Fatigue in multiple sclerosis – Insights into evaluation and management

Ayache, Samar S.; Chalah, Moussa A.

doi:10.1016/j.neucli.2017.02.004

Cited by 129 publications

(96 citation statements)

References 239 publications

(286 reference statements)

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“…The giving findings in consistent with ] 6,35 [ who emphasized that that fatigue may affect up to 80 % of MS patients, it can be severe in up to 60-70 % of them, and it tends to persist over time once it appears as it compared to those with chronic fatigue syndrome.. Moreover, [36] mentioned that 90% of fatigue could be a very debilitating and difficult to treat symptom.…”

Section: Discussionsupporting

confidence: 82%

Fatigue and Self-management among Multiple Sclerosis Patients

Shawli¹,

Abdulmutalib²,

Nagshabandi³

2019

AJNR

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Fatigue is considered as the most revealed symptoms in multiple sclerosis patients, reported by 88% of patients and has significant impact on all stages of life such as altering in daily living activity or psychosocial/mental functions. The pathogenesis of fatigue remain poorly understood and how its impact on self-management. The aim of study was to assess fatigue and self management among multiple sclerosis patients. A quantitative descriptive correlational design was used in this study. The study was conducted at both King Abdulaziz University Hospital and King Fahad Armed Forces Hospitals in Jeddah City from January till March 2018, data collected from outpatients' clinic and Inpatients' medical-wards. A convenience sample of 50 Multiple Sclerosis patients. Data was collected through the main one tool, it consists of three parts; Part I, Socio-demographic and clinical data constructed by the researchers. Part П, Modified Fatigue Impact scale; to assess the Impact of fatigue on physical, cognitive, and psychosocial functioning in patient with Multiple Sclerosis.. Part ПІ, Multiple Sclerosis Self Management Scale Revised; to provide a multidimensional and psychometrically assessment of self-management knowledge and behavior among Multiple Sclerosis patients. The study results showed there was a statistically significant negative correlations between fatigue subscales and overall self-management among Multiple Sclerosis patients with p-value (.019). Also, there was a statistically significant negative correlations between self-management factor scales and overall fatigue among Multiple Sclerosis patients with p-value (.019). It was concluded that there was a negative correlations between overall fatigue and overall self-management among Multiple Sclerosis patients, whenever fatigue severity increases, self-management decreases. It was a recommendation to encourage governmental policy and other decision makers in the Saudi community to develop periodically structure health education training program regarding self-management in MS and provide appropriate environments or facilities to conduct such programs, where nurses play a key role through health education and cooperate with other health care system.

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Section: Discussionsupporting

confidence: 82%

Fatigue and Self-management among Multiple Sclerosis Patients

Shawli¹,

Abdulmutalib²,

Nagshabandi³

2019

AJNR

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“…Indeed, this intervention was found in some studies to significantly decrease fatigue severity when applied over the left DLPFC for 20 min [28]. Such antifatigue effects were only obtained when the sessions were repeated daily for five consecutive days [1,28]. Since tDCS effects seems transient and could fade away one to two weeks later, some case studies aimed to prolong the efficacy and have documented that repetition of stimulation sessions could guarantee the maintenance of such effects [29,30], and could significantly decrease the anxiety and depression scores, the latter being evaluated as secondary endpoints.…”

Section: Therapeutic Approach and Perspectivesmentioning

confidence: 96%

“…Regarding fatigue, the available pharmacological strategies are limited to few treatments, most of which ended up being inefficient or responsible for several annoying side effects [1]. The fact that most of the available treatments are unsatisfactory makes the management of MS fatigue disappointing in the majority of cases.…”

Section: Therapeutic Approach and Perspectivesmentioning

confidence: 99%

“…Among these symptoms, fatigue stands as one of the most common complaints and is usually perceived as the most debilitating MS-related problem. Indeed, 75%-90% of MS patients suffer from fatigue at some point during their lifetime and could be left without an efficient solution despite the tremendous effort usually exerted by the medical staff [1].…”

Section: Introductionmentioning

confidence: 99%

“…Indeed, it is now widely accepted that MS fatigue implies three components: physical, psychosocial, and cognitive. All of the components are screened for and assessed in a subjective manner, using some available questionnaires, among which, we can cite the modified fatigue impact scale, a 21-item tool that permits clinicians to evaluate the three dimensions of fatigue [1].…”

