Quality of Life and Treatment Outcomes Among People with Multiple Sclerosis before and during the COVID-19 Pandemic

Background: Ongoing research on the impact of COVID-19 on people with multiple sclerosis (MS) is needed.

Objectives: To evaluate quality of life (QoL) and treatment outcomes before and during COVID-19 among participants in MS Lifelines (MSLL), a patient-support program for individuals receiving cladribine tablets or subcutaneous interferon-β1a (scIFNβ1a), and the National Health and Wellness Survey (NHWS).

Methods: MSLL participants with relapsing MS, treatment with cladribine tablets/scIFNβ1a, and age ≥18 years from May 12–July 2, 2021 were propensity-score matched based on age, sex, race, and Charlson Comorbidity Index (CCI) score to individuals without MS from the 2019 and 2021 NHWS. Participants with MS from the 2019 and 2021 NHWS were also evaluated. Demographics, clinical characteristics, QoL (Short-Form 12-Item v2), fatigue (Modified Fatigue Impact Scale-5), cognitive impairment (Perceived Deficits Questionnaire-5), and depression (Patient Health Questionnaire-9) were compared.

Results: Among MSLL participants (n=1090), 2019 NHWS participants with MS (n=101), matched 2019 NHWS participants without MS (n=2180), 2021 NHWS participants with MS (n=65), and matched 2021 NHWS participants without MS (n=2180): mean (SD) age was 50.01 (11.85)/51.75 (12.26)/49.90 (11.88)/51.77 (12.60)/49.92 (12.02); % female was 78.2%/82.2%/78.2%/90.8%/78.2%; and mean (SD) CCI score was 0.41 (0.89)/1.05 (3.89)/0.39 (0.81)/0.52 (0.97)/0.39 (0.81). Compared with 2019/2021 NHWS participants without MS, MSLL participants had lower mean [SD] physical component QoL (PC; 50.04 [9.41]/50.48 [9.35] vs. 43.82 [11.51]) and health utilities (HU; 0.722 [0.136]/0.717 [0.146] vs. 0.687 [0.145]) and more depression (35.8%/38.1% vs. 56.5%). However, compared with 2019/2021 NHWS participants without MS, MSLL participants had higher mental component QoL (MC; 47.59 [10.87]/46.91 [11.85] vs. 48.35 [10.47]). Compared with 2019/2021 NHWS participants with MS, MSLL participants had higher mean [SD] QoL (MC 44.88 [12.12]/45.48 [12.91] vs. 48.35 [10.47]; PC 39.41 [10.89]/39.46 [10.65] vs. 43.82 [11.51]; HU 0.633 [0.132]/0.638 [0.123] vs. 0.687 [0.145]) and QoL, fatigue, and cognitive impairment were similar for NHWS participants with MS pre- and during COVID-19.

Conclusions: MSLL participants had favorable QoL vs. NHWS participants with MS and favorable mental QoL vs. NHWS participants without MS; however, differences were small and must be interpreted in the context of study design limitations