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Related Experiment Videos

Disability progression in multiple sclerosis is slower than previously reported.

Helen Tremlett1, Donald Paty, Virginia Devonshire

  • 1Department of Medicine (Neurology), University of British Columbia, Vancouver, Canada. tremlett@interchange.ubc.ca

Neurology
|January 26, 2006
PubMed
Summary

Multiple sclerosis (MS) disability progression is slower than previously thought. Male sex and older age at onset do not predict worse outcomes in this large population study.

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Area of Science:

  • Neurology
  • Epidemiology

Background:

  • Multiple sclerosis (MS) is a chronic, demyelinating disease of the central nervous system.
  • Understanding disease progression and risk factors is crucial for patient management and therapeutic development.

Purpose of the Study:

  • To investigate disease progression and identify risk factors in a large, geographically defined multiple sclerosis (MS) population.
  • To analyze progression using both clinical onset and date of birth as inception points.

Main Methods:

  • A retrospective review of a database of 2,837 patients with definite MS and symptom onset before July 1988.
  • Prospective follow-up for 22,723 patient-years, assessing time to Expanded Disability Status Scale (EDSS) 6 (cane use).
  • Analysis of risk factors including sex, disease course (relapsing vs. primary progressive), age at onset, and onset symptoms.

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Main Results:

  • The median time to EDSS 6 was 27.9 years from onset; 21% reached EDSS 6, and 28% required a cane by age 50.
  • Men progressed 38% faster than women from onset, but cane use occurred at similar ages (58.8 for men, 60.1 for women).
  • Primary progressive MS course significantly predicted more rapid progression (HR=2.7). Younger onset age predicted slower progression, but older onset individuals reached EDSS 6 at older ages.

Conclusions:

  • Disability progression in MS appears slower than reported in earlier studies.
  • Contrary to some prior beliefs, male sex and older age at onset were not associated with worse long-term disability outcomes in this cohort.