We have discussed differences between men and women who develop multiple sclerosis.  Next we explored how hormones, specifically testosterone, play a significant role in men who develop MS.  We saw how testosterone and estradiol affect brain damage seen in women with MS.  Then we explored how the pregnancy hormone estriol could be used to treat women with MS. 

Today, we will discuss possible differences men and women may have in health-related quality of life, symptom management, treatment management, and even personality.

Compliance and Disease Management

A recent study published in the Journal of Managed Care Pharmacy (JMCP) sought to evaluate gender differences in self-reported clinical characteristics, symptom awareness, and perceived ability to manage therapy among MS patients taking a disease-modifying drug.  How do we respond differently to our MS?

Of 4,700 patients surveyed, only 44.1% responded.  Of those 2,022 patients, 80.6% were female, 82.3% were relapsing-remitting, and 83.1% were taking Avonex (33.4%), Rebif (15.9%), or Copaxone (33.8%).  Curious that Betaseron, Tysabri, or Novantrone were not called out as well, only referred to as the 16.9% who were not using one of the drugs mentioned above. 

The flip side of the 2,022 patients who responded is that 19.4% were male (4:1 ratio, women to men) and 17.7% were progressive.  Comparatively, the men were typically older and a great proportion of them had more progressive MS.  This reinforces what we discussed in MS in Men vs. Women: Does Gender Matter?

What they found was that women were more likely to report a relapse/exacerbation or know what to do when a relapse occurs.  Women were also more likely to report knowing what the treatment options are and to believe that the DMD was helping their MS, while also knowing what to do if they missed a dose.

Based on the analysis of the results of this survey, the researchers suggest that male MS patients may need additional education and support in managing their disease and therapy needs.  They also suggest that “knowledge of these gender differences potentially could help managed care organizations to improve therapy adherence by guiding gender-specific patient support programs.” 

This study/survey was support by Express Scripts, Inc., a pharmacy benefit manager. Basically, an increase in compliance is the goal in patients who have MS.

Quality of Life

In another study, researchers surveyed multiple sclerosis patients in Ferrara, Italy, assessing health-related quality of life by using the MSQOL54 questionnaire.  We’ve discussed health-related quality of life previously and you can learn more about the MSQOL54 questionnaire here.  Included in the study were 370 MS patients (265 women and 105 men) who consistently had worse scores than the general population in all HRQOL dimensions, ranging from 2.5 standard deviations (SD) lower for physical functioning to less then 0.5 SD for mental health.