Ramirez AO, Keenan A, Kalau O, et al. - In people with multiple sclerosis (pwMS), fatigue is prevalent and is linked with considerable quality of life (QoL) and financial burden. For such patients, improved health and economic outcomes may be achieved by addressing fatigue over the clinical course of the disease.

• In this systematic literature review, relevant studies of fatigue in pwMS were identified from MEDLINE, Embase, and Evidence-Based Medicine Reviews, to assess epidemiology and burden of fatigue in pwMS (of 8147 identified records, 54 were eligible for inclusion).

• In pwMS, the reported prevalence of fatigue ranged from 36.5 to 78.0%.

• A consistent association of multiple sclerosis (MS)-related fatigue with a significantly lower QoL was found.

• Although heterogeneous results were obtained regarding the financial impact of fatigue, most studies revealed a significant link between presence or severity of fatigue and employment status, capacity to work, and sick leave.

• There exist gaps in the evidence linked with the direct expenses of MS-related fatigue and the burden of fatigue on caregivers.