Older SPMS Patients More Likely to Suffer from Fatigue, Limited Leg Function, Study Says

People with secondary progressive multiple sclerosis (SPMS) are more likely to feel exhausted and have limited leg function than those without progressive MS as they age, a preliminary study suggests.

The findings will be presented at the American Academy of Neurology (AAN) 69th Annual Meeting, set for April 22-28 in Boston.

Researchers analyzing 155 people with SPMS, aged 50 and older, compared symptoms and disability severity at baseline and then five years after entering the study. By the first five-year follow-up, patients had already been living with MS for about two decades.

Overall, by that point, 30 percent of participants had progressed to secondary progressive MS (SPMS) — and they were about four times more likely to experience fatigue (91 percent) than those whose disease had not progressed (68 percent). They were also three times more likely to develop limited leg function (53 percent versus 22 percent).

Researchers, whose work was supported by the National Multiple Sclerosis Society, found that the results held even after adjusting to include factors that might influence disease progression, such as age, years living with MS and severity of the disease.

“Study participants with those symptoms [fatigue and limited leg function] were more likely to progress from relapsing-remitting MS (RRMS) to secondary progressive MS within five years,” the study’s author, Bianca Weinstock-Guttman, MD, of the University at Buffalo, said in a press release. “Better understanding who is at high risk of getting worse may eventually allow us to tailor more specific treatments to these people.”

Those with a progressive form of the disease were typically older at the start of the study (average age of 55) than those whose disease did not progress (average age of 52). Older participants also had higher rates of disability at baseline, as well as five years later.

“While more research needs to be done, this study brings us closer to understanding which older adults with MS may be at higher risk of getting worse,” Weinstock-Guttman said. “With the aging population, this information will be vital as people with MS, their families and policy makers make decisions about their care.”

About 80 to 85 percent of MS patients are initially diagnosed with RRMS, which is characterized by sudden flare-ups of symptoms followed by periods of remission. Some people eventually transition to SPMS, which is marked by a steady worsening of the disease. Some drugs have slowed or halted disease progression in RRMS; in contrast, no approved therapies are yet available for SPMS.