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复发对接受皮质类固醇治疗的多发性硬化症患者疼痛及生活质量的影响

The Impact of Relapses on Pain and Quality of Life in Patients with Multiple Sclerosis Treated with Corticosteroids.

作者信息

Rakusa Martin, Chataway Jeremy, Hardy Todd A

机构信息

Division of Neurology, University Medical Centre Maribor, Ljubljanska 5, 2000 Maribor, Slovenia.

Faculty of Medicine, University of Maribor, Taborska 8, 2000 Maribor, Slovenia.

出版信息

Pharmaceuticals (Basel). 2023 Sep 4;16(9):1244. doi: 10.3390/ph16091244.

Abstract

BACKGROUND

We assessed the prevalence and risks associated with pain during and after a multiple sclerosis (MS) relapse, and the impact of pain on quality of life (QoL), in MS patients.

METHODS

117 patients suffering an acute MS relapse were evaluated with clinician- and patient-reported outcomes, including the expanded disability status scale (EDSS), Multiple Sclerosis Impact Scale (MSIS-29), and MS Walking scale-12 (MSWS-12). Relapse-related pain was assessed via the short-form 36 (SF-36) questionnaire upon first visit (relapse onset) and at 6 weeks after treatment with intravenous methylprednisolone (follow-up visit).

RESULTS

Pain was present in 80% of patients at relapse onset. Patients with pain were more impaired physically (higher mean scores on MSIS-29 and MSWS-12 and lower mean scores on SF-36 role physical, physical, and vitality scales) at relapse and six weeks after. In total, 74% of patients with MS relapse reported a poorer QoL due to pain. A lower psychological well-being was correlated with greater pain (MSIS29 score). An increased number of prior relapses was a predictor of more pain at relapse onset.

CONCLUSIONS

Pain was common at the time of MS relapse and improved, but was still significant, six weeks after treatment with corticosteroids. Further studies are required to better understand relapse-related pain.

摘要

背景

我们评估了多发性硬化症(MS)复发期间及复发后疼痛的患病率、相关风险,以及疼痛对MS患者生活质量(QoL)的影响。

方法

对117例急性MS复发患者进行了临床医生和患者报告结局的评估,包括扩展残疾状态量表(EDSS)、多发性硬化症影响量表(MSIS-29)和MS步行量表-12(MSWS-12)。在首次就诊(复发开始)时和静脉注射甲泼尼龙治疗6周后(随访就诊),通过简短健康调查问卷36(SF-36)评估与复发相关的疼痛。

结果

80%的患者在复发开始时存在疼痛。有疼痛的患者在复发时及复发后6周身体功能受损更严重(MSIS-29和MSWS-12的平均得分更高,SF-36角色身体、身体和活力量表的平均得分更低)。总体而言,74%的MS复发患者报告因疼痛导致生活质量较差。较低的心理健康与更严重的疼痛相关(MSIS29评分)。既往复发次数增加是复发开始时疼痛更严重的一个预测因素。

结论

MS复发时疼痛很常见,且在使用皮质类固醇治疗6周后有所改善,但仍很显著。需要进一步研究以更好地了解与复发相关的疼痛。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4431/10536772/a34d05307121/pharmaceuticals-16-01244-g001.jpg

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