Quality of life of patients with multiple sclerosis and neuromyelitis optica spectrum disorders: Cross-sectional and longitudinal analysis

• Published in: Multiple sclerosis and related disorders Vol. 58; p. 103500
• Main Authors: Kim, Seungmin, Lee, Eun-Jae, Kim, Keon-Woo, Seo, Dayoung, Moon, Seongshin, Kim, Kwang-Kuk, Lim, Young-Min
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.02.2022
• Subjects: Anxiety; Cross-Sectional Studies; Humans; Middle Aged; Multiple sclerosis; Multiple Sclerosis - complications; Multiple Sclerosis - epidemiology; Neuromyelitis Optica - complications; Neuromyelitis optica spectrum disorder; Quality of Life; EQ-5D; Multiple sclerosis; Neuromyelitis optica spectrum disorder; MS; HADS; NMOSD; Quality of life; EDSS; QoL
• ISSN: 2211-0348; 2211-0356
• DOI: 10.1016/j.msard.2022.103500

•QoL of patients with MS and NMOSD is impaired and remains low during follow-up.•High HADS scores is an independent risk factor for low baseline and follow-up QoL.•Clinicians should pay attention to anxiety/depression symptoms to improve QoL. Multiple sclerosis (MS) and aquaporin-4 antibody-positive neuromyelitis optica spectrum disorders (NMOSD), which have different pathogenic mechanisms, both negatively affect patients during their lifetime. We aimed to analyze and compare the quality of life (QoL) of patients with MS and NMOSD, its longitudinal course, and associated factors between the two diseases. Between June 2018 and April 2020, patients with MS and NMOSD who visited a tertiary hospital were prospectively enrolled. The EuroQoL-5 Dimension (EQ-5D) utility index, of which low values represent poor QoL, Expanded Disability Status Scale (EDSS), and the Hospital Anxiety and Depression Scale (HADS) were collected at enrollment and at follow-up with a 6–12-month interval. At baseline, the degree of QoL and its determinants were analyzed and compared between the MS and NMOSD groups. We also analyzed the longitudinal alteration of the EQ-5D utility indices over time and the factors associated with the follow-up QoL. During the study period, 171 patients (MS, 120; NMOSD, 51) were included. The median age was 46 years, and median EDSS score and follow-up duration were 2.5 and 8 months, respectively. At baseline, the EQ-5D utility indices were low and comparable between the MS and NMOSD groups (median: 0.86 vs. 0.82, p = 0.823). A higher HADS total score (more severe anxiety/depression symptoms) showed an independent and significant association with the baseline EQ-5D utility index in both disease groups. Longitudinally, the EQ-5D utility indices remained low. Although they did not significantly change over time at a group level, more than 50% of patients showed a longitudinal change in their EQ-5D indices in both disease groups. Of note, a higher HADS total score at enrollment was an independent predictor for poor QoL at follow-up in both disease groups. The QoL was similarly impaired between patients with MS and those with NMOSD and remained low during the follow-up period. A higher total scale of HADS was an independent risk factor for a lower QoL at baseline and at follow-up in both disease conditions, suggesting that clinicians should pay more attention to anxiety and depression in patients with MS and those with NMOSD in the long term.