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Early predictors of conversion to secondary progressive multiple sclerosis
Mahdi Barzegar1, Soroush Najdaghi1, Alireza Afshari-Safavi2
1Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran; Department of neurology, Isfahan University of Medical Sciences, Isfahan, Iran.
Multiple Sclerosis and Related Disorders
|July 3, 2021
Summary
Predictors for conversion to secondary progressive multiple sclerosis (SPMS) were identified in this study. Smoking, older age at onset, and higher disability scores increase the risk of SPMS progression.
Area of Science:
- Neurology
- Immunology
- Clinical Research
Background:
- Relapsing-remitting multiple sclerosis (RRMS) can progress to secondary progressive multiple sclerosis (SPMS).
- Identifying early predictors of SPMS conversion is crucial for patient management.
- Understanding the timeline of RRMS to SPMS conversion is essential for prognosis.
Purpose of the Study:
- To estimate the time of conversion from RRMS to SPMS.
- To identify early predictor factors for this conversion.
Main Methods:
- Retrospective study analyzing demographic, clinical, and imaging data at diagnosis.
- Cox proportional hazards model used to assess baseline characteristics associated with SPMS conversion.
- Evaluation of escalation and early intensive therapy (EIT) approaches on transition to the progressive phase.
Main Results:
- 15.4% of 1903 RRMS patients progressed to SPMS.
- Estimated conversion rates: 10% at 10 years, 50% at 20 years, 93% at 30 years.
- Significant predictors for SPMS conversion included older age at onset, smoking, higher baseline EDSS, motor and cerebellar dysfunction, and spinal cord lesions.
Conclusions:
- Smoking is a modifiable risk factor for SPMS.
- Spinal cord involvement, age at onset, and disease severity at onset are prognostic factors for SPMS conversion.
- No significant difference in transition risk was found between escalation and EIT groups.
