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Early non-disabling relapses are important predictors of disability accumulation in people with relapsing-remitting multiple sclerosis.
Daruwalla, Cyrus; Shaygannejad, Vahid; Ozakbas, Serkan; Havrdova, Eva Kubala; Horakova, Dana; Alroughani, Raed; Boz, Cavit; Patti, Francesco; Onofrj, Marco; Lugaresi, Alessandra; Eichau, Sara; Girard, Marc; Prat, Alexandre; Duquette, Pierre; Yamout, Bassem; Khoury, Samia J; Sajedi, Seyed Aidin; Turkoglu, Recai; Altintas, Ayse; Skibina, Olga; Buzzard, Katherine; Grammond, Pierre; Karabudak, Rana; van der Walt, Anneke; Butzkueven, Helmut; Maimone, Davide; Lechner-Scott, Jeannette; Soysal, Aysun; John, Nevin; Prevost, Julie; Spitaleri, Daniele; Ramo-Tello, Cristina; Gerlach, Oliver; Iuliano, Gerardo; Foschi, Matteo; Ampapa, Radek; van Pesch, Vincent; Barnett, Michael; Shalaby, Nevin; D'hooghe, Marie; Kuhle, Jens; Sa, Maria Jose; Fabis-Pedrini, Marzena; Kermode, Allan; Mrabet, Saloua; Gouider, Riadh; Hodgkinson, Suzanne; Laureys, Guy; Van Hijfte, Liesbeth; Macdonell, Richard.
Afiliação
  • Daruwalla C; Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK.
  • Shaygannejad V; Isfahan University of Medical Sciences, Isfahan, Iran.
  • Ozakbas S; Dokuz Eylul University, Izmir, Turkey.
  • Havrdova EK; Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University in Prague and General University Hospital, Prague, Czech Republic.
  • Horakova D; Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University in Prague and General University Hospital, Prague, Czech Republic.
  • Alroughani R; Division of Neurology, Department of Medicine, Amiri Hospital, Sharq, Kuwait.
  • Boz C; KTU Medical Faculty Farabi Hospital, Trabzon, Turkey.
  • Patti F; Department of Medical and Surgical Sciences and Advanced Technologies, GF Ingrassia, Catania, Italy Multiple Sclerosis Center, University of Catania, Catania, Italy.
  • Onofrj M; Department of Neuroscience, Imaging and Clinical Sciences, University G. D'Annunzio, Chieti, Italy.
  • Lugaresi A; Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna, Bologna, Italy IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy.
  • Eichau S; Hospital Universitario Virgen Macarena, Sevilla, Spain.
  • Girard M; CHUM and Universite de Montreal, Montreal, QC, Canada.
  • Prat A; CHUM and Universite de Montreal, Montreal, QC, Canada.
  • Duquette P; CHUM and Universite de Montreal, Montreal, QC, Canada.
  • Yamout B; Nehme and Therese Tohme Multiple Sclerosis Center, American University of Beirut Medical Center, Beirut, Lebanon.
  • Khoury SJ; Nehme and Therese Tohme Multiple Sclerosis Center, American University of Beirut Medical Center, Beirut, Lebanon.
  • Sajedi SA; Department of Neurology, Neuroscience Research Center, Golestan University of Medical Sciences, Gorgan, Iran.
  • Turkoglu R; Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey.
  • Altintas A; Department of Neurology, School of Medicine and Koc University Research Center for Translational Medicine (KUTTAM), Koc University, Istanbul, Turkey.
  • Skibina O; Department of Neurology, Box Hill Hospital, Melbourne, VIC, Australia Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC, Australia Department of Neurology, The Alfred Hospital, Melbourne, VIC, Australia.
  • Buzzard K; Department of Neurology, Box Hill Hospital, Melbourne, VIC, Australia Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC, Australia MS Centre, Royal Melbourne Hospital, Melbourne, VIC, Australia.
  • Grammond P; CISSS Chaudière-Appalache, Levis, QC, Canada.
  • Karabudak R; Hacettepe University, Ankara, Turkey.
  • van der Walt A; Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC, Australia Department of Neurology, The Alfred Hospital, Melbourne, VIC, Australia.
  • Butzkueven H; Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC, Australia.
  • Maimone D; Centro Sclerosi Multipla, UOC Neurologia, ARNAS Garibaldi, Catania, Italy.
  • Lechner-Scott J; School of Medicine and Public Health, University Newcastle, Newcastle, NSW, Australia Department of Neurology, John Hunter Hospital, Hunter New England Health, Newcastle, NSW, Australia.
  • Soysal A; Bakirkoy Education and Research Hospital for Psychiatric and Neurological Diseases, Istanbul, Turkey.
  • John N; Monash Medical Centre, Melbourne, VIC, Australia Department of Medicine, School of Clinical Sciences, Monash University, Melbourne, VIC, Australia.
  • Prevost J; CSSS Saint-Jérôme, Saint-Jerome, QC, Canada.
  • Spitaleri D; Azienda Ospedaliera di Rilievo Nazionale San Giuseppe Moscati Avellino, Avellino, Italy.
  • Ramo-Tello C; Hospital Germans Trias i Pujol, Badalona, Spain.
  • Gerlach O; Academic MS Center Zuyderland, Department of Neurology, Zuyderland Medical Center, Sittard-Geleen, The Netherlands School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands.
  • Iuliano G; Ospedali Riuniti di Salerno, Salerno, Italy.
  • Foschi M; Department of Neuroscience, Neurology Unit, S. Maria delle Croci Hospital of Ravenna, AUSL Romagna, Ravenna, Italy.
  • Ampapa R; Nemocnice Jihlava, Jihlava, Czech Republic.
  • van Pesch V; Cliniques Universitaires Saint-Luc, Brussels, Belgium Université Catholique de Louvain, Ottignies-Louvain-la-Neuve, Belgium.
  • Barnett M; Brain and Mind Centre, Sydney, NSW, Australia.
  • Shalaby N; Neurology, Kasr Al Ainy MS Research Unit (KAMSU), Cairo, Egypt.
  • D'hooghe M; Department of Neurology, National MS Center, Melsbroek, Belgium.
  • Kuhle J; Neurology, MS Center and Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), Departments of Head, Spine and Neuromedicine, Biomedicine and Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland.
  • Sa MJ; Department of Neurology, Centro Hospitalar Universitario de Sao Joao, Porto, Portugal Faculty of Health Sciences, University Fernando Pessoa, Porto, Portugal.
  • Fabis-Pedrini M; Perron Institute for Neurological and Translational Science, University of Western Australia, Nedlands, WA, Australia Centre for Molecular Medicine and Innovative Therapeutics, Murdoch University, Perth, WA, Australia.
  • Kermode A; Perron Institute for Neurological and Translational Science, University of Western Australia, Nedlands, WA, Australia Institute of Immunology and Infectious Diseases, Murdoch University, Perth, WA, Australia Sir Charles Gairdner Hospital, Nedlands, WA, Australia.
  • Mrabet S; Department of Neurology, University Hospital Razi - Manouba, Tunis, Tunisia Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia.
  • Gouider R; Department of Neurology, University Hospital Razi - Manouba, Tunis, Tunisia.
  • Hodgkinson S; Immune Tolerance Laboratory, Ingham Institute and Department of Medicine, University of New South Wales (UNSW), Sydney, NSW, Australia.
  • Laureys G; Department of Neurology, University Hospital Ghent, Ghent, Belgium.
  • Van Hijfte L; Department of Neurology, University Hospital Ghent, Ghent, Belgium.
  • Macdonell R; Austin Health, Melbourne, VIC, Australia.
Mult Scler ; 29(7): 875-883, 2023 Jun.
Article em En | MEDLINE | ID: mdl-36851894
ABSTRACT

