 31). A group of subjects with no relapses was also identified (remission) (n = 336). PRO measures in these three groups were compared. All outcomes were compared using a t test and linear regression controlling for age, disease duration, sex, and EDSS.
  
  
  RESULTS
  Subjects with a recent relapse had significantly worse functioning on several physical and mental health scales compared to subjects in remission even after adjusting for potential confounders. Subjects with a recent relapse also showed significant deterioration on PRO measures over 1 year compared to subjects in remission (P < 0.05 for each comparison). Subjects in the pre-relapse group were not significantly different than subjects in remission.
  
  
  CONCLUSIONS
  Clinical relapses have a measurable effect on PRO in subjects with RRMS.
authors.affiliation: Partners Multiple Sclerosis Center, Brigham and Women's Hospital, 6th Floor, 1 Brookline Place, Brookline, MA 02445, USA. bchealy@partners.org
authors.forename: Brian C
authors.initials: BC
authors.lastname: Healy
authors.forename: Irene R
authors.initials: IR
authors.lastname: Degano
authors.forename: Ana
authors.initials: A
authors.lastname: Schreck
authors.forename: David
authors.initials: D
authors.lastname: Rintell
authors.forename: Howard
authors.initials: H
authors.lastname: Weiner
authors.forename: Tanuja
authors.initials: T
authors.lastname: Chitnis
authors.forename: Bonnie I
authors.initials: BI
authors.lastname: Glanz
mesh_terms: D000328:Adult; D003863:Depression / Q000175:diagnosis; D005221:Fatigue / Q000175:diagnosis; D005260:Female; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000503:physiopathology* / Q000523:psychology*; D011379:Prognosis; D011788:Quality of Life; D012008:Recurrence; D012720:Severity of Illness Index