RT Journal Article
T1 Quantifying risk of early relapse in patients with first demyelinating events: Prediction in clinical practice.
A1 Spelman, Tim
A1 Meyniel, Claire
A1 Rojas, Juan Ignacio
A1 Lugaresi, Alessandra
A1 Izquierdo, Guillermo
A1 Grand'Maison, Francois
A1 Boz, Cavit
A1 Alroughani, Raed
A1 Havrdova, Eva
A1 Horakova, Dana
A1 Iuliano, Gerardo
A1 Duquette, Pierre
A1 Terzi, Murat
A1 Grammond, Pierre
A1 Hupperts, Raymond
A1 Lechner-Scott, Jeannette
A1 Oreja-Guevara, Celia
A1 Pucci, Eugenio
A1 Verheul, Freek
A1 Fiol, Marcela
A1 Van Pesch, Vincent
A1 Cristiano, Edgardo
A1 Petersen, Thor
A1 Moore, Fraser
A1 Kalincik, Tomas
A1 Jokubaitis, Vilija
A1 Trojano, Maria
A1 Butzkueven, Helmut
A1 MSBasis (an MSBase Substudy) Investigators, 
K1 CIS
K1 CSF
K1 MRI
K1 MS
K1 Nomogram
K1 clinically definite multiple sclerosis
K1 clinically isolated syndrome
K1 disease-modifying drugs
K1 second attack
AB Characteristics at clinically isolated syndrome (CIS) examination assist in identification of patient at highest risk of early second attack and could benefit the most from early disease-modifying drugs (DMDs). To examine determinants of second attack and validate a prognostic nomogram for individualised risk assessment of clinical conversion. Patients with CIS were prospectively followed up in the MSBase Incident Study. Predictors of clinical conversion were analysed using Cox proportional hazards regression. Prognostic nomograms were derived to calculate conversion probability and validated using concordance indices. A total of 3296 patients from 50 clinics in 22 countries were followed up for a median (inter-quartile range (IQR)) of 1.92 years (0.90, 3.71). In all, 1953 (59.3%) patients recorded a second attack. Higher Expanded Disability Status Scale (EDSS) at baseline, first symptom location, oligoclonal bands and various brain and spinal magnetic resonance imaging (MRI) metrics were all predictors of conversion. Conversely, older age and DMD exposure post-CIS were associated with reduced rates. Prognostic nomograms demonstrated high concordance between estimated and observed conversion probabilities. This multinational study shows that age at CIS onset, DMD exposure, EDSS, multiple brain and spinal MRI criteria and oligoclonal bands are associated with shorter time to relapse. Nomogram assessment may be useful in clinical practice for estimating future clinical conversion.
YR 2016
FD 2016-11-25
LK https://hdl.handle.net/10668/27691
UL https://hdl.handle.net/10668/27691
LA en
DS RISalud
RD Apr 7, 2025