Author Topic: (AAN abst.) Benign MS in the era of disease-modifying therapies  (Read 2 times)

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Offline agate

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Presented as a platform session at the annual conference of the AAN in Boston, April 2017:
Quote
Benign multiple sclerosis in the era of disease modifying therapies

Camilo Diaz-Cruz1, Cindy Gonzalez1, Alicia Chua1, Brian Healy1,2, NedaSattarnezhad1, James Stankiewicz1, Christopher Severson1, Shamik Bhattacharyya1, Dorlan Kimbrough1, Bonnie Glanz1, Howard Weiner1, Tanuja
Chitnis1,3

1
Neurology, Brigham and Women's Hospital, 2
Biostatistics Center, 3
Partners Pediatric MS Center, Massachusetts
General Hospital

Objective:

To determine factors associated with benign multiple sclerosis (BMS) at 10 years from disease onset in the disease-modifying treatment (DMT) era.

Background:

BMS predictors have been assessed in populations before DMTs were introduced as the standard of care. However, factors associated with BMS have not been reassessed after DMTs became widely used.

Design/Methods:

312 subjects in the Comprehensive Longitudinal Investigation of Multiple Sclerosis at the Brigham and Women’s Hospital (CLIMB) with disease onset between 2002 and 2005 were included.

Using the expanded disability status scale (EDSS) score, subjects were classified as benign (EDSS≤2.0) or non-benign (EDSS>2.0) at the clinic visit closest to 10 years after the first symptom date.

Univariate and multivariate logistic regression models were used to test the association between benign status and sex, age at disease onset (ADO),
race, family history of MS, smoking history, symptoms at onset, number of DMTs and proportion of time on DMTs during the first 5 years of disease (PTDMT5).

Results:


62.5% of subjects were classified as BMS. In comparison to non-benign MS (NBMS), BMS subjects were more likely to be female (79% vs. 67%, p=0.012), never-smokers (58% vs. 40%, p=0.002), younger at disease onset (35 vs. 40, p<0.0001), and to experience sensory symptoms at onset (66% vs. 50%, p=0.006). In the
multivariate model, older ADO (OR=0.95, p=0.0002), PTDMT5 of 1-33% (OR=0.26, p=0.002), and motor symptoms at onset (OR=0.46, p=0.008) were negatively associated with BMS at 10 years. When smoking history was included in the multivariate model (n=286), ever-smokers had a lower probability of benign status at 10 years compared to never smokers (OR=0.46, p=0.005).

Conclusions:

Compared to previous observational studies, we found a higher proportion of BMS. In our cohort, older ADO, low PTDMT5, motor symptoms at disease onset and smoking history predict a lower likelihood of BMS at 10 years from MS onset.

_______________
Study Supported by:
EMD-Serono, Nancy Davis Center without Walls.





SPMS, diagnosed 1980. Avonex 2001-2004. Copaxone 2007-2010.

 

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