Progressive and Relapsing-Remitting Multiple Sclerosis Share Similar Fatigue Severity

September 21, 2020
Marco Meglio
Marco Meglio

Marco Meglio, Associate Editor for NeurologyLive, has been with the team since October 2019. Follow him on Twitter @marcomeglio1 or email him at

Future research may help better characterize whether fatigue interventions aimed at one patient population may be effective in the other.

Results from a study presented at MS Virtual 2020, the 8th Joint ECTRIMS-ACTRIMS meeting, September 11–13, 2020, revealed that there are no between group differences in average fatigue severity or fatigue interference among persons with progressive multiple sclerosis (MS) or relapsing-remitting MS (RRMS).1

Tracy Herring, PhD, senior fellow, Multiple Sclerosis Rehabilitation & Wellness Research Center, University of Washington, who presented the data, noted that “given the similarity between fatigue and its correlates for both progressive and relapsing forms of MS, future research should consider if the interventions that work for fatigue management in people with relapsing forms of MS work similarly for people with progressive forms of MS.”

The study, which included 573 community-dwelling individuals with MS, looked at outcome measures such as fatigue severity and fatigue interference and used T-test and chi-square analyses to compare group differences.

Researchers also used multiple regression analysis to examine the extent to which the association of risk factors with fatigue severity and interference are moderated by MS subtype. They found that longer MS disease duration was associated with lower average fatigue severity (B = –0.082; T = –3.637; P <.001) for persons with progressive MS compared to persons with RRMS (B = –0.025; T = –1.900; P = .058).

In an effort to identify common demographic risk factors, Herring and colleagues found that having a college degree or higher was associated with higher fatigue interference in persons with progressive MS (B = 2.90; T = 2.28; P = .023) compared to persons with RRMS (B = –0.17; T = –.22; P = .825).

As the investigators previously noted, future studies will confirm whether interventions for patients with progressive MS can be used for those with RRMS. Fatigue increase has been documented as a major symptom that can impact quality of life for those with MS.

Another study presented at MS Virtual 2020 revealed that patients with RRMS who were stratified by high levels of fatigue (RRMS+HF) had greater comorbidity and economic burdens compared to those with low fatigue (RRMS+LF) and individuals with MS.2

The data showed that the annualized number of outpatient visits, emergency room visits, and hospitalizations were greater for those with RRMS+HF (15.5 [±15.4]; 1.3 [±3.5]; 0.9 [±2.6]) compared to those with RRMS+LF (11.5 [±17.6]; 0.7 [±2.0]; 0.4 [±1.6]) and non-MS (7.4 [±11.3]; 0.5 [±2.5]; 0.4 [±2.8]) groups.

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1. Herring T, Alschuler K, Knowles L, et al. Differences in correlates of fatigue between relapsing and progressive forms of multiple sclerosis. Presented at MS Virtual 2020 Joint ECTRIMS-ACTRIMS meeting; September 11–13, 2020. Abstract P1090.
2. Le H, Ken-Opurum J, Maculaitis M, Sheehan J. Comorbidity and economic burdens of fatigue among patients with relapsing-remitting multiple sclerosis in the United States. Presented at: MS Virtual 2020 Joint ACTRIMS-ECTRIMS meeting, September 11–13, 2020. Abstract P0857.