A snapshot on patient-reported outcome measures of people with multiple sclerosis on first-line therapies in a real worl
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ORIGINAL ARTICLE
A snapshot on patient-reported outcome measures of people with multiple sclerosis on first-line therapies in a real world setting R. Lanzillo 1 & M. Sparaco 2 & L. Lavorgna 2 & L. Carmisciano 3 & E. Signoriello 2 & A. Signori 3 & T. Costabile 1 & G. T. Maniscalco 4 & F. Saccà 1 & S. Cepparulo 2 & C. V. Russo 1 & A. Bisecco 2 & N. Frattaruolo 1 & A. Strianese 1 & G. Lus 2 & V. Brescia Morra 1 & S. Bonavita 2 Received: 28 December 2019 / Accepted: 20 March 2020 # Fondazione Società Italiana di Neurologia 2020
Abstract Background Patient-reported outcomes (PROs) may help patients and clinicians in selecting disease-modifying therapies (DMTs) for multiple sclerosis (MS). Objective To evaluate PRO differences among first-line DMTs for relapsing-remitting (RR) people with MS (pwMS). Methods Multicenter study. RR pwMS on first-line DMTs completed Fatigue Severity Scale (FSS), PROs Indices for MS (PRIMUS), 36-item Short-Form Health Survey (SF-36), treatment satisfaction questionnaire for medication (TSQM), Beck Depression Inventory-II (BDI-II), and Symbol Digit Modalities Test (SDMT). Differences among PROs across DMTs were tested by ANOVA. Multivariable linear regressions were used to investigate associations between PROs and the treatment group. Results Two-hundred eighty pwMS were enrolled: 56% were on interferons (INF), 22% on dimethylfumarate (DMF), 13% on glatiramer acetate, and 9% on teriflunomide (Teri). Compared with INF, pwMS on Teri were the oldest, with higher disability, worst depression at BDI, worst cognitive performances at SDMT (p = 0.001), fatigue at FSS (p = 0.001), and activity limitation and quality of life respectively at PRIMUS (p = 0.005) and SF-36 Mental Composite Score (p < 0.001); pwMS on DMF reported highest side effects and, together with pwMS on Teri, better treatment satisfaction at TSQM. Conclusions Compared with INF-treated patients, pwMS on DMF and Teri reported the best treatment satisfaction, although DMF-treated pwMS reported higher side effects and those on Teri the worst QoL and fatigue; however, the older age, higher disability and depression, and worse cognitive performance of pwMS on Teri suggest to be careful in evaluating these results. Keywords Multiple sclerosis . Patient-reported outcomes . First-line therapies . Disease-modifying therapies
Introduction R. Lanzillo and M. Sparaco contributed equally to the manuscript. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10072-020-04367-9) contains supplementary material, which is available to authorized users. * S. Bonavita [email protected] 1
Multiple Sclerosis Center, Department of Neuroscience, Reproductive Sciences and Odontostomatology, Federico II University, Naples, Italy
2
Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, Piazza Miraglia, 2, 80138 Naples, Italy
3
Department of Health Sciences (DISSAL), Section of Biostatistics, University of Genova, Genova, Italy
4
MS Centre, Neurology Unit, Ca
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