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Risk of secondary progressive multiple sclerosis: A longitudinal study
A. Fambiatos, V. Jokubaitis, D. Horakova, E. Kubala Havrdova, M. Trojano, A. Prat, M. Girard, P. Duquette, A. Lugaresi, G. Izquierdo, F. Grand'Maison, P. Grammond, P. Sola, D. Ferraro, R. Alroughani, M. Terzi, R. Hupperts, C. Boz, J....
Language English Country Great Britain
Document type Journal Article, Observational Study, Research Support, Non-U.S. Gov't
- MeSH
- Multiple Sclerosis, Chronic Progressive drug therapy epidemiology physiopathology MeSH
- Adult MeSH
- Immunologic Factors pharmacology MeSH
- Humans MeSH
- Longitudinal Studies MeSH
- Disease Progression * MeSH
- Multiple Sclerosis, Relapsing-Remitting drug therapy epidemiology physiopathology MeSH
- Risk MeSH
- Severity of Illness Index * MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Observational Study MeSH
- Research Support, Non-U.S. Gov't MeSH
BACKGROUND: The risk factors for conversion from relapsing-remitting to secondary progressive multiple sclerosis remain highly contested. OBJECTIVE: The aim of this study was to determine the demographic, clinical and paraclinical features that influence the risk of conversion to secondary progressive multiple sclerosis. METHODS: Patients with adult-onset relapsing-remitting multiple sclerosis and at least four recorded disability scores were selected from MSBase, a global observational cohort. The risk of conversion to objectively defined secondary progressive multiple sclerosis was evaluated at multiple time points per patient using multivariable marginal Cox regression models. Sensitivity analyses were performed. RESULTS: A total of 15,717 patients were included in the primary analysis. Older age (hazard ratio (HR) = 1.02, p < 0.001), longer disease duration (HR = 1.01, p = 0.038), a higher Expanded Disability Status Scale score (HR = 1.30, p < 0.001), more rapid disability trajectory (HR = 2.82, p < 0.001) and greater number of relapses in the previous year (HR = 1.07, p = 0.010) were independently associated with an increased risk of secondary progressive multiple sclerosis. Improving disability (HR = 0.62, p = 0.039) and disease-modifying therapy exposure (HR = 0.71, p = 0.007) were associated with a lower risk. Recent cerebral magnetic resonance imaging activity, evidence of spinal cord lesions and oligoclonal bands in the cerebrospinal fluid were not associated with the risk of conversion. CONCLUSION: Risk of secondary progressive multiple sclerosis increases with age, duration of illness and worsening disability and decreases with improving disability. Therapy may delay the onset of secondary progression.
American University of Beirut Medical Center Beirut Lebanon
Amiri Hospital Kuwait City Kuwait
Azienda Ospedaliera di Rilievo Nazionale San Giuseppe Moscati Avellino Avellino Italy
Bakirkoy Education and Research Hospital for Psychiatric and Neurological Diseases Istanbul Turkey
Bombay Hospital Institute of Medical Sciences Mumbai India
Brain and Mind Centre Sydney NSW Australia
Central Clinical School Monash University Melbourne VIC Australia
Central Clinical School Monash University Melbourne VIC Australia The Alfred Melbourne VIC Australia
Cerrahpasa School of Medicine Istanbul University Istanbul Turkey
CISSS de Chaudière Appalache Centre Hospitalier Levis Canada
Cliniques Universitaires Saint Luc Brussels Belgium
CORe Department of Medicine The University of Melbourne Melbourne VIC Australia
CSSS Saint Jérôme Saint Jerome QC Canada
Department of Basic Medical Sciences Neuroscience and Sense Organs University of Bari Bari Italy
Department of Medicine and Surgery University of Parma Parma Italy
Department of Neurology Faculty of Medicine University of Debrecen Debrecen Hungary
Department of Neurology Razi Hospital Manouba Tunisia
Department of Neuroscience Azienda Ospedaliera Universitaria Modena Italy
Dokuz Eylul University Izmir Turkey
Flinders University Adelaide SA Australia
Geelong Hospital Geelong VIC Australia
Groene Hart Ziekenhuis Gouda The Netherlands
Haydarpasa Numune Training and Research Hospital Istanbul Turkey
Hopital Notre Dame Montreal QC Canada CHUM and Universite de Montreal Montreal QC Canada
Hospital de Galdakao Usansolo Galdakao Spain
Hospital Fernandez Buenos Aires Argentina
Hospital Italiano de Buenos Aires Buenos Aires Argentina
Hospital Universitario Donostia Instituto de Investigación Sanitaria Biodonostia San Sebastian Spain
Hospital Universitario Virgen Macarena Sevilla Spain
Institute of Neurosciences Buenos Aires Buenos Aires Argentina
IRCCS Mondino Foundation Pavia Italy
Jewish General Hospital Montreal QC Canada
King Fahad Specialist Hospital Dammam Dammam Saudi Arabia
Kommunehospitalet Arhus Denmark
Liverpool Hospital Sydney NSW Australia
Medical Faculty Ondokuz Mayis University Samsun Turkey
Nemocnice Jihlava Jihlava Czech Republic
Neuro Rive Sud Greenfield Park QC Canada
Ospedale P A Micone Genova Italy
Ospedali Riuniti di Salerno Salerno Italy
Rehabilitation and MS Centre Overpelt and Hasselt University Hasselt Belgium
Royal Hobart Hospital Hobart TAS Australia
St Vincent's Hospital Melbourne VIC Australia
The Alfred Melbourne VIC Australia
TU Medical Faculty Farabi Hospital Karadeniz Technical University Trabzon Turkey
Universidade Metropolitana de Santos Santos Brazil
UOC Neurologia Azienda Sanitaria Unica Regionale Marche Macerata Italy
References provided by Crossref.org
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- $a BACKGROUND: The risk factors for conversion from relapsing-remitting to secondary progressive multiple sclerosis remain highly contested. OBJECTIVE: The aim of this study was to determine the demographic, clinical and paraclinical features that influence the risk of conversion to secondary progressive multiple sclerosis. METHODS: Patients with adult-onset relapsing-remitting multiple sclerosis and at least four recorded disability scores were selected from MSBase, a global observational cohort. The risk of conversion to objectively defined secondary progressive multiple sclerosis was evaluated at multiple time points per patient using multivariable marginal Cox regression models. Sensitivity analyses were performed. RESULTS: A total of 15,717 patients were included in the primary analysis. Older age (hazard ratio (HR) = 1.02, p < 0.001), longer disease duration (HR = 1.01, p = 0.038), a higher Expanded Disability Status Scale score (HR = 1.30, p < 0.001), more rapid disability trajectory (HR = 2.82, p < 0.001) and greater number of relapses in the previous year (HR = 1.07, p = 0.010) were independently associated with an increased risk of secondary progressive multiple sclerosis. Improving disability (HR = 0.62, p = 0.039) and disease-modifying therapy exposure (HR = 0.71, p = 0.007) were associated with a lower risk. Recent cerebral magnetic resonance imaging activity, evidence of spinal cord lesions and oligoclonal bands in the cerebrospinal fluid were not associated with the risk of conversion. CONCLUSION: Risk of secondary progressive multiple sclerosis increases with age, duration of illness and worsening disability and decreases with improving disability. Therapy may delay the onset of secondary progression.
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