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Disability progression in aggressive multiple sclerosis.

Suresh Menon1, Feng Zhu2, Afsaneh Shirani2

  • 1Division of Neurology, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada/Division of Neurology, Department of Medicine, McMaster University, Hamilton, ON, Canada.

Multiple Sclerosis (Houndmills, Basingstoke, England)
|June 22, 2016
PubMed
Summary
This summary is machine-generated.

Disease duration and primary progressive multiple sclerosis (MS) course are linked to worsening disability in aggressive MS patients. Other factors showed no significant association with disease progression in this Canadian study.

Keywords:
Multiple sclerosisepidemiologyneuroepidemiology

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Area of Science:

  • Neurology
  • Clinical Research
  • Epidemiology

Background:

  • Multiple sclerosis (MS) is a chronic neurological disease with variable progression.
  • Aggressive or malignant MS subtypes present unique challenges in predicting disease course and disability.
  • Understanding factors associated with worsening disability is crucial for managing aggressive MS.

Purpose of the Study:

  • To investigate disease progression in patients diagnosed with aggressive multiple sclerosis (MS).
  • To identify clinical characteristics associated with worsening disability in aggressive MS.
  • To analyze longitudinal data from a Canadian cohort spanning 1980-2009.

Main Methods:

  • Defined aggressive MS by Expanded Disability Status Scale (EDSS) ⩾6 within 5 years of onset.
  • Categorized patients as 'worsened' or 'improved' relative to baseline EDSS at 2, 3, and 5 years post-baseline.
  • Employed logistic regression to examine associations between patient characteristics and disability worsening.

Main Results:

  • 5.2% of 4341 MS patients met criteria for aggressive MS (n=225).
  • The odds of worsening disability increased with longer disease duration (AOR=1.36) and primary progressive MS onset (AOR=1.85).
  • No other examined patient characteristics demonstrated a clinically significant association with subsequent disability worsening.

Conclusions:

  • Disease duration and a primary progressive course are significant predictors of worsening disability in aggressive MS.
  • Few other patient characteristics reliably predict disease worsening in this aggressive MS cohort.
  • Findings highlight the importance of disease duration and MS course in managing aggressive forms of the disease.