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Disease activity in primary progressive multiple sclerosis: a systematic review and meta-analysis
Katelijn M Blok1,2, Joost van Rosmalen3,4, Nura Tebayna1
1Department of Neurology, Albert Schweitzer Hospital, Dordrecht, Netherlands.
Frontiers in Neurology
|November 29, 2023
Summary
Inflammatory disease activity is common in primary progressive multiple sclerosis (PPMS), affecting over a quarter of patients. Younger age at inclusion and longer follow-up predict disease activity, suggesting prolonged monitoring for potential treatment benefits.
Area of Science:
- Neurology
- Immunology
- Radiology
Background:
- Disease activity in multiple sclerosis (MS) is defined by relapses and MRI lesions.
- Understanding disease activity in primary progressive MS (PPMS) is crucial for treatment efficacy.
- Contemporary data on PPMS disease activity prevalence is lacking.
Approach:
- Systematic literature search across major databases (EMBASE, MEDLINE, Web of Science, Cochrane).
- Inclusion of original studies with predefined data on PPMS cohort characteristics and disease activity.
- Meta-regression analyses to identify predictors of disease activity.
Key Points:
- 34 articles and 7,109 individuals with PPMS were analyzed.
- Overall disease activity was observed in 26.8% of people with PPMS.
- Radiological activity (31.9%) was more common than relapses (9.2%).
Conclusions:
- Inflammatory disease activity is prevalent and stable in PPMS.
- Younger age at inclusion and longer follow-up duration predict disease activity.
- Prolonged monitoring of younger individuals with PPMS is recommended to assess treatment benefits.
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