Multiple Sclerosis Progressive Courses: A Clinical Cohort Long-Term Disability Progression Study

Area of Science:

• Neurology
• Clinical Epidemiology
• Biostatistics

Background:

• Assessing healthcare interventions for multiple sclerosis (MS) requires understanding disease progression.
• Data on disability progression in progressive MS courses are limited.
• This study addresses the need for better data on progressive MS disability.

Purpose of the Study:

• To estimate annual disability progression in primary progressive MS (PPMS) and secondary progressive MS (SPMS).
• To provide data for evaluating the impact of clinical interventions in MS.
• To fill the gap in knowledge regarding progressive MS disability.

Main Methods:

• Observational cohort study of 758 patients with PPMS and SPMS from Italian MS registries.
• Utilized continuous Markov models to estimate annual transition probabilities between Expanded Disability Status Scale (EDSS) states.
• Conducted a sensitivity analysis considering clinical characteristics associated with disability progression.

Main Results:

• The study included 758 patients (274 PPMS, 434 SPMS) with a median follow-up of 8.2 years.
• Annual transition probabilities differed between PPMS and SPMS.
• Excluding relapse-associated EDSS changes, the probability of remaining stable in an EDSS level increased non-significantly in both disease courses.

Conclusions:

• Provides estimates of annual disability progression (EDSS changes) for PPMS and SPMS.
• These estimates can aid healthcare decision-makers and clinicians in assessing intervention effectiveness.
• Enhances understanding of MS disability progression for progressive forms.