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PubMed

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Contribution of different relapse phenotypes to disability in multiple sclerosis

Multiple sclerosis (Houndmills, Basingstoke, England). 2017 Feb ; 23 (2) : 266-276. [epub] 20160711

Mult Scler
ISSN 1477-0970 | 1352-4585
Source

Language English Country England, Great Britain Media print-electronic

Document type Journal Article

Persistent link https://www.medvik.cz/link/pmid27055805

PubMed 27055805
DOI 10.1177/1352458516643392
PII: 1352458516643392
Knihovny.cz E-resources

Keywords
Prognosis, cohort studies, multiple sclerosis, observational study, outcome research, relapse phenotype,
MeSH
Chronic Disease MeSH
Adult MeSH
Interferon-beta therapeutic use MeSH
Middle Aged MeSH
Humans MeSH
Persons with Disabilities statistics & numerical data MeSH
Disability Evaluation MeSH
Disease Progression MeSH
Prospective Studies MeSH
Recurrence * MeSH
Multiple Sclerosis drug therapy physiopathology MeSH
Check Tag
Adult MeSH
Middle Aged MeSH
Humans MeSH
Male MeSH
Female MeSH
Publication type
Journal Article MeSH
Names of Substances
Interferon-beta MeSH

OBJECTIVE: This study evaluated the effect of relapse phenotype on disability accumulation in multiple sclerosis. METHODS: Analysis of prospectively collected data was conducted in 19,504 patients with relapse-onset multiple sclerosis and minimum 1-year prospective follow-up from the MSBase cohort study. Multivariable linear regression models assessed associations between relapse incidence, phenotype and changes in disability (quantified with Expanded Disability Status Scale and its Functional System scores). Sensitivity analyses were conducted. RESULTS: In 34,858 relapses recorded during 136,462 patient-years (median follow-up 5.9 years), higher relapse incidence was associated with greater disability accumulation (β = 0.16, p < 0.001). Relapses of all phenotypes promoted disability accumulation, with the most pronounced increase associated with pyramidal (β = 0.27 (0.25-0.29)), cerebellar (β = 0.35 (0.30-0.39)) and bowel/bladder (β = 0.42 (0.35-0.49)) phenotypes (mean (95% confidence interval)). Higher incidence of each relapse phenotype was associated with an increase in disability in the corresponding neurological domain, as well as anatomically related domains. CONCLUSION: Relapses are associated with accumulation of neurological disability. Relapses in pyramidal, cerebellar and bowel/bladder systems have the greatest association with disability change. Therefore, prevention of these relapses is an important objective of disease-modifying therapy. The differential impact of relapse phenotypes on disability outcomes could influence management of treatment failure in multiple sclerosis.

AORN San Giuseppe Moscati Avellino Italy

Bombay Hospital Institute of Medical Sciences Mumbai India

Brain and Mind Centre Camperdown NSW Australia

C Mondino National Neurological Institute Pavia Italy

Centre for Clinical Research The University of Queensland Australia Brisbane QLD Australia

Centre Intégré de Santé et de Services Sociaux des Laurentides Saint Jerome QC Canada

Clinical Neurology Clinical Center Skopje Macedonia

Cliniques Universitaires Saint Luc Brussels Belgium

Craigavon Area Hospital Portadown UK

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

Department of Medicine The University of Melbourne Melbourne VIC Australia

Department of Medicine The University of Melbourne Melbourne VIC Australia Department of Neurology Melbourne Brain Centre at Royal Melbourne Hospital Parkville VIC Australia