Real world prognosis in MS: does early versus late diagnosis matter?

Area of Science:

• Neurology
• Clinical Neuroscience
• Autoimmune Diseases

Background:

• Multiple sclerosis (MS) diagnosis often follows a clinically isolated syndrome (CIS).
• Understanding CIS patient data is crucial for interpreting clinical trial results.
• Determining if early CIS presentation is representative of relapsing-remitting MS (RRMS) is important.

Purpose of the Study:

• To identify a distinct clinical profile for MS patients presenting with early CIS.
• To compare long-term disability outcomes between early and late CIS presentation groups.
• To investigate reasons for delayed presentation in some MS patients.

Main Methods:

• Retrospective chart review of relapsing-remitting MS patients diagnosed between 1989 and 2005.
• Categorization into early presentation (EP) and late presentation (LP) groups based on symptom onset to diagnosis delay.
• Analysis of 10- and 15-year disability outcomes (EDSS) and identification of reasons for delayed presentation.

Main Results:

• Demographics and long-term disability outcomes were similar between EP and LP groups (median EDSS 2.25 vs. 2.0 at 10 years).
• EP patients experienced more frequent attacks in the initial years post-onset.
• EP patients were diagnosed and initiated treatment earlier than LP patients.

Conclusions:

• Early presentation of CIS in MS patients is associated with more frequent initial attacks and earlier treatment.
• Despite earlier intervention, early CIS presentation does not lead to better 10- or 15-year disability outcomes.
• The clinical profile and long-term prognosis for early and late CIS presenters are comparable in terms of disability progression.