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. 2017 May 18:13:1349-1357.
doi: 10.2147/NDT.S132079. eCollection 2017.

Characteristics, burden of illness, and physical functioning of patients with relapsing-remitting and secondary progressive multiple sclerosis: a cross-sectional US survey

Hillary J Gross  1 , Crystal Watson  2
Affiliations

Characteristics, burden of illness, and physical functioning of patients with relapsing-remitting and secondary progressive multiple sclerosis: a cross-sectional US survey

Hillary J Gross et al. Neuropsychiatr Dis Treat. .

Abstract

Background: Although most patients with relapsing-remitting multiple sclerosis (RRMS) will develop secondary progressive multiple sclerosis (SPMS), little is known about the burden of multiple sclerosis by disease subtype. This study describes the burden of disease in terms of demographics, disease severity, symptoms, health care resource and disease-modifying therapy (DMT) utilization, work and activity impairment, and physical functioning of SPMS and RRMS patients.

Methods: SPMS and RRMS patient responses from the 2012 and 2013 waves of the US National Health and Wellness Survey were evaluated to detect differences in demographics, disease severity, symptoms, and health care resource and DMT utilization. In addition, data from the Work Productivity and Activity Impairment and Short Form-36 questionnaires were analyzed.

Results: SPMS patients were older than RRMS patients (mean age 55.7 vs 48.9 years; P<0.001); a lower proportion were female (56.2% with SPMS vs 71.6% with RRMS; P=0.002), and fewer SPMS than RRMS patients were employed (20.0% vs 39.7%; P<0.001). SPMS patients described their disease as more severe, reporting several neurological symptoms more frequently and higher hospitalization rates than RRMS patients. A lower percentage of SPMS than RRMS patients reported DMT use. SPMS patients had greater overall work and activity impairment than RRMS patients. After controlling for baseline characteristics, impairment in physical functioning was greater in SPMS patients.

Conclusion: Overall, SPMS patients had a higher burden of illness than RRMS patients, underscoring the need to treat RRMS patients early to delay disability progressing using therapies that are effective in real-world settings.

Keywords: US National Health and Wellness Survey; disease-modifying therapy; multiple sclerosis.

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Conflict of interest statement

Disclosure At the time of the analysis, Ms Gross was an employee of Kantar Health, which was contracted by Biogen to perform the analysis on previously collected data. She is currently employed by Adelphi Research Global, which was not in any way associated with this study. Ms Watson is an employee of the study sponsor, Biogen. Preliminary results from this study have previously been presented at the Joint ACTRIMS-ECTRIMS Meeting (September 10–13, 2014, Boston, MA, USA). The authors report no other conflicts of interest in this work.

Figures

Figure 1
Figure 1
Use of DMTs by multiple sclerosis subtype. Notes: Percentages of patients using specific types of DMT are shown. Percentages may not add up to 100% because of rounding. aTwo RRMS patients and one SPMS patient were taking more than one DMT and were excluded from the analysis. Abbreviations: DMT, disease-modifying therapy; RRMS, relapsing-remitting multiple sclerosis; SPMS, secondary progressive multiple sclerosis.
Figure 2
Figure 2
Physical aspects of health-related quality of life. Notes: (A) PCS scores from the SF-36v2 questionnaire; (B) SF-36v2 physical domain scores. Mean scores are shown. Error bars represent 95% CIs. P-values are for testing differences between RRMS and SPMS using a multivariable linear regression model controlling for age, sex, and ethnicity. Dashed horizontal lines indicate mean scores in the general US population. Abbreviations: CIs, confidence intervals; PCS, physical component score; RRMS, relapsing-remitting multiple sclerosis; SF-36v2, Short Form-36; SPMS, secondary progressive multiple sclerosis.
Figure 3
Figure 3
Patient-reported general health rating. Notes: Percentages of patients reporting general health ratings from 1 (excellent) to 5 (poor) are shown. P-value is for testing difference in distribution of responses between RRMS and SPMS using a multivariable linear regression model controlling for age, sex, and ethnicity. Abbreviations: RRMS, relapsing-remitting multiple sclerosis; SPMS, secondary progressive multiple sclerosis.
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