Influence of Interferon beta treatment on quality of life in multiple sclerosis patients

Isabella Laura Simone,Fabio Pellegrini,Francesco Girolamo,Maria Fara De Caro,Immacolata Plasmati,Antonia Ceccarelli,Paolo Livrea,Carla Tortorella,Alessandra Bellacosa,Mariangela Lopez

doi:10.1186/1477-7525-4-96

Abstract

BackgroundInterferon-beta (IFN-β) shows beneficial effect on the course of multiple sclerosis (MS), nevertheless its route and frequency of administration and side effects might impact negatively the quality of life (QoL) of MS patients. The objective of this study was to evaluate the influence of IFN-β on QoL in MS patients.MethodsSeventy-seven disease modifying treatment (DMT) free and 41 IFN-β treated MS patients were evaluated. QoL, assessed by MSQoL-54, was related to IFN-β treatment and to clinical and demographic parameters at baseline and after two years. Multivariate hierarchical linear model for repeated measurements was used.ResultsTreated patients showed a younger age, a lower disease duration and a higher relapse rate in the two years preceding study entry. At inclusion time treated and untreated patients did not differ in relapse rate, expanded disability status scale (EDSS), fatigue, depression, physical and mental QoL. IFN-β did not influence QoL at inclusion time, but when QoL was evaluated after two years, treatment negatively affected mental QoL. Depression and fatigue negatively influenced physical and mental QoL both at baseline and after two years. EDSS correlated with a poor physical QoL only at baseline.ConclusionIFN-β had a negative impact on QoL over the time in MS patients, influencing mainly mental QoL. The impairment of QoL in MS was strongly associated with increasing fatigue and depression, whereas clinical disability had a minor unfavourable role.

Highlights

Interferon-beta (IFN-β) shows beneficial effect on the course of multiple sclerosis (MS), its route and frequency of administration and side effects might impact negatively the quality of life (QoL) of MS patients
At baseline MS groups did not differ in expanded disability status scale (EDSS), Beck Depression Inventory (BDI), Fatigue severity scale (FSS), physical, mental health composite scores as well as relative scales
Relapse rate in the two years before study entry was significantly higher in IFN-β treated patients (p < 0.0001) (Table 2)

Summary

Introduction

Interferon-beta (IFN-β) shows beneficial effect on the course of multiple sclerosis (MS), its route and frequency of administration and side effects might impact negatively the quality of life (QoL) of MS patients. The objective of this study was to evaluate the influence of IFN-β on QoL in MS patients. Recent studies reported that QoL assessment may provide unique information often underestimated by the EDSS [1,2,3], which remains to date the primary clinical outcome measure for MS related disability [4]. The QoL instrument is recommended as an outcome measure of therapeutic choices and treatment effectiveness, its use is still limited in the routine clinical approaches [12]. Some authors reported a beneficial influence of IFN-β therapy on QoL [13,14]. Adverse effects related to treatment may negatively impact QoL [14,15]

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