Risk of secondary progressive multiple sclerosis: A longitudinal study.

Area of Science:

• Neurology
• Immunology
• Clinical Research

Background:

• The progression from relapsing-remitting multiple sclerosis (RRMS) to secondary progressive multiple sclerosis (SPMS) is a critical concern.
• Identifying factors that predict this conversion is essential for patient management and therapeutic strategies.

Purpose of the Study:

• To investigate demographic, clinical, and paraclinical factors associated with the risk of conversion from RRMS to SPMS.
• To provide a comprehensive analysis of predictors for SPMS development in a large, real-world cohort.

Main Methods:

• Utilized data from MSBase, a global observational registry of patients with adult-onset RRMS.
• Employed multivariable marginal Cox regression models to assess the risk of objectively defined SPMS conversion over multiple time points.
• Included sensitivity analyses to ensure robustness of findings.

Main Results:

• Older age, longer disease duration, higher Expanded Disability Status Scale (EDSS) scores, faster disability progression, and increased relapse frequency were linked to higher SPMS risk.
• Conversely, improving disability and exposure to disease-modifying therapies (DMTs) were associated with a reduced risk of conversion.
• Cerebral MRI activity, spinal cord lesions, and oligoclonal bands did not significantly predict SPMS risk.

Conclusions:

• Age, disease duration, and disability trajectory are key determinants of SPMS progression.
• Therapeutic interventions, particularly DMTs, show potential in delaying the onset of SPMS.
• Further research into early detection and intervention strategies is warranted.