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Differential multiple sclerosis treatment allocation between Australia and New Zealand associated with clinical outcomes but not mood or quality of life

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Phyo, AZZ, Jelinek, GA, Brown, CR, O'Kearney, E, Neate, SL, De Livera, AM, Taylor, KL, Bevens, W, Simpson Jr, S ORCID: 0000-0001-6521-3056 and Weiland, TJ 2019 , 'Differential multiple sclerosis treatment allocation between Australia and New Zealand associated with clinical outcomes but not mood or quality of life' , Multiple Sclerosis and Related Disorders, vol. 30 , pp. 25-32 , doi: 10.1016/j.msard.2019.01.037.

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Abstract

Background: Differential treatment allocation may impact on clinical phenotype in MS and in turn upon quality of life (QoL).Objectives: (a) Investigate the association between disease-modifying drugs (DMDs) use and relapse frequency, disability, clinically significant fatigue, and physical and mental health-related QoL among participants with MS residing in Australia and New Zealand (NZ); (b) assess whether these associations differed between Australia and NZ.Methods: Disability and fatigue were measured by PDDS and FSS, respectively. QoL was assessed by MSQOL-54. Associations were assessed by binomial and multinomial logistic regression, as appropriate. Multivariable models were adjusted for demographic and clinical covariates, as appropriate.Results: 837 participants (627 from Australia; 210 from NZ) were identified from an online cohort of people with MS. First- and second-generation DMD use was associated with higher adjusted-odds of fatigue and disability, though not with 12-month relapse number. DMD use was not independently associated with physical or mental QoL. The association of first-generation DMD use with moderate disability differed between nations, such that treatment was associated with lower odds in Australia but not in NZ; a similar but a small difference was found for severe disability. No differences were seen in the DMD association with relapse number, nor with fatigue or QoL, between Australia and NZ.Conclusion:The differential treatment allocation associations in NZ are evident in the DMD-disability association, but there is no evidence that this treatment regimen has negative associations with fatigue, mood, or QoL.

Item Type: Article
Authors/Creators:Phyo, AZZ and Jelinek, GA and Brown, CR and O'Kearney, E and Neate, SL and De Livera, AM and Taylor, KL and Bevens, W and Simpson Jr, S and Weiland, TJ
Keywords: disability, disease modifying drug, fatigue, multiple sclerosis, quality of life, relapse
Journal or Publication Title: Multiple Sclerosis and Related Disorders
Publisher: Elsevier BV
ISSN: 2211-0348
DOI / ID Number: 10.1016/j.msard.2019.01.037
Copyright Information:

Copyright 2019 The Authors. Licensed under Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) https://creativecommons.org/licenses/by-nc-nd/4.0/

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