Improvement in Fatigue during Natalizumab Treatment is Linked to Improvement in Depression and Day-Time Sleepiness

• Published in: Frontiers in neurology 2015, Vol.6, p.18-18
• Main Authors: Penner, Iris-Katharina, Sivertsdotter, Eva Catharina, Celius, Elisabeth G, Fuchs, Siegrid, Schreiber, Karen, Berkö, Sara, Svenningsson, Anders
• Format: Article
• Language: English
• Subjects: Depression; Fatigue; multiple sclerosis; multiple sclerosis (MS); Neuroscience; sleepiness; treatment response
• ISSN: 1664-2295; 1664-2295
• DOI: 10.3389/fneur.2015.00018

Fatigue is a frequent symptom in multiple sclerosis (MS) and often interrelated with depression and sleep disorders making symptomatic treatment decisions difficult. In the single-arm, observational phase IV TYNERGY study, relapsing-remitting MS patients showed a clinically meaningful decrease in fatigue over 1 year of treatment with natalizumab. To evaluate whether fatigue improvement might be directly linked to improved depression and day-time sleepiness. Patients were assessed regarding fatigue, depression, and day-time sleepiness. The relation between changes of the two latter symptoms and changes in fatigue was analyzed. After 1 year of natalizumab treatment, the majority of patients (>92%) remained stable or improved in total, motor, and cognitive fatigue. Proportion of patients without depression increased by 17% while proportions of mildly depressed patients or patients with potential major depression decreased by 5 and 12%, respectively. Proportion of patients classified as not being sleepy increased by 13% while proportions of sleepy and very sleepy patients decreased by 11 and 2%, respectively. Most importantly, improved depression and sleepiness were significantly related to improved fatigue. Our findings highlight the importance of patient-reported outcomes in identifying potential benefits of drug treatment beyond its well-established effects on disease activity and disability progression.