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141 Cognitive processing speed predicts disease progression in SPMS: post hoc analysis from the EXPAND study

Authors :
Penner, Iris-Katharina
Giovannoni, Gavin
Chitnis, Tanuja
Vermesch, Patrick
Arnould, Sophie
DeLasHeras, Virginia
Karlsson, Goeril
Piani-Meier, Daniela
Kappos, Ludwig
Benedict, Ralph
Source :
Journal of Neurology, Neurosurgery, & Psychiatry (JNNP); 2022, Vol. 93 Issue: 9 pe2-cq-e2-cq, 1p
Publication Year :
2022

Abstract

ObjectiveAssess the predictive value of cognitive processing speed (CPS), using the Symbol Digit Modali- ties Test (SDMT) score, on disability progression in secondary progressive multiple sclerosis (SPMS).Design/MethodsSPMS patients from the Phase 3 EXPAND study (core part [CP] and core+extension part [CP+EP]) were categorised into quartiles of baseline SDMT score (worst-WQ [Q1], intermediate [Q2-Q3], and best-BQ [Q4] quartile). The predictive value of baseline SDMT quartiles for time-to-wheelchair (T2W; i.e., Expanded Disability Status Scale [EDSS] score ≥7) sustained until end of follow-up, or 6-month confirmed disability progression (6mCDP) by EDSS, were assessed at the end of the CP (up to 37-months) and CP+EP (up to 5-years) by Cox regression (adjusted for treatment, age, gender, baseline EDSS, baseline SDMT quartile, and treatment-by-baseline SDMT quartile interaction).ResultsAnalyses included 1628/1651 patients (98.6%) randomised in EXPAND (baseline SDMT: WQ, n=435; intermediate, n=808; BQ, n=385). Risk of T2W (WQ vs BQ) was higher in the CP (HRWQ/BQ=1.31, 95% CI:0.72–2.38; p=0.37) and increased with long-term follow-up (HRWQ/BQ=1.81; 1.17–2.78; p=0.01). Baseline SDMT was not predictive of 6mCDP. The predictive value of on-study SDMT score change will be presented.ConclusionsThe results support the predictive value of CPS for long-term physical disability progression in SPMS. Funding: Novartis Pharma AG, Basel, Switzerland.

Details

Language :
English
ISSN :
00223050 and 1468330X
Volume :
93
Issue :
9
Database :
Supplemental Index
Journal :
Journal of Neurology, Neurosurgery, & Psychiatry (JNNP)
Publication Type :
Periodical
Accession number :
ejs60602081
Full Text :
https://doi.org/10.1136/jnnp-2022-abn2.185