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Multiple sclerosis relapses contribute to long-term disability
Journal article   Open access   Peer reviewed

Multiple sclerosis relapses contribute to long-term disability

Thomas F. Scott, Daniel Diehl, Wisam Elmalik, Edward J. Gettings, Chris Hackett and Carol J. Schramke
Acta neurologica Scandinavica, v 140(5), pp 336-341
01 Nov 2019
DOI: https://doi.org/10.1111/ane.13149
PMID: 31314902
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://doi.org/10.1111/ane.13149View
Published, Version of Record (VoR)Open Access (License Unspecified),  Open

Abstract

Clinical Neurology Life Sciences & Biomedicine Neurosciences & Neurology Science & Technology
Background Treatments affect both relapse-related disability and short-term disability change, but measurements of their impact on long-term outcomes remain a challenge. Objective To ascertain the contribution of relapse-associated disability to overall disability in relapse-onset multiple sclerosis (RMS) using long-term data collected in our clinic. Materials and Methods Retrospective study of a cohort of newly diagnosed patients with RMS, (n = 176) was undertaken, measuring all confirmed changes in disability up to 15 years after onset. Worsening was assessed yearly and in 5-year epochs and was attributed to either relapse (RW) or slow progression (PW). Results At data lock, 139/176 (81%) of patients were still actively followed, with Expanded Disability Status Scale (EDSS) available for 10 years post-onset in 145/176 (82%) patients and 15 years post-onset EDSS in 83 patients (mean follow-up entire group 12.7 years post-onset). RW accounted for a large amount of worsening seen in the first 15 years of RMS. RW was less frequent over time, but accounted for most EDSS changes in the first decade of MS (167/267, 63% of EDSS changes), and remained important even in years 11-15 (17/50, 34% of EDSS changes). Median change in disability due to RW vs PW was similar over the entire 15 years. Conclusions Worsening of treated MS was associated with relapses in many RMS patients throughout the first 15 years after onset, suggesting an opportunity for long-term benefit through relapse reduction.

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12 citations in Web of Science
12 citations in Scopus

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Collaboration types
Domestic collaboration
Web of Science research areas
Clinical Neurology
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