Author Topic: (Abst.) Disability progression in aggressive MS  (Read 57 times)

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Offline agate

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(Abst.) Disability progression in aggressive MS
« on: June 22, 2016, 05:19:31 pm »
From PubMed, June 22, 2016:

Quote
Mult Scler. 2016 Jun 20.

Disability progression in aggressive multiple sclerosis
.

Menon S1, Zhu F2, Shirani A2, Oger J2, Freedman MS3, Tremlett H4.

Author information


1Division of Neurology, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada/Division of Neurology, Department of Medicine, McMaster University, Hamilton, ON, Canada.

2Division of Neurology, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.

3The Ottawa Hospital Research Institute and University of Ottawa, Ottawa, ON, Canada.

4Division of Neurology, Faculty of Medicine, University of


OBJECTIVE:


To examine disease progression in 'aggressive' multiple sclerosis (MS), British Columbia, Canada (1980-2009).

METHODS:

Aggressive (or 'malignant') MS was defined as Expanded Disability Status Scale (EDSS) [>]6 within 5 years from onset. The first EDSS [>]6 was termed 'baseline'. Within 2, 3 and 5 years post-baseline, patients were categorized as follows: 'worsened' or 'improved', relative to baseline EDSS (the remainder exhibited no change or had no new scores). The associations between patient characteristics (sex, relapsing onset/primary progressive, onset age, onset symptoms, disease duration, cumulative prior relapses and baseline EDSS) and worsening in disability were examined longitudinally using logistic regression.

RESULTS:

Of the 225/4341 (5.2%) aggressive/malignant MS patients, 134 (59.6%) were female, 167 (74.2%) were relapsing onset, 94 (41.8%) had received disease-modifying drugs at some point and the mean follow-up was 8.7 years. The proportion of patients who 'worsened' increased from 40.4% to 57.8%, while those who 'improved' varied little (range, 8.9%-10.2%). The odds of worsening increased with disease duration (adjusted odds ratio (AOR) = 1.36; 95% confidence interval (CI) = 1.22-1.52) and the presence of primary progressive (vs relapsing-onset) MS (AOR = 1.85; 95% CI = 1.01-3.38).

CONCLUSION:

Apart from disease duration and a primary progressive course, no clinically useful associations of subsequent disease worsening in patients with aggressive/malignant MS were identified.
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