Quality of Life, Depression, Sexual Dysfunction and Work Absenteeism in Relapsing-Remitting Multiple Sclerosis Patients Starting Glatiramer Acetate as First-Line Treatment: A Prospective Cohort Study

Introduction: Quality of life (QoL) has gained increasing importance in multiple sclerosis (MS). We aimed to assess QoL and potentially associated factors such as depression, sexual dysfunction and work absenteeism in patients starting glatiramer acetate (GA) in clinical practice. Methods: A prospective cohort study carried out in relapsing-remitting MS patients starting GA as first-line treatment. Patient information on QoL (Multiple Sclerosis Quality of Life-54 [MSQoL-54]), depression (Beck Depression Inventory), sexual dysfunction (Multiple Sclerosis Intimacy and Sexuality Questionnaire-19) and work absenteeism was assessed from starting GA to week 96. Results: Ninety-eight evaluable patients were enrolled in the study (mean age, 38.0 ± 8.4 years; female, 69.4%; mean MS duration, 42.6 ± 62.9 months; annual relapse rate since MS diagnosis, 0.4), and followed up at weeks 24 (n=96), 48 (n=94), 72 (n=89) and 96 (n=80). Patient QoL was preserved during the study, with improvements on the MSQoL-54 subscales of change in health (p<0.05) and health distress (p<0.05). Depression, primary and secondary sexual dysfunction remained stable, but the number of patients with tertiary sexual dysfunction decreased at week 96 (p<0.05). Work absenteeism also decreased over the study (p<0.01). Depression, sexual dysfunction and work absenteeism affected MSQoL-54 physical and mental health composites (p<0.05). Conclusion: QoL of our patients was preserved during the 96-week administration of GA. Though depression, sexual dysfunction and work absenteeism impair patient QoL, they remained stable or even improved during the study.