Loading…
Patterns and predictors of multiple sclerosis phenotype transition
Currently, there are limited therapeutic options for patients with non-active secondary progressive multiple sclerosis. Therefore, real-world studies have investigated differences between patients with relapsing-remitting multiple sclerosis, non-active secondary progressive multiple sclerosis, and a...
Saved in:
Published in: | Brain communications 2024-11 |
---|---|
Main Authors: | , , , , , , , , , , , , , , , , , , , |
Format: | Article |
Language: | English |
Online Access: | Get full text |
Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
Summary: | Currently, there are limited therapeutic options for patients with non-active secondary progressive multiple sclerosis. Therefore, real-world studies have investigated differences between patients with relapsing-remitting multiple sclerosis, non-active secondary progressive multiple sclerosis, and active secondary progressive multiple sclerosis. Here, we explore patterns and predictors of transitioning between these phenotypes.
We performed a cohort study using data from The Danish Multiple Sclerosis Registry. We included patients with a relapsing-remitting phenotype, registered changes to secondary progressive multiple sclerosis and subsequent transitions between relapsing and non-relapsing secondary progressive multiple sclerosis, which was defined by the presence of relapses in the previous two years. We analyzed predictors of transitioning from relapsing-remitting multiple sclerosis to relapsing and non-relapsing secondary progressive multiple sclerosis, as well as between the secondary progressive states using a multi-state Markov model.
We included 4413 patients with relapsing-remitting multiple sclerosis. Within a median follow-up of 16.2 years, 962 were diagnosed with secondary progressive multiple sclerosis by their treating physician. Of these, we classified 729 as non-relapsing and 233 as relapsing secondary progressive multiple sclerosis. The risk of transitioning from relapsing-remitting to non-relapsing secondary progressive multiple sclerosis included older age (hazard ratio per increase of one-year in age: 1.044, 95% confidence interval: 1.035—1.053), male sex (hazard ratio for female: 0.735, 95% confidence interval: 0.619—0.874), fewer relapses (hazard ratio per each additional relapse: 0.863, 95% confidence interval: 0.823—0.906), higher expanded disability status scale (hazard ratio per each additional point: 1.522, 95% confidence interval: 1.458—1.590) and longer time on disease-modifying therapies (hazard ratio per increase of one-year in treatment, high-efficacy disease-modifying therapy: 1.095, 95% confidence interval: 1.051—1.141; hazard ratio, moderate-efficacy disease-modifying therapy: 1.073, 95% confidence interval: 1.051—1.095). We did not find significant predictors associated with the transition from relapsing secondary progressive multiple sclerosis to non-relapsing secondary progressive multiple sclerosis, whereas older age (hazard ratio per increase of one-year in age: 0.956, 95% confidence interval: 0.942—0.971) prevented |
---|---|
ISSN: | 2632-1297 2632-1297 |
DOI: | 10.1093/braincomms/fcae422 |