Abstract Details

Title Disability Level and Comorbidity Burden among Multiple Sclerosis (MS) Patients in the US

Topic Multiple Sclerosis

Presentation(s) P4 - Poster Session 4 (5:30 PM-6:30 PM)

Poster/Presentation
Number 15-082

Objective Examine burden of comorbidity and MS-related secondary conditions among patients with 12-month stable EDSS (Expanded Disability Status Scale) assessment.

Background While the overall burden of MS is clear, information on comorbidity burden associated with different degrees of disability is sparse. Examining whether comorbidity burden increases in the absence of EDSS score change may inform our understanding of disease progression.

Design/Methods EDSS score was used to characterize disability level. Data (January 2012-April 2018) from US ambulatory electronic health records (primary care; specialists) were used in cross-sectional analysis. MS patients with ≥2 EDSS scores and EDSS score stability (< ±0.5) over a 12-month period (index=start of period) were included. Comorbidity score (Charlson Comorbidity Index) and MS-related secondary conditions collected within 90 days pre/post each time point (index, month 12) were described using repeated-measures ANOVA, McNemar’s test and pairwise comparison.

Results Patients (n=134) were grouped by EDSS score: mild (0 to <4; n=63), moderate (4 to 6; n=33), severe disability (>6; n=38); mean EDSS score was 4.13. Average age was 45.5 years with older patients in the severe group (49.5 years). Comparing across all disability groups, an increase was observed in comorbidity score (0.31 to 0.75, p<0.001); number of secondary conditions (0.34 to 0.67, p=0.002); and percent of patients with depression (9.7 to 20.9%, p=0.025) or fatigue (7.5 to 18.7%, p=0.018). Within group analysis revealed that those with moderate disability experienced a notable increase in number of secondary conditions (0.30 to 0.82, p=0.027) and fatigue (6.1 to 42.4%, p=0.004). Three-fold greater odds of experiencing fatigue were observed for moderate vs. mild patients (OR=3.16 [1.23, 8.90], p=0.013).

Conclusions Comorbidity burden increased for MS patients with 12-month stable EDSS score. Further, an increase in fatigue among patients with moderate disability may signal the opportunity to assess progression even in the absence of EDSS score deterioration.

Authors/Disclosures
PRESENTER	No disclosure on file
Regina Berkovich, MD, PhD (Regina Berkovich MD PhD Inc)	The institution of Dr. Berkovich has received personal compensation in the range of $50,000-$99,999 for serving as a Consultant for Alexion, Biogen, Genentec, Mallincrodt, Sanofi, Novartis, . Dr. Berkovich has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen, Genentec, Sanofi, Merck . Dr. Berkovich has received personal compensation in the range of $50,000-$99,999 for serving on a Speakers Bureau for Alexion, Biogen, Sanofi, Merck, Mallincrodt . The institution of Dr. Berkovich has received research support from Biogen, Sanofi, Merck.
	No disclosure on file
	No disclosure on file
Wendy Su, PhD	No disclosure on file
	No disclosure on file

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