Section: Introductionmentioning

confidence: 99%

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Fatigue and Affective Manifestations in Multiple Sclerosis—A Cluster Approach

Ayache

Chalah

2019

Brain Sciences

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Ponesimod Compared With Teriflunomide in Patients With Relapsing Multiple Sclerosis in the Active-Comparator Phase 3 OPTIMUM Study

et al. 2021

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IMPORTANCE To our knowledge, the Oral Ponesimod Versus Teriflunomide In Relapsing Multiple Sclerosis (OPTIMUM) trial is the first phase 3 study comparing 2 oral disease-modifying therapies for relapsing multiple sclerosis (RMS).OBJECTIVE To compare the efficacy of ponesimod, a selective sphingosine-1-phosphate receptor 1 (S1P 1 ) modulator with teriflunomide, a pyrimidine synthesis inhibitor, approved for the treatment of patients with RMS. DESIGN, SETTING, AND PARTICIPANTSThis multicenter, double-blind, active-comparator, superiority randomized clinical trial enrolled patients from April 27, 2015, to May 16, 2019, who were aged 18 to 55 years and had been diagnosed with multiple sclerosis per 2010 McDonald criteria, with a relapsing course from the onset, Expanded Disability Status Scale (EDSS) scores of 0 to 5.5, and recent clinical or magnetic resonance imaging disease activity.INTERVENTIONS Patients were randomized (1:1) to 20 mg of ponesimod or 14 mg of teriflunomide once daily and the placebo for 108 weeks, with a 14-day gradual up-titration of ponesimod starting at 2 mg to mitigate first-dose cardiac effects of S1P 1 modulators and a follow-up period of 30 days. MAIN OUTCOMES AND MEASURESThe primary end point was the annualized relapse rate. The secondary end points were the changes in symptom domain of Fatigue Symptom and Impact Questionnaire-Relapsing Multiple Sclerosis (FSIQ-RMS) at week 108, the number of combined unique active lesions per year on magnetic resonance imaging, and time to 12-week and 24-week confirmed disability accumulation. Safety and tolerability were assessed. Exploratory end points included the percentage change in brain volume and no evidence of disease activity (NEDA-3 and NEDA-4) status.RESULTS For 1133 patients (567 receiving ponesimod and 566 receiving teriflunomide; median [range], 37.0 [18-55] years; 735 women [64.9%]), the relative rate reduction for ponesimod vs teriflunomide in the annualized relapse rate was 30.5% (0.202 vs 0.290; P < .001); the mean difference in FSIQ-RMS, −3.57 (−0.01 vs 3.56; P < .001); the relative risk reduction in combined unique active lesions per year, 56% (1.405 vs 3.164; P < .001); and the reduction in time to 12-week and 24-week confirmed disability accumulation risk estimates, 17% (10.1% vs 12.4%; P = .29) and 16% (8.1% vs 9.9; P = .37), respectively. Brain volume loss at week 108 was lower by 0.34% (-0.91% vs -1.25%; P < .001); the odds ratio for NEDA-3 achievement was 1.70 (25.0% vs 16.4%; P < .001). Incidence of treatment-emergent adverse events (502 of 565 [88.8%] vs 499 of 566 [88.2%]) and serious treatment-emergent adverse events (49 [8.7%] vs 46 [8.1%]) was similar for both groups. Treatment discontinuations because of adverse events was more common in the ponesimod group (49 of 565 [8.7%] vs 34 of 566 [6.0%]). CONCLUSIONS AND RELEVANCEIn this study, ponesimod was superior to teriflunomide on annualized relapse rate reduction, fatigue, magnetic resonance imaging activity, brain volume loss, and no evidence of disease activity status, bu...

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Fatigue in multiple sclerosis – Insights into evaluation and management

Cited by 129 publications

References 239 publications

Fatigue and Self-management among Multiple Sclerosis Patients

Fatigue and Self-management among Multiple Sclerosis Patients

Fatigue and Affective Manifestations in Multiple Sclerosis—A Cluster Approach

Ponesimod Compared With Teriflunomide in Patients With Relapsing Multiple Sclerosis in the Active-Comparator Phase 3 OPTIMUM Study

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