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Predictors of disability worsening in clinically isolated syndrome
- Source :
- Annals of Clinical and Translational Neurology, 2(5), 479-491. Wiley, Annals of Clinical and Translational Neurology
- Publication Year :
- 2015
-
Abstract
- Objective 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). Methods 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. Results 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. Interpretation 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.
- Subjects :
- Pediatrics
medicine.medical_specialty
Clinically isolated syndrome
Expanded Disability Status Scale
business.industry
General Neuroscience
Multiple sclerosis
Hazard ratio
Placebo-controlled study
Interferon beta-1a
Multiple sclerosis, clinically isolated syndrome, predictor, prognosis, disability
medicine.disease
3. Good health
Cohort
medicine
Neurology (clinical)
10. No inequality
business
Prospective cohort study
Research Articles
medicine.drug
Subjects
Details
- Language :
- English
- ISSN :
- 23289503
- Database :
- OpenAIRE
- Journal :
- Annals of Clinical and Translational Neurology, 2(5), 479-491. Wiley, Annals of Clinical and Translational Neurology
- Accession number :
- edsair.doi.dedup.....157ba3a6dace94b603762d0dd40c7d98