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Longitudinal changes in social functioning in mildly disabled patients with relapsing–remitting multiple sclerosis receiving subcutaneous interferon β-1a: results from the COGIMUS (COGnitive Impairment in MUltiple Sclerosis) study (II)

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Abstract

Purpose

To report longitudinal changes in and explore the influence of cognition on social functioning in mildly disabled patients with relapsing–remitting multiple sclerosis (RRMS).

Methods

Italian patients (18–50 years) with RRMS and Expanded Disability Status Scale (EDSS) score ≤4.0 were assigned to interferon β-1a, 44 or 22 μg subcutaneously three times weekly, and underwent annual assessments for social functioning (Environmental Status Scale [ESS]) over 3 years.

Results

Baseline total ESS score did not differ between patients with and without cognitive impairment (P = 0.505). Total ESS score remained low (<2.0) and stable over 3 years in the whole study population, but worsened slightly when assessed by assigned treatment or treatment and baseline cognitive status (both P = 0.004), driven mostly by changes in the ‘transportation’ and ‘financial/economic status’ subscales. The strongest independent predictor of worsening ESS score was baseline EDSS score. Test–retest analyses confirmed that total ESS score and most subscales changed little over 3 years.

Conclusion

ESS scores remained low and changed minimally over 3 years, reflecting the mild physical disability and good cognitive performance in this patient population. Determining the influence of cognitive function and treatment on longitudinal changes in social functioning requires further studies.

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Abbreviations

ANCOVA:

Analysis of covariance

ANOVA:

Analysis of variance

BRB:

Brief Repeatable Battery

CI:

Confidence interval

COGIMUS:

COGnitive Impairment in MUltiple Sclerosis

EDSS:

Expanded Disability Status Scale

ESS:

Environmental Status Scale

FIS:

Fatigue Impact Scale

HDRS:

Hamilton Depression Rating Scale

IFN:

Interferon

IQ:

Intelligence quotient

MHCS:

Mental Health Composite Score

MRI:

Magnetic resonance imaging

MS:

Multiple sclerosis

MSQoL:

Multiple Sclerosis Quality of Life

OR:

Odds ratio

QoL:

Quality of life

RRMS:

Relapsing–remitting multiple sclerosis

sc:

Subcutaneous(ly)

SD:

Standard deviation

SPART:

Spatial Recall Test

SRT:

Selective Reminding Test

ST:

Stroop Color Word Task

tiw:

Three times weekly

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Acknowledgments

This study was supported by the European Biomedical Foundation, Rome, Italy. The authors thank Andrea Plant of, and Reza Sayeed for, Caudex Medical Ltd, Oxford, UK (supported by Merck Serono S.A.—Geneva, Switzerland, a branch of Merck Serono S.A., Coinsins, Switzerland, an affiliate of Merck KGaA, Darmstadt, Germany), for assistance in the preparation of this manuscript. The manuscript has been reviewed by Merck Serono for the limited purpose of providing complete and balanced medical/scientific information and to ensure that the publication is objective and scientifically/medically accurate. The views and opinions described herein do not necessarily reflect those of Merck Serono.

Author information

Authors and Affiliations

  1. Multiple Sclerosis Centre Sicilia Region, First Neurology Clinic, University Hospital, Catania, Italy

    Francesco Patti

  2. Department of Neurology, University of Florence, Florence, Italy

    Maria Pia Amato

  3. Department of Neurological and Psychiatric Sciences, University of Bari, Bari, Italy

    Maria Trojano

  4. Neurological Institute, IRCCS Fondazione C. Mondino, Pavia, Italy

    Stefano Bastianello

  5. U.O. Neurology, Department of Neuroscience and Rehabilitation, Azienda Università-Ospedale, S. Anna, Ferrara, Italy

    Maria Rosalia Tola

  6. Opera CRO Scientific Advisory Board, Genoa, Italy

    Orietta Picconi & Sabina Cilia

  7. Centro Di Riferimento Regionale di Neuroimmunologia, Palermo, Italy

    Salvatore Cottone

  8. Fondazione Istituto S. Raffaele “g. Giglio”, Cefalù, Italy

    Luigi M. E. Grimaldi

  9. Department of Neurology, University of Catania, Via Santa Sofia 78, 95123, Catania, Italy

    Francesco Patti

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  1. Francesco Patti
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  2. Maria Pia Amato
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  9. Luigi M. E. Grimaldi
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Correspondence to Francesco Patti.

Additional information

This study is conducted on behalf of the COGIMUS study group.

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Patti, F., Amato, M.P., Trojano, M. et al. Longitudinal changes in social functioning in mildly disabled patients with relapsing–remitting multiple sclerosis receiving subcutaneous interferon β-1a: results from the COGIMUS (COGnitive Impairment in MUltiple Sclerosis) study (II). Qual Life Res 21, 1111–1121 (2012). https://doi.org/10.1007/s11136-011-0021-6

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  • DOI: https://doi.org/10.1007/s11136-011-0021-6

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