BACKGROUND: Daily practice is still faced with uncertainty in predicting the long-term disability of multiple sclerosis (MS). Most information comes from northern hemisphere cohorts, but in South America this information is scarce, and race, genetic and environmental factors could play an important role in the heterogeneity observed in disease outcomes. METHODS: We evaluated 197 patients attending our MS Center gathering clinical and demographic information. Outcome measures analyzed were time from first clinical symptom to EDSS of 6, 7 and 8. For survival analysis we employed Cox regression models and the Kaplan-Meier method. RESULTS: Time to EDSS 6 was 25.83 years (95% CI 15.36-36.31), and 36.25 years (95% CI 20.72-51.78) for EDSS 7. Male sex was associated with a 4.63 and 4.69 fold increased risk to EDSS 6 and 7, respectively (p<0.001 and p=0.006). Motor and brainstem symptoms at onset were also associated with an 8.1 and 13.1 fold increased risk to EDSS 6, respectively (p=0.04 and p=0.01). The number of relapses in five and ten years of disease onset was associated with a slightly increased risk to EDSS 8 (1.28 and 1.19, respectively; p=0.032 and p=0.015). CONCLUSIONS: Male patients presenting with frequent relapses, especially those with motor and brainstem involvement, deserve close observation and should be cautiously monitored to early signs of treatment failure.
BACKGROUND: Daily practice is still faced with uncertainty in predicting the long-term disability of multiple sclerosis (MS). Most information comes from northern hemisphere cohorts, but in South America this information is scarce, and race, genetic and environmental factors could play an important role in the heterogeneity observed in disease outcomes. METHODS: We evaluated 197 patients attending our MS Center gathering clinical and demographic information. Outcome measures analyzed were time from first clinical symptom to EDSS of 6, 7 and 8. For survival analysis we employed Cox regression models and the Kaplan-Meier method. RESULTS: Time to EDSS 6 was 25.83 years (95% CI 15.36-36.31), and 36.25 years (95% CI 20.72-51.78) for EDSS 7. Male sex was associated with a 4.63 and 4.69 fold increased risk to EDSS 6 and 7, respectively (p<0.001 and p=0.006). Motor and brainstