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April 18, 2017; 88 (16 Supplement) April 24, 2017

Self-reported fatigue and lower limb problems predictive of conversion to secondary progressive multiple sclerosis in an aging sample of patients (S10.004)

Caila Vaughn, Katelyn Kavak, Aisha Bushra, Ekaterina Noyes, Keith Edwards, Andrew Goodman, Patricia Coyle, Lauren Krupp, Burk Jubelt, Malcolm Gottesman, Ralph Benedict, Bianca Weinstock-Guttman
First published April 17, 2017,
Caila Vaughn
1New York State Multiple Sclerosis Consortium Buffalo NY United States
2Neurology, State University of New York at Buffalo Buffalo NY United States
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Katelyn Kavak
4Jacobs MS Treatment and Research Center Buffalo NY United States
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Aisha Bushra
4Jacobs MS Treatment and Research Center Buffalo NY United States
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Ekaterina Noyes
3State University of New York at Buffalo Buffalo NY United States
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Keith Edwards
1New York State Multiple Sclerosis Consortium Buffalo NY United States
5MS Center of Northeastern NY-Empire Neurology, P.C. Latham NY United States
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Andrew Goodman
1New York State Multiple Sclerosis Consortium Buffalo NY United States
6University of Rochester Dept. Neurology Rochester NY United States
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Patricia Coyle
1New York State Multiple Sclerosis Consortium Buffalo NY United States
7SUNY At Stony Brook Stony Brook NY United States
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Lauren Krupp
1New York State Multiple Sclerosis Consortium Buffalo NY United States
8NYU Langone Medical Center New York NY United States
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Burk Jubelt
1New York State Multiple Sclerosis Consortium Buffalo NY United States
9SUNY Upstate Medical University Syracuse NY United States
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Malcolm Gottesman
10Winthrop Comprehensive MS Care Center Mineola NY United States
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Ralph Benedict
11Buffalo General Hospital Buffalo NY United States
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Bianca Weinstock-Guttman
1New York State Multiple Sclerosis Consortium Buffalo NY United States
2Neurology, State University of New York at Buffalo Buffalo NY United States
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Citation
Self-reported fatigue and lower limb problems predictive of conversion to secondary progressive multiple sclerosis in an aging sample of patients (S10.004)
Caila Vaughn, Katelyn Kavak, Aisha Bushra, Ekaterina Noyes, Keith Edwards, Andrew Goodman, Patricia Coyle, Lauren Krupp, Burk Jubelt, Malcolm Gottesman, Ralph Benedict, Bianca Weinstock-Guttman
Neurology Apr 2017, 88 (16 Supplement) S10.004;

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Abstract

Objective: To investigate patient reported outcomes predictive of conversion to SPMS in an aging sample of MS patients.

Background: The secondary progressive (SP) phase of multiple sclerosis (MS) is characterized by a progressive accumulation of neurological disability, preceded by a relapsing remitting (RR) disease course. Older age at disease onset, high frequency of relapses and male sex have frequently been found to be predictive of a higher risk of disease conversion.

Design/Methods: Subjects are part of the New York State Multiple Sclerosis Consortium (NYSMSC). Patients with an RRMS disease type at study enrollment, age 50 or over, with a disease duration of at least 15 years were selected for this study (n=155). Chi-squared tests and logistic regression modelling were used to investigate the predictive value of patient reported outcomes at study enrollment and conversion to SPMS at year 5.

Results: Five years after study enrollment (median disease duration=22 years), 47 (30.3%) RRMS subjects progressed to SPMS. Those who converted were older at study enrollment (54.8 vs 52.1, p=.01), and had a higher Kurtzke Expanded Disability Status Scale (EDSS) at both baseline (3.5 vs 2.6, p<.001), and at year 5 (5.6 vs 3.0, p<.001). Patients who progressed at year 5 were more likely to report lower limb problems at baseline (53.2% vs 21.5%, OR: 3.0, p<.001), and were more likely to report some degree of fatigue (91.5% vs 68.2%, OR: 4.2, p=.004), compared to those who did not progress, even after adjusting for age, disease duration and EDSS. Fatigue and lower limb problems were strongly correlated (p-value=0.001).

Conclusions: Fatigue and lower limb problems at baseline were predictive of a higher chance of conversion after 5 years of follow-up. Targeting patients with these symptoms may result in more successfully predicting patients at higher risk of disease conversion and subsequently tailoring therapeutic strategies.

Study Supported by: The study was supported by the National Multiple Sclerosis Society grant HC-1411-02004

Disclosure: Dr. Vaughn has nothing to disclose. Dr. Kavak has nothing to disclose. Dr. Bushra has nothing to disclose. Dr. Noyes has nothing to disclose. Dr. Edwards has received personal compensation for activities with Biogen and Sanofi Genzyme as a speaker and/or consultant. Dr. Edwards has received research support from Biogen, Genentech, Sanofi-Genzyme, and Hoffmann-La Roche. Dr. Goodman received personal compensation for activities with Abbvie, Acorda Therapeutics, Atara, Bayer HealthCare, Biogen, Novartis, Sanofi-Genzyme, and Teva. Dr. Goodman has received research support from Acorda, Avanir, Biogen, EMD-Serono, Novartis, Ono, Roche, Sanofi-Genzyme, Sun and Teva. Dr. Coyle has received personal compensation for activities with AbbVie, Accordant, Acorda, Bayer, Biogen Idec, Genentech/Roche, Genzyme/Sanofi, Mallinckrodt, Novartis, Serono, and Teva as a consultant. Dr. Krupp has received licensing and/or royalty fees from Johnson and Johnson, AbbVie, and Grifols. Dr. Jubelt received personal compensation for activities with EMD Serono, Novartis and Biogen. Dr. Gottesman has received personal compensation for activities with Biogen, Teva and Gemzyme as a consultant. Dr. Benedict has received personal compensation for activities with Actelion, Biogen Idec, Bayer, and Novartis as a consultant. Dr. Weinstock-Guttman has received personal compensation for activities with Biogen, Teva Pharmaceuticals, EMD Serono, Genzyme&Sanofi, Novartis and Genentech as a speaker and consultant. Dr. Weinstock-Guttman has received research support from Biogen, Teva Pharmaceuticals, EMD Serono, Genzyme & Sanofi, Novartis, Genentech.

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