Neuroepidemiology Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Level 3, 207 Bouverie Street, Carlton, Melbourne, Victoria 3053 Australia.
Neuroepidemiology Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Level 3, 207 Bouverie Street, Carlton, Melbourne, Victoria 3053 Australia; Department of Psychiatry and Psychosocial Cancer Care, St Vincent's Hospital, Melbourne, Australia.
Mult Scler Relat Disord. 2019 May;30:25-32. doi: 10.1016/j.msard.2019.01.037. Epub 2019 Jan 24.
Differential treatment allocation may impact on clinical phenotype in MS and in turn upon quality of life (QoL).
(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.
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.
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.
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.
不同的治疗分配可能会影响 MS 的临床表型，进而影响生活质量（QoL）。
（a）研究居住在澳大利亚和新西兰（NZ）的 MS 患者中使用疾病修正药物（DMD）与复发频率、残疾、临床显著疲劳以及身体和心理健康相关 QoL 之间的关联；（b）评估这些关联在澳大利亚和新西兰之间是否存在差异。
使用 PDDS 和 FSS 分别测量残疾和疲劳。使用 MSQOL-54 评估 QoL。使用二项式和多项逻辑回归评估关联，具体取决于情况。适当调整多变量模型以调整人口统计学和临床协变量。
从 MS 患者在线队列中确定了 837 名参与者（627 名来自澳大利亚；210 名来自 NZ）。第一代和第二代 DMD 的使用与调整后疲劳和残疾的几率增加有关，但与 12 个月的复发次数无关。DMD 的使用与身体或心理健康 QoL 没有独立关联。第一代 DMD 使用与中度残疾的关联在国家之间存在差异，因此在澳大利亚治疗与较低的几率相关，但在 NZ 则没有；对于严重残疾，也发现了类似但较小的差异。在澳大利亚和 NZ 之间，DMD 与复发次数、疲劳或 QoL 之间没有关联差异。
在 NZ 中，不同的治疗分配关联在 DMD-残疾关联中显而易见，但没有证据表明这种治疗方案与疲劳、情绪或 QoL 有负面关联。
