In a study of commonly used treatments for people with multiple sclerosis, both medical and behavioral interventions, and a combination of the two, resulted in meaningful improvements in fatigue, a University of Michigan-led study finds.
The randomized clinical trial compared the effectiveness of modafinil, a wake-promoting medication used to treat sleepiness in people with sleep disorders, and cognitive behavioral therapy, or CBT, on reducing fatigue for over 300 adults with multiple sclerosis whose symptoms interfered with their daily activities.
Overall, investigators found that treatment with either modafinil or CBT alone, which was delivered over the phone, was associated with significant reductions of fatigue over 12 weeks.
A combination of both treatments also worked as well as each individual treatment but did not result in better fatigue scores than the independent interventions.
The findings are published in The Lancet Neurology.
"Fatigue is one of the most common and debilitating symptoms of multiple sclerosis, yet there is still uncertainty about how available treatments should be used or how medication-based treatments compare to behavioral treatments in the real world" said first author Tiffany J. Braley, M.D., M.S., director of the Multiple Sclerosis/Neuroimmunology Division and co-founder of the Multidisciplinary MS Fatigue and Sleep Clinic at University of Michigan Health.
"This research offers new evidence to show that both CBT and modafinil are comparably effective for MS fatigue, which could shape treatment approaches to one of the most challenging symptoms experienced by people with multiple sclerosis."
Of nearly 3 million people with multiple sclerosis worldwide, up to 90% experience fatigue. Nearly half describe it as their most disabling and impactful symptom.
The research used a real world approach that more closely resembled clinical practice than traditional clinical trials and included stakeholders with MS who helped design the study.More than 60% of participants in each group of the study reported clinically meaningful improvement in fatigue, which was measured with a survey called the Modified Fatigue Impact Scale. These treatments, both individually and as a combination, should be considered as potential options for people with multiple sclerosis with chronic, problematic fatigue." Anna L. Kratz, Ph.D., senior author, professor of physical medicine and rehabilitation […]
Medical and behavioral interventions can reduce fatigue in people with multiple sclerosis