BACKGROUND:

The prognostic significance of non-disabling relapses in people with relapsing-remitting multiple sclerosis (RRMS) is unclear.

OBJECTIVE:

To determine whether early non-disabling relapses predict disability accumulation in RRMS.

METHODS:

We redefined mild relapses in MSBase as 'non-disabling', and moderate or severe relapses as 'disabling'. We used mixed-effects Cox models to compare 90-day confirmed disability accumulation events in people with exclusively non-disabling relapses within 2 years of RRMS diagnosis to those with no early relapses; and any early disabling relapses. Analyses were stratified by disease-modifying therapy (DMT) efficacy during follow-up.

RESULTS:

People who experienced non-disabling relapses within 2 years of RRMS diagnosis accumulated more disability than those with no early relapses if they were untreated (n = 285 vs 4717; hazard ratio (HR) = 1.29, 95% confidence interval (CI) = 1.00-1.68) or given platform DMTs (n = 1074 vs 7262; HR = 1.33, 95% CI = 1.15-1.54), but not if given high-efficacy DMTs (n = 572 vs 3534; HR = 0.90, 95% CI = 0.71-1.13) during follow-up. Differences in disability accumulation between those with early non-disabling relapses and those with early disabling relapses were not confirmed statistically.

CONCLUSION:

This study suggests that early non-disabling relapses are associated with a higher risk of disability accumulation than no early relapses in RRMS. This risk may be mitigated by high-efficacy DMTs. Therefore, non-disabling relapses should be considered when making treatment decisions.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Esclerose Múltipla Recidivante-Remitente / Esclerose Múltipla Tipo de estudo: Prognostic_studies / Risk_factors_studies Limite: Humans Idioma: En Revista: Mult Scler Assunto da revista: NEUROLOGIA Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Reino Unido
Texto completo
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Buscar no Google

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Esclerose Múltipla Recidivante-Remitente / Esclerose Múltipla Tipo de estudo: Prognostic_studies / Risk_factors_studies Limite: Humans Idioma: En Revista: Mult Scler Assunto da revista: NEUROLOGIA Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Reino Unido