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Health-related quality of life in secondary progressive multiple sclerosis

Department of Neurology, University Hospital of Akershus, Lørenskog, Norway

H. Naess

Department of Neurology, Haukeland University Hospital, Bergen, Norway

J.H. Aarseth

Institute of Clinical Neuroscience, Sahlgrenska University Hospital, University of Göteborg, Göteborg, Sweden

O. Andersen

Institute of Clinical Neuroscience, Sahlgrenska University Hospital, University of Göteborg, Göteborg, Sweden

I. Elovaara

Neuroimmunology Unit, Department of Neurology, Tampere University Hospital and Medical School, University of Tampere, Tampere, Finland

M. Farkkila

Department of Neurology, Helsinki University, Helsinki, Finland

H.J. Hansen

Department of Neurology, Aarhus Hospital, Aarhus University Hospital, Aarhus, Denmark

S.I. Mellgren

Department of Neurology, University Hospital of North Norway, Tromsö, Norway

M. Sandberg-Wollheim

Department of Neurology, University Hospital, University of Lund, Lund, Sweden

P.S. Sorensen

Danish MS Research Centre, Department of Neurology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark

K.M. Myhr

Department of Clinical Medicine, Section of Neurology, University of Bergen, Bergen, Norway

Common disability scales in multiple sclerosis (MS) are often weighted towards physical disability. Non-motor symptoms such as depression, fatigue and pain substantially influence wellbeing in MS. Health-related quality of life (HRQoL) measures the broader impact of MS and might indicate less obvious disease burdens. We analysed HRQoL, using the Nottingham Health Profile Part I (NHP-I), among 345 secondary progressive MS (SPMS) patients participating in a randomized trial of interferon-ß1a (IFN-ß1a), 22 µg subcutaneously weekly, or matching placebo. The results did not reveal any beneficial effect of IFN-ß1a in any outcome measure. NHP-I sub- and sum scores were compared for 217 population controls and correlated with demographic and clinical disease variables. SPMS patients had lower NHP-I sum and all subscores than the controls. Patients experiencing disease progression reported worse NHP-I sum scores. Increased fatigue, Expanded Disability Status Scale (EDSS) and Arm Index scores were independently associated with reduction in several NHP-I subscores. SPMS patients had significantly lower HRQoL than controls and physical disability (EDSS and Arm Index), disease progression and fatigue strongly influenced this. MS

Key Words: fatigue • multiple sclerosis • quality of life

Multiple Sclerosis, Vol. 13, No. 3, 386-392 (2007)
DOI: 10.1177/13524585070130030101


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