OBJECTIVE: To investigate factors associated with the risk of secondary progression in relapsing-remitting onset multiple sclerosis (MS). METHODS: We used Kaplan-Meier survival analyses and a multivariable Cox regression model to estimate the influence of the factors: gender, age at disease onset, use of immunomodulatory drugs (IMD), and clinical manifestation at disease onset on the time to secondary progression in a hospital-based cohort of 571 MS patients with a relapsing-remitting onset. RESULTS: Gender and onset manifestation had no significant influence on the timing of secondary progression. A higher age at disease onset was associated with a shorter time to secondary progression (multivariable hazard ratio per year increase: 1.02, 95% CI:1.01 - 1.03). The use of IMD was associated with a longer time to secondary progression (multivariable hazard ratio: 0.30, 95% CI: 0.15 - 0.61). CONCLUSIONS: The inverse relationship between age at disease onset and onset of secondary progression is in keeping with previous natural history studies. The beneficial effect of IMD treatment on the time to secondary progression should be taken as hypothesis-generating rather than as proof of a treatment effect, and needs to be further evaluated in well-designed randomised controlled trials.
OBJECTIVE: To investigate factors associated with the risk of secondary progression in relapsing-remitting onset multiple sclerosis (MS). METHODS: We used Kaplan-Meier survival analyses and a multivariable Cox regression model to estimate the influence of the factors: gender, age at disease onset, use of immunomodulatory drugs (IMD), and clinical manifestation at disease onset on the time to secondary progression in a hospital-based cohort of 571 MSpatients with a relapsing-remitting onset. RESULTS: Gender and onset manifestation had no significant influence on the timing of secondary progression. A higher age at disease onset was associated with a shorter time to secondary progression (multivariable hazard ratio per year increase: 1.02, 95% CI:1.01 - 1.03). The use of IMD was associated with a longer time to secondary progression (multivariable hazard ratio: 0.30, 95% CI: 0.15 - 0.61). CONCLUSIONS: The inverse relationship between age at disease onset and onset of secondary progression is in keeping with previous natural history studies. The beneficial effect of IMD treatment on the time to secondary progression should be taken as hypothesis-generating rather than as proof of a treatment effect, and needs to be further evaluated in well-designed randomised controlled trials.
Authors: Karen Ann Ribbons; Patrick McElduff; Cavit Boz; Maria Trojano; Guillermo Izquierdo; Pierre Duquette; Marc Girard; Francois Grand'Maison; Raymond Hupperts; Pierre Grammond; Celia Oreja-Guevara; Thor Petersen; Roberto Bergamaschi; Giorgio Giuliani; Michael Barnett; Vincent van Pesch; Maria-Pia Amato; Gerardo Iuliano; Marcela Fiol; Mark Slee; Freek Verheul; Edgardo Cristiano; Ricardo Fernandez-Bolanos; Maria-Laura Saladino; Maria Edite Rio; Jose Cabrera-Gomez; Helmut Butzkueven; Erik van Munster; Leontien Den Braber-Moerland; Daniele La Spitaleri; Alessandra Lugaresi; Vahid Shaygannejad; Orla Gray; Norma Deri; Raed Alroughani; Jeannette Lechner-Scott Journal: PLoS One Date: 2015-06-05 Impact factor: 3.240