A real-world study characterizing symptoms and impacts of fatigue in US adults with relapsing multiple sclerosis using a novel disease specific scale (4119)

Objective: To measure multiple sclerosis (MS) fatigue and its impact on daily life in a real-world population using a survey including the relapsing MS (RMS)-specific Fatigue Symptoms and Impacts Questionnaire-Relapsing Multiple Sclerosis (FSIQ-RMS).

Background: Fatigue is among the most frequent and disabling symptoms in RMS patients.

Design/Methods: This is an ongoing noninterventional prospective study of RMS patients recruited across the USA via an online survey. Participants completed questionnaires including disease history, disease status, sleep, social and emotional functioning, and the FSIQ-RMS, administered daily for 7 days. The FSIQ-RMS measures self-reported fatigue, and scores range from 0–100 (higher score = greater severity).

Results: A total of 300 RMS participants completed the 7-day assessment: mean age: 43.0 yrs; 88% women; mean diagnosis age: 32 yrs. Fatigue was reported as the symptom with the greatest impact on daily functioning. Fatigue was rated as severe, with a mean score of 57.3 for the FSIQ-RMS symptom domain; 3 impact sub-domain scores were 42.3, 43.4 and 50.1 (physical, cognitive/emotional, and coping). Most participants (78%) were outside the window of a self-reported relapse, and reported less severe fatigue than those in relapse: mean fatigue symptom domain score of 54.6±17.8 vs. 67.0±19.7, p=0.0001. Fatigue had a higher intensity among those with depression than without (49% vs. 51%, with scores of 62.7±16.8 vs. 52.1±19.3, p<0.001) and among those with sleep disorder than without (26% vs. 74%, with scores of 61.4±19.2 vs. 55.8±18.6; p<0.01). A majority of participants (52%) reported experiencing fatigue before their MS diagnosis. Those with lower disability rated fatigue as the most impactful symptom on daily life. The most common factor associated with increased fatigue was heat exposure (82%).

Conclusions: In this survey including the novel RMS specific FSIQ-RMS, fatigue occurred in most MS participants and adversely influenced daily functioning. Fatigue remains a major concern for those with MS.

Disclosure: Dr. Lair has received personal compensation for serving as an employee of Janssen. An immediate family member of Dr. Lair has received personal compensation for serving as an employee of Johnson & Johnson. An immediate family member of Dr. Lair has received personal compensation for serving as an employee of Aetna/CVS. Dr. Lair has received stock or an ownership interest from Johnson & Johnson. An immediate family member of Dr. Lair has received stock or an ownership interest from Aetna/CVS. Dr. Lair has a non-compensated relationship as a Board Member with NY State Neurological Society that is relevant to AAN interests or activities. Tiphaine Lévy-Heidmann has nothing to disclose. Valentin Morisseau has nothing to disclose. Carol Jamieson has received personal compensation for serving as an employee of Janssen. Dr. Charvet has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Johnson & Johnson. An immediate family member of Dr. Charvet has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Springer Healthcare. The institution of Dr. Charvet has received research support from Biogen Idec. Dr. Krupp has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Biogen. The institution of Dr. Krupp has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Dr. Krupp has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Janssen. Dr. Krupp has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Gerson Lerhman. Dr. Krupp has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi. Dr. Krupp has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Krupp has received personal compensation in the range of $500-$4,999 for serving as an officer or member of the Board of Directors for Cleveland Clinic. Dr. Krupp has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for MCIC. The institution of Dr. Krupp has received research support from Biogen. The institution of Dr. Krupp has received research support from National Multiple Sclerosis Society. Dr. Krupp has received intellectual property interests from a discovery or technology relating to health care. Marion Azoulai has nothing to disclose.