Evidence map›Paper›PMID 41262065›Full record

ArticleAnnals of clinical and translational neurology2026

Use of Symptomatic Drug Treatment for Fatigue in Multiple Sclerosis and Patterns of Work Loss.

Simon Englund, Johan Reutfors, Thomas Frisell, Fredrik Piehl

Abstract read
In one paragraph

Article in Annals of clinical and translational neurology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Simon EnglundDepartment of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.ORCID 0000-0002-1042-4400
Johan ReutforsClinical Epidemiology Division, Department of Medicine, Karolinska Institutet, Stockholm, Sweden.
Thomas FrisellClinical Epidemiology Division, Department of Medicine, Karolinska Institutet, Stockholm, Sweden.ORCID 0000-0002-5735-9626
Fredrik PiehlDepartment of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.

Funding

Erling Persson's Foundation 2024-0127NEURO SwedenSwedish Research Council 2021-01418Swedish Research Council 2023-02639the Region Stockholm FoUI-987565the Swedish Brain Fund FO2023-0336
6 · The paper itself

Abstract

objectiveTo describe the use of central stimulants and amantadine for fatigue in MS and evaluate a potential association with reduced work loss in people with MS.

methodsWe conducted a nationwide, matched, register-based cohort study in Sweden (2006 to 2023) using national registers with prospective data collection. We included individuals with MS, identified via the Swedish MS register or ≥ 3 MS diagnoses in the National Patient Register, who initiated treatment with modafinil, amantadine, or central stimulants for ADHD (ADHD-Drugs), along with untreated individuals matched on modafinil start date, age, sex, time since MS diagnosis, and prior-year work loss. The main outcome was monthly work loss, defined as the sum of net days on sick leave, disability pension, and activity compensation.

resultsWe identified 2162 new modafinil users, 462 amantadine, 424 ADHD drugs, and 9762 untreated. All cohorts showed increasing work loss before index, followed by no change in work loss over the subsequent 24 months. Modafinil users had a significantly greater attenuation, but with low effect size, of the increasing trajectory of average monthly work loss than untreated (-0.17 days; 95% CI: -0.22, -0.12), with no significant differences between modafinil and other treated groups. Modafinil was the most prescribed treatment, with 1-year prevalence of 8.5% in 2006 and 7% in 2023.

interpretationA potential minor treatment benefit is suggested by the statistically significant, small attenuation of worsening work loss following fatigue treatment initiation compared with untreated people with MS. No differences in treatment benefit were observed across fatigue treatments.

Indexed as

AmantadineCentral Nervous System StimulantsFatigueModafinilMultiple SclerosisSick LeaveAdultCohort StudiesFemaleHumansMaleMiddle AgedRegistriesSwedenAmantadineCentral Nervous System StimulantsModafinilamantadinecentral stimulantsfatiguemodafinilmultiple sclerosiswork loss

Identifiers

PMID41262065
PMCPMC13071106

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.