TY - JOUR
T1 - Predictors of disability worsening in clinically isolated syndrome
AU - Jokubaitis, Vilija G.
AU - Spelman, Tim
AU - Kalincik, Tomas
AU - Izquierdo, Guillermo
AU - Grand'Maison, Francois
AU - Duquette, Pierre
AU - Girard, Marc
AU - Lugaresi, Alessandra
AU - Grammond, Pierre
AU - Hupperts, Raymond
AU - Cabrera-Gomez, Jose
AU - Oreja-Guevara, Celia
AU - Boz, Cavit
AU - Giuliani, Giorgio
AU - Fernandez-Bolanos, Ricardo
AU - Iuliano, Gerardo
AU - Lechner-Scott, Jeannette
AU - Verheul, Freek
AU - van Pesch, Vincent
AU - Petkovska-Boskova, Tatjana
AU - Fiol, Marcela
AU - Moore, Fraser
AU - Cristiano, Edgardo
AU - Alroughani, Raed
AU - Bergamaschi, Roberto
AU - Barnett, Michael
AU - Slee, Mark
AU - Vella, Norbert
AU - Herbert, Joseph
AU - Shaw, Cameron
AU - Saladino, Maria Laura
AU - Amato, Maria Pia
AU - Liew, Danny
AU - Paolicelli, Damiano
AU - Butzkueven, Helmut
AU - Trojano, Maria
PY - 2015/5
Y1 - 2015/5
N2 - To assess demographic, clinical, magnetic resonance imaging, and treatment exposure predictors of time to 3 or 12-month confirmed disability worsening in clinically isolated syndrome (CIS) and early multiple sclerosis (MS).We utilized the MSBase Incident Study (MSBasis), a prospective cohort study of outcome after CIS. Predictors of time to first 3 and 12-month confirmed expanded disability status scale worsening were analyzed using Cox proportional hazards regression.About 1989 patients were analyzed, the largest seen-from-onset cohort reported to-date. A total of 391 patients had a first 3-month confirmed disability worsening event, of which 307 were sustained for 12 months. Older age at CIS onset (adjusted hazard ratio: aHR 1.17, 95% 1.06, 1.30), pyramidal (aHR 1.45, 95% CI 1.13, 1.89) and ambulation (HR 1.60, 95% CI 1.09, 2.34) system dysfunction, annualized relapse rate (aHR 1.20, 95% CI 1.18, 1.22), and lower proportion of observation time on treatment were associated with 3-month confirmed worsening. Predictors of time to 12-month sustained worsening included pyramidal system dysfunction (Hazard ratio: aHR 1.38, 95% CI 1.05, 1.83), and older age at CIS onset (aHR 1.17, 95% CI 1.04, 1.31). Greater proportion of follow-up time exposed to treatment was associated with greater reductions in the rate of worsening.This study provides class IV evidence for a strong protective effect of disease-modifying treatment to reduce disability worsening events in patients with CIS and early MS, and confirms age and pyramidal dysfunction at onset as risk factors.
AB - To assess demographic, clinical, magnetic resonance imaging, and treatment exposure predictors of time to 3 or 12-month confirmed disability worsening in clinically isolated syndrome (CIS) and early multiple sclerosis (MS).We utilized the MSBase Incident Study (MSBasis), a prospective cohort study of outcome after CIS. Predictors of time to first 3 and 12-month confirmed expanded disability status scale worsening were analyzed using Cox proportional hazards regression.About 1989 patients were analyzed, the largest seen-from-onset cohort reported to-date. A total of 391 patients had a first 3-month confirmed disability worsening event, of which 307 were sustained for 12 months. Older age at CIS onset (adjusted hazard ratio: aHR 1.17, 95% 1.06, 1.30), pyramidal (aHR 1.45, 95% CI 1.13, 1.89) and ambulation (HR 1.60, 95% CI 1.09, 2.34) system dysfunction, annualized relapse rate (aHR 1.20, 95% CI 1.18, 1.22), and lower proportion of observation time on treatment were associated with 3-month confirmed worsening. Predictors of time to 12-month sustained worsening included pyramidal system dysfunction (Hazard ratio: aHR 1.38, 95% CI 1.05, 1.83), and older age at CIS onset (aHR 1.17, 95% CI 1.04, 1.31). Greater proportion of follow-up time exposed to treatment was associated with greater reductions in the rate of worsening.This study provides class IV evidence for a strong protective effect of disease-modifying treatment to reduce disability worsening events in patients with CIS and early MS, and confirms age and pyramidal dysfunction at onset as risk factors.
U2 - 10.1002/acn3.187
DO - 10.1002/acn3.187
M3 - Article
C2 - 26000321
SN - 2328-9503
VL - 2
SP - 479
EP - 491
JO - Annals of Clinical and Translational Neurology
JF - Annals of Clinical and Translational Neurology
IS - 5
ER -