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The association between disease activity and health-related quality of life in RRMS patients
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
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2017 (English)In: Value in Health, ISSN 1098-3015, E-ISSN 1524-4733, Vol. 20, no 9, p. A728-A728Article in journal, Meeting abstract (Other academic) Published
Abstract [en]

Objectives: Relapse-remitting multiple sclerosis (RRMS) is the most common disease course of multiple sclerosis (MS) patients. Disease activity (DA) has been shown to impact intermediate clinical outcomes including relapse rates and disease progression. However, it is unclear to what extent DA is related to ultimate health outcomes such as health-related quality of life (HRQoL). This study investigates the association between HRQoL and DA. Methods: Generic HRQoL was measured using the EQ-5D-3L utility instrument index value under the United Kingdom tariff. A cohort of 3496 adult RRMS patients enrolled in the Swedish population-based MS register during 1996-2015 (inclusive) was included from the date of first recorded EQ-5D-3L assessment (baseline). Patients were grouped according to DA within +/- 12 months of baseline. Active disease was the reference group, defined as 1+ relapse or T2 lesion. Two high disease activity groups were considered: HDA-R defined as 2+ relapses recorded within 1 year of each other, or Highly Active RRMS (HA-RRMS) defined as 9+ T2 lesions or 1+ gadolinium-enhanced T1 lesion. Patients not fulfilling any DA criteria were labelled unclassified. A general estimating equation was used to analyse the association between longitudinal EQ-5D-3L and disease activity group; adjusting for age, sex, proportion of time treated with disease modifying treatment (%DMT), and time since registry enrolment. Results: HA-RRMS was associated with a statistically significant decrease in EQ-5D-3L (coefficient -0.01, p=0.04). HDA-R and unclassified patients were not statistically significantly associated with EQ-5D-3L. Female sex and increasing age were significantly associated with decreasing EQ-5D-3L, while %DMT and time since registry enrolment were significantly associated with increasing EQ-5D-3L. Conclusions: HA-RRMS is associated with lower HRQoL over time, although it is unclear whether it is clinically significant. Additional data and modelling may be required to uncover the subtleties of the relationship between DA and HRQoL.

Place, publisher, year, edition, pages
ELSEVIER SCIENCE INC , 2017. Vol. 20, no 9, p. A728-A728
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Health Care Service and Management, Health Policy and Services and Health Economy
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URN: urn:nbn:se:umu:diva-143154DOI: 10.1016/j.jval.2017.08.1975ISI: 000413599902509OAI: oai:DiVA.org:umu-143154DiVA, id: diva2:1168339
Conference
ISPOR 20th Annual European Congress, 4–8 November 2017, Glasgow, Scotland
Available from: 2017-12-20 Created: 2017-12-20 Last updated: 2018-06-09Bibliographically approved

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Geale, Kirk

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