The effect of immunomodulatory treatment on multiple sclerosis fatigue
- L M Metz1,3,
- S B Patten2,
- C J Archibald1,3,
- J I Bakker1,3,
- C J Harris1,3,
- D G Patry1,3,
- R B Bell1,3,
- M Yeung1,3,
- W F Murphy1,3,
- C A Stoian3,
- K Billesberger3,
- L Tillotson3,
- S Peters3,
- D McGowan1,3
- 1Department of Clinical Neurosciences, University of Calgary, Alberta, Canada
- 2Department of Community Health Sciences, University of Calgary
- 3Multiple Sclerosis Program, Foothills Medical Center, Calgary, Alberta, Canada
- Correspondence to: Dr L Metz Foothills Hospital, 1403-29th Street NW, Calgary, Alberta T2N 2T9, Canada; lmetzucalgary.ca
- Received 25 November 2002
- Accepted 25 November 2003
- Revised 22 November 2003
Abstract
Objective: To assess the effects of glatiramer acetate and β interferon on fatigue in multiple sclerosis.
Methods: Fatigue was measured at baseline and six months using the fatigue impact scale (FIS). Groups (glatiramer acetate and β interferon) were evaluated for the proportion improved, using Fisher’s exact test. Logistic regression analysis assessed the relation between treatment group and improvement and controlled for confounding variables.
Results: Six month paired FIS assessments were available for 218 patients (76% female). Ages ranged between 19 and 61 years, with 86% having relapsing-remitting disease. Glatiramer acetate was used by 61% and β interferon by 39%. At baseline, total FIS and subscale scores were comparable in the two groups. More patients improved on glatiramer acetate than on β interferon on total FIS (24.8% v 12.9%, p = 0.033; adjusted odds ratio = 2.36, 95% confidence interval 1.03 to 5.42), and on physical (28.6% v 14.1%, p = 0.013) and cognitive subscales (21.1% v 10.6%, p = 0.045). Logistic regression analysis confirmed the association between glatiramer acetate use and improved fatigue, after accounting for baseline group differences.
Conclusions: The odds of reduced multiple sclerosis fatigue were around twice as great with glatiramer acetate treatment as with β interferon. Confirmation of this result is required.
- EDSS, extended disability status scale
- FIS, fatigue impact scale
- RRMS, relapsing-remitting multiple sclerosis
Footnotes
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Competing interests: LMM, CJH, DGP, MY, WFM, and RBB have all received speakers’ fees and fees for consulting from the manufacturers of all products mentioned (Serono, Biogen, Berlex, Teva). LMM, RBB, and DGP have received fees for organising educational events from all the above manufacturers. Fellows in the Calgary MS Clinic have been sponsored by Teva and Biogen. LMM has received funds for research from all manufacturers.
