RT Journal Article
T1 Predictors of long-term disability accrual in relapse-onset multiple sclerosis.
A1 Jokubaitis, Vilija G
A1 Spelman, Tim
A1 Kalincik, Tomas
A1 Lorscheider, Johannes
A1 Havrdova, Eva
A1 Horakova, Dana
A1 Duquette, Pierre
A1 Girard, Marc
A1 Prat, Alexandre
A1 Izquierdo, Guillermo
A1 Grammond, Pierre
A1 Van Pesch, Vincent
A1 Pucci, Eugenio
A1 Grand'Maison, François
A1 Hupperts, Raymond
A1 Granella, Franco
A1 Sola, Patrizia
A1 Bergamaschi, Roberto
A1 Iuliano, Gerardo
A1 Spitaleri, Daniele
A1 Boz, Cavit
A1 Hodgkinson, Suzanne
A1 Olascoaga, Javier
A1 Verheul, Freek
A1 McCombe, Pamela
A1 Petersen, Thor
A1 Rozsa, Csilla
A1 Lechner-Scott, Jeannette
A1 Saladino, Maria Laura
A1 Farina, Deborah
A1 Iaffaldano, Pietro
A1 Paolicelli, Damiano
A1 Butzkueven, Helmut
A1 Lugaresi, Alessandra
A1 Trojano, Maria
A1 MSBase Study Group, 
AB To identify predictors of 10-year Expanded Disability Status Scale (EDSS) change after treatment initiation in patients with relapse-onset multiple sclerosis. Using data obtained from MSBase, we defined baseline as the date of first injectable therapy initiation. Patients need only have remained on injectable therapy for 1 day and were monitored on any approved disease-modifying therapy, or no therapy thereafter. Median EDSS score changes over a 10-year period were determined. Predictors of EDSS change were then assessed using median quantile regression analysis. Sensitivity analyses were further performed. We identified 2,466 patients followed up for at least 10 years reporting post-baseline disability scores. Patients were treated an average 83% of their follow-up time. EDSS scores increased by a median 1 point (interquartile range = 0-2) at 10 years post-baseline. Annualized relapse rate was highly predictive of increases in median EDSS over 10 years (coeff = 1.14, p = 1.9 × 10(-22) ). On-therapy relapses carried greater burden than off-therapy relapses. Cumulative treatment exposure was independently associated with lower EDSS at 10 years (coeff = -0.86, p = 1.3 × 10(-9) ). Furthermore, pregnancies were also independently associated with lower EDSS scores over the 10-year observation period (coeff = -0.36, p = 0.009). We provide evidence of long-term treatment benefit in a large registry cohort, and provide evidence of long-term protective effects of pregnancy against disability accrual. We demonstrate that high annualized relapse rate, particularly on-treatment relapse, is an indicator of poor prognosis. Ann Neurol 2016;80:89-100.
YR 2016
FD 2016-06-01
LK http://hdl.handle.net/10668/10056
UL http://hdl.handle.net/10668/10056
LA en
DS RISalud
RD Apr 18, 2025