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

Martin Rakusa; Jeremy Chataway; Todd A Hardy

doi:10.3390/ph16091244

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

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

Authors

Martin Rakusa^{1

2}, Jeremy Chataway^{3

4}, Todd A Hardy^{5

6}

Affiliations

¹ Division of Neurology, University Medical Centre Maribor, Ljubljanska 5, 2000 Maribor, Slovenia.
² Faculty of Medicine, University of Maribor, Taborska 8, 2000 Maribor, Slovenia.
³ Queen Square Multiple Sclerosis Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London WC1B 5EH, UK.
⁴ National Institute for Health Research, University College London Hospitals, Biomedical Research Centre, London W1T 7DN, UK.
⁵ Department of Neurology, Concord Hospital, University of Sydney, Sydney, NSW 2050, Australia.
⁶ Brain & Mind Centre, University of Sydney, Sydney, NSW 2050, Australia.

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_phys 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_psy 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.

Keywords: SF-36; corticosteroids; multiple sclerosis; pain; quality of life; relapse; the short-form health survey.

Grants and funding

This research received no external funding.