Journal article
Risk factors for short-term prognosis in the first decade of relapsing-remitting multiple sclerosis
Multiple sclerosis, Vol.14, pp.S199-S199
01 Sep 2008
Abstract
Background: Determining which patients are at greatest risk for multiple sclerosis (MS) progression, even over the short term, is important in both clinical and research settings. We previously demonstrated a short-term association between an increased number of risk factors and progression in patients with early relapsing-remitting MS, examining age, early relapse rate, severity of initial attack and mode of initial attack. Objective: Using a modified set of risk factors similar to our previous work, and a larger sample of patients, with longer follow-up, we again attempted to show an increased risk of progression associated with having a greater number of risk factors in this sample. Methods: All patients were seen within one year of their second attack of MS (or following the first attack and diagnosis based on magnetic resonance imaging (MRI)). They were seen by the lead investigator (TS) at least twice and were followed for at least 2 years after their first attack. Data were collected on the following risk factors: (1) age greater than 40 at first attack; (2) more than two attacks in 2 years; (3) an Expanded Disability Status Scale (EDSS) score greater than 1.5 after a second attack; (4) male gender; and (5) motor symptoms at onset. Groups were defined as having low (0 or 1), medium (2), or high (3 or greater) numbers of risk factors. EDSS scores were recorded for each visit. A final sustained EDSS score was used to measure progression. Results: Two hundred and ten patients (160 females and 50 males)were followed for an average of 94 months (SD = 44). Final EDSS scores were rated, on average, 116 months after first attack (SD = 51), and 90 months (SD = 43) following MS diagnosis. Around 30% were over 40 at onset, 38% had more than two attacks in 2 years, 21% had an EDSS score greater than 1.5 after a second attack, 24% were male and 58% had motor symptoms at onset. Kruskal-Wallis analysis found a significant group effect (P <.0001) on final EDSS. Low, medium and high-risk group mean ranks were 74, 108, and 132, respectively. Conclusions: This study, using a modified group of risk factors and following patients for a longer period of time, supported our previous findings, which suggest an additive effect of individual risk factors for increasing the risk of MS progression in the short term.
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Details
- Title
- Risk factors for short-term prognosis in the first decade of relapsing-remitting multiple sclerosis
- Creators
- T ScottC Schramke
- Publication Details
- Multiple sclerosis, Vol.14, pp.S199-S199
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Neurology
- Identifiers
- 991019170120204721