Fatigue at enrollment predicts EDSS worsening in the New York State Multiple Sclerosis Consortium. (January 2020)

• Record Type: Journal Article
• Authors: Vaughn, Caila B; Kavak, Katelyn S; Dwyer, Michael G; Bushra, Aisha; Nadeem, Muhammad; Cookfair, Diane L; Ramanathan, Murali; Benedict, Ralph HB; Zivadinov, Robert; Goodman, Andrew; Krupp, Lauren; Motl, Robert W; Weinstock-Guttman, Bianca
• Other Names: Kolb Channa non-byline-author.; Robb Jessica F. non-byline-author.; Jubelt Burk non-byline-author.; Gerber Allen non-byline-author.; Kister Ilya non-byline-author.; Ryerson Lana Zhovtis non-byline-author.; Coyle Patricia non-byline-author.; Perel Allan non-byline-author.; Gottesman Malcolm non-byline-author.; Lenihan Michael non-byline-author.; Edwards Keith non-byline-author.; Garten Lore non-byline-author.; Picone Mary Ann non-byline-author.
• Is Part Of: Multiple sclerosis. Volume 26:Number 1(2020)
• Page Start: 99
• Page End: 108
• Publication Date: 2020-01
• Subjects: Fatigue -- EDSS worsening -- progression -- patient-reported outcomes; Central nervous system -- Diseases -- Periodicals; Myelin sheath -- Diseases -- Periodicals; Inflammation -- Periodicals; Multiple sclerosis -- Periodicals; Central Nervous System Diseases -- Periodicals; Demyelinating Diseases -- Periodicals; Inflammation -- Periodicals; Multiple Sclerosis -- Periodicals; Système nerveux central -- Maladies -- Périodiques; Gaine de myéline -- Maladies -- Périodiques; Inflammation (Pathologie) -- Périodiques; Sclérose en plaques -- Périodiques; Electronic journals; 616.834005
• DOI: 10.1177/1352458518816619
• Languages: English
• ISSNs: 1352-4585

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 p s ⩽ 0.01). Conclusion: In addition to being a common symptom of MS, severe fatigue was a significant predictor for EDSS worsening in the NYSMSC.