Predictive factors for the progression of multiple sclerosis: a meta-analysis

Area of Science:

• Neurology
• Clinical Research
• Epidemiology

Background:

• Multiple sclerosis (MS) is a chronic neurological disease with variable progression.
• Identifying predictive factors for MS progression is crucial for patient management and treatment strategies.

Purpose of the Study:

• To systematically review and meta-analyze predictive factors influencing the progression of multiple sclerosis.
• To identify key clinical and demographic variables associated with MS deterioration.

Main Methods:

• Systematic literature search of major databases (PubMed, Ovid, Web of Science, Willey Library, EMbase) up to August 2023.
• Inclusion of 14 studies analyzing predictors like age, sex, smoking, disease duration, relapses, EDSS, symptoms, and DMT use.
• Categorization of patients into deterioration and non-deterioration groups based on Expanded Disability Status Scale (EDSS) changes.

Main Results:

• Male sex (OR=1.15), smoking (OR=1.92), higher relapse frequency (OR=1.05), and higher EDSS scores (OR=1.54) were significant predictors of MS progression.
• Disease-modifying therapy (DMT) use was associated with a reduced risk of MS progression (OR=0.38).
• Age at onset, disease duration, and prodromal symptoms did not significantly predict MS progression.

Conclusions:

• Male sex, smoking, increased relapse frequency, and higher EDSS scores are significant risk factors for multiple sclerosis deterioration.
• The use of disease-modifying therapies (DMTs) appears to be a protective factor against MS progression.
• These identified factors warrant close attention for monitoring and managing MS progression.