Abstract
ObjectivesTreatment of multiple sclerosis patients with glatiramer acetate has been demonstrated a beneficial effect on disease activity. The objective of this prospective naturalistic study was to evaluate the impact of glatiramer acetate on fatigue and work absenteeism.Methods291 treatment-naïve patients with relapsing remitting multiple sclerosis were included and treated with glatiramer acetate for twelve months. Relapse rates, disability, fatigue symptoms, days of absence from work and adverse events were monitored. Fatigue was measured with the MFIS scale and with a visual analogue scale.ResultsTotal MFIS scores decreased by 7.6 ± 16.4 from 34.6 to 27.0 (p ≤ 0.001). Significant reductions were observed on all three subscales of the MFIS. Fatigue symptoms, assessed using a visual analogue scale, decreased by 1.04 ± 2.88 cm from 4.47 cm to 3.43 cm (p ≤ 0.001). The proportion of patients absent from work at least once was reduced by a factor of two from 65.1% to 30.1% (p ≤ 0.001). Tolerance to treatment was rated as very good or good in 78.3% of patients. Adverse effects, most frequently local injection site reactions, were reported in 15.1% of patients.ConclusionTreatment with glatiramer acetate was associated with a significant improvement in fatigue symptoms and a marked reduction in absence from work. Treatment was well-tolerated. Such benefits are of relevance to overall patient well-being.
Highlights
Fatigue is a common symptom of multiple sclerosis [1,2,3,4,5], reported by around three-quarters of affected patients [3], and considered one of the most distressing symptoms of disease by over half [2]
This study was a prospective, observational, non-interventional study of patients with relapsing remitting multiple sclerosis treated with glatiramer acetate conducted in Germany. 130 ambulatory and hospital neurologists participated in the study
Fatigue was assessed by the patient using a visual analogue scale scored from 0 to 10 and with the Modified Fatigue Impact Scale (MFIS) [25] in its validated German translation
Summary
Fatigue is a common symptom of multiple sclerosis [1,2,3,4,5], reported by around three-quarters of affected patients [3], and considered one of the most distressing symptoms of disease by over half [2]. Fatigue has a major detrimental impact on quality of life [6,7,8], is frequently associated with depression [9,10] and is a leading cause of absence from work or impaired work performance [6,11,12]. Treatment of fatigue in multiple sclerosis is a major challenge, which cannot be adequately achieved at the present time. Both non-pharmacological and pharmacological interventions have been proposed for the management of fatigue in multiple sclerosis patients [15,17],. Of particular interest was the observation that a significantly higher proportion of glatiramer acetate treated patients than β-interferon-treated patients improved by at least one standard deviation of the Fatigue Impact Scale (FIS)
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