MS Relapses Need To Be Reported

By Simon Fishman, MD

Relapses are a significant hallmark of multiple sclerosis (MS), with approximately 80 percent of MS cases diagnosed as relapsing-remitting (RRMS) at onset. Unfortunately, a recently released UK study revealed that many people with MS do not always report their relapses, even though more effective treatment options have become standard in the last five years.

“Even minor relapses have an impact on a patient's physical and psychological well being, as well as their financial well being. The uncertainty of not knowing when the next relapse might come can be a strain for many people,” said Dr. Martin Duddy, consultant neurologist at Royal Victoria Infirmary and lead researcher on the study. We need to have a clear picture of whether or not patients are having relapses, as they have an important role in assessing whether they need treatment and whether that treatment is working.”

Presented at the 2013 European Committee for Treatment and Research in Multiple Sclerosis Congress, the study found that over a quarter of MS patients had not reported their most recent relapse, despite two out of three employed respondents having to take time off work and an equal number needing to call on their support network for help with simple

daily tasks.

The financial burden for relapsed patients was striking, with a third of patients studied reporting a decrease in family income as a result of taking time off of work, reducing their work hours or having to stop work completely.

The main reasons cited for under-reporting relapses were that patients considered their symptoms too mild or did not feel there was anything their doctor could do about it. However, underreporting may have negative impacts on the disease progression. With many new, more potent medications available, the entire prognosis for MS has radically changed.

The number of relapses experienced is one of the key measures used to assess the progression of MS. If relapses even mild ones are not reported, the treating physician will be unable to assess if the patient's medication is failing to control the disease and may not be able to change to one of the newer medications.

This study provides further evidence that MS patients need to report even minor relapses to their neurologist and care team because failing to prevent relapses and adjust treatments can have a negative effect on their health, finances, and family life.