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Fatigue is regarded as one of the most common symptoms encountered in multiple sclerosis (MS), leading to a severe impairment of quality of life.
This was a cross-sectional case control study. Forty-nine consecutive patients treated with Natalizumab (ntz, all patients treated at our center at time of study) were compared to 320 MS patients in our database who have been investigated for fatigue before ntz was licensed.
FSS
Mean FSS (Fatigue Severity Scale) score was 3.7 ± 1.9 with ntz versus 4.9 ± 0.8 with IFN/GA (p=0.012) (figure 1). Severe fatigue and borderline fatigue were less frequent in the ntz-group (see figure 1).

MFIS
Mean total MFIS (Modified Fatigue Impact Scale Score) was 32.6 ± 20.9 with ntz and IFN/GA with 47.8 ± 13.7 (p<0.001) (findings for GA and IFN were similar).Fewer patients with ntz suffered from severe fatigue (50% vs. 71%, p=0.036). Fatigue was less on all subscales of the MFIS for ntz treated patients (all p=0.001). See figure 2 for detailed information on the subscales of MFIS. Results for fatigue assessed by means of MFIS correlated with FSS.
Conclusion:
Prevalence and severity of fatigue during ntz treatment is reduced compared to IFN and GA. A more potent reduction of central inflammatory activity with ntz may account for this additional treatment benefit.