Prognostic Factors Associated with Long-term Disability and Secondary Progression in Patients with Multiple Sclerosis

Abstract Background Predicting the long-term prognosis of patients with multiple sclerosis (MS) remains an uncertain and difficult task, with most data having been obtained exclusively from Caucasian cohorts. Objective To investigate clinical prognostic factors in a Brazilian mixed-race cohort. Meth...

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Bibliographic Details
Published in:Multiple sclerosis and related disorders 2016-07, Vol.8, p.27-34
Main Authors: Vasconcelos, Claudia Cristina Ferreira, Aurenção, Juliana Calvet Kallenbach, Thuler, Luiz Claudio Santos, Camargo, Solange, Alvarenga, Marcos Papais, Alvarenga, Regina Maria Papais
Format: Article
Language:English
Subjects:
Adult
African Ancestry
African Continental Ancestry Group
Age of Onset
Brazil - epidemiology
Cohort Studies
Disability
Disability Evaluation
European Continental Ancestry Group
Female
Humans
Kaplan-Meier Estimate
Male
Multiple Sclerosis
Multiple Sclerosis - diagnosis
Multiple Sclerosis - epidemiology
Multivariate Analysis
Neurology
Prognosis
Prognostic factors
Risk factors
Secondary progression
Sex Factors
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Summary:Abstract Background Predicting the long-term prognosis of patients with multiple sclerosis (MS) remains an uncertain and difficult task, with most data having been obtained exclusively from Caucasian cohorts. Objective To investigate clinical prognostic factors in a Brazilian mixed-race cohort. Methods Demographic, clinical and therapeutic factors were investigated in 303 patients with relapsing-remitting MS in relation to the following outcomes: time until reaching Expanded Disability Status Scale (EDSS) 3 and EDSS 6, and until secondary progression. Results Benign course was significantly more frequent among Caucasians when compared to Afrodescendants. Patients with a malignant course had more than one relapse in the first year of the disease and reached EDSS 3 faster if treatment was not started. In the multivariate analysis, the following factors were associated with a significantly shorter time until the established outcomes: male gender, being of African descent, non-recovery after the first relapse, two or more relapses during the first year, a short interval between initial relapses, initial polysymptomatic presentation of pyramidal and cerebellar dysfunction and no treatment prior to reaching EDSS 3. Conclusions Being of African descent was found to be an unfavorable factor for all outcomes, reinforcing the need to take ethnicity into consideration when defining treatment, particularly in mixed MS populations.
ISSN:2211-0348
2211-0356
DOI:10.1016/j.msard.2016.03.011