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Quantifying risk of early relapse in patients with first demyelinating events: Prediction in clinical practice

T. Spelman, C. Meyniel, JI. Rojas, A. Lugaresi, G. Izquierdo, F. Grand'Maison, C. Boz, R. Alroughani, E. Havrdova, D. Horakova, G. Iuliano, P. Duquette, M. Terzi, P. Grammond, R. Hupperts, J. Lechner-Scott, C. Oreja-Guevara, E. Pucci, F. Verheul,...

. 2017 ; 23 (10) : 1346-1357. [pub] 20161125

Jazyk angličtina Země Anglie, Velká Británie

Typ dokumentu časopisecké články, multicentrická studie

Perzistentní odkaz   https://www.medvik.cz/link/bmc18025249

BACKGROUND: 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). OBJECTIVE: To examine determinants of second attack and validate a prognostic nomogram for individualised risk assessment of clinical conversion. METHODS: 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. RESULTS: 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. CONCLUSION: 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.

Amiri Hospital Kuwait City Kuwait

Centre de réadaptation en déficience physique Chaudière Appalaches Levis QC Canada

Cliniques Universitaires Saint Luc Brussels Belgium

Department of Basic Medical Sciences Neuroscience and Sense Organs University of Bari Bari Italy

Department of Medicine and Melbourne Brain Centre at the Royal Melbourne Hospital University of Melbourne Parkville VIC Australia

Department of Medicine and Melbourne Brain Centre at the Royal Melbourne Hospital University of Melbourne Parkville VIC Australia Department of Neurophysiologie Pitié Salpêtrière Hospital Paris France

Department of Neurology and Center of Clinical Neuroscience 1st Faculty of Medicine General University Hospital and Charles University Prague Prague Czech Republic

Department of Neurology Box Hill hospital Monash University Box Hill VIC Australia

Fundación para la Lucha contra las Enfermedades Neurológicas de la Infancia Buenos Aires Argentina

Groene Hart Ziekenhuis Gouda The Netherlands

Hôpital Notre Dame Montreal QC Canada

Hospital Clínico San Carlos Madrid Spain

Hospital Italiano de Buenos Aires Buenos Aires Argentina

Hospital Universitario Virgen Macarena Sevilla Spain

Jewish General Hospital Montreal QC Canada

John Hunter Hospital Newcastle NSW Australia

Karadeniz Technical University Trabzon Turkey

Kommunehospitalet Aarhus Denmark

Maaslandziekenhuis Sittard The Netherlands

MS Center Department of Neuroscience and Imaging University 'G d'Annunzio' Chieti Italy

Neuro Rive Sud Hôpital Charles LeMoyne Greenfield Park QC Canada

Neurology Unit ASUR Marche AV3 Macerata Italy

Ondokuz Mayis University Samsun Turkey

Ospedali Riuniti di Salerno Salerno Italy

Citace poskytuje Crossref.org

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