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Updated: Aug 7, 2026
A Method of Trigonometric Modelling of Seasonal Variation Demonstrated with Multiple Sclerosis Relapse Data
Published on: December 9, 2015
The prognostic value of initial relapses on the evolution of disability in patients with relapsing-remitting multiple
C Binquet1, C Quantin, G Le Teuff
1Department of Biostatistics and Medical Informatics, Centre Hospitalier Universitaire de Dijon, Dijon, France.
Abstract:
The evolution of multiple sclerosis (MS) and the resulting disability are unpredictable. To identify clinical variables that could be potential prognostic factors, we followed a cohort of 288 patients diagnosed as having relapsing-remitting MS between 1990 and 2003. The end point was the first occurrence of a non-reversible EDMUS-GS score >or=3 (moderate disability). The impact of the number of MS attacks during the first 2 years of the disease as well as the first interattack interval were assessed in two Cox models, one using a fixed-in-time covariate, the other using a time-dependent covariate. Older age at onset and a higher number of MS attacks during the first 2 years of MS proved to be predictors of unfavourable prognosis. The first interattack interval had no influence on the evolution of the disability, conversely to the first relapse which had a short-term impact on the prognosis. We confirmed that the age at onset and the number of MS attacks during the first 2 years of MS are predictors of the evolution of the disability and demonstrated the importance of using time-dependent covariates.
Insights
Predicting multiple sclerosis (MS) disability progression is challenging. Older age at onset and more relapses in early relapsing-remitting MS significantly predict worse outcomes, highlighting key prognostic factors.
Area of Science:
- Neurology
- Clinical Research
- Epidemiology
Background:
- Multiple sclerosis (MS) progression and disability are highly variable.
- Identifying early prognostic factors is crucial for patient management.
Purpose of the Study:
- To identify clinical variables predicting disability progression in relapsing-remitting MS.
- To evaluate the impact of early disease activity on long-term prognosis.
Main Methods:
- A cohort of 288 relapsing-remitting MS patients diagnosed between 1990-2003 was followed.
- The endpoint was the first occurrence of a non-reversible EDMUS-GS score >=3 (moderate disability).
- Cox models, including time-dependent covariates, assessed the impact of early relapses and inter-attack intervals.
Main Results:
- Older age at onset and a higher number of MS attacks within the first two years were significant predictors of unfavorable prognosis.
- The first inter-attack interval did not influence disability evolution.
- The initial relapse had a short-term prognostic impact.
Conclusions:
- Age at onset and early relapse frequency are key predictors of disability progression in MS.
- The use of time-dependent covariates is important for accurate prognostic modeling in MS research.
