Abstract
Objective: Using conversion to secondary progressive (SP) multiple sclerosis (MS) as cutoff event for selecting patients with benign course, we tested which baseline features affects the probability of becoming "no longer benign" in the long term.
Background Clinical severity of MS is extremely variable. Patients with not more than moderate disability within 10-15 years from onset are regarded as "benign" however, lack of consensus exists.
Design/Methods: Among patients in the London Ontario database with benign course who had not experienced SP at 10 years from onset, binary logistic regression analysis assessed factors affecting the probability of remaining "benign" after 20 years.
Results: Outcome at 20 years was known for 75% (n = 339/445) of those patients benign at 10 years from onset. Females predominated (71 %), mean age at onset was 26.8 years (S.D. 7.9) and most of patients had mono-symptomatic onset (71%) characterized by sensory disturbances (52.2%). Nearly half (166/339) had entered SP and were "no longer benign". Eventually, among this subgroup 91.5% (152/166) reached DSS 6, 60.8% (101/166) DSS 8 and 16.8% (28/166) DSS 10 in 19.9, 31.2 and 49.7 mean years respectively. Female sex (OR = 1.68; p = 0.032) and younger age at disease onset (age 21-30 Vs > 30: OR = 1.77, p = 0.02; age ≤ 20 Vs > 30: OR = 3.36, p < 0.001) associated with a higher probability of remaining benign at 20 years. Type and number of neurological systems at onset and early (year 1 + year 2) relapse frequency did not exert any predictive effect.
Conclusions: The onset of the SP phase is the watershed event differentiating benign cases. Lack of progression at 10 years from onset associated with about 50% probability of remaining benign 10 years later. Males and those older at disease onset had higher risk to become "no longer benign".
Supported by: Italian MS society. UK MS society.
Disclosure: Dr. Scalfari has nothing to disclose. Dr. Neuhaus has nothing to disclose. Dr. Daumer has nothing to disclose. Dr. Muraro has nothing to disclose. Dr. Ebers has received personal compensation for activities with Bayer HealthCare Pharmaceuticals as a consultant.
Monday, April 23 2012, 14:00 pm-18:30 pm
- Copyright © 2011 by AAN Enterprises, Inc.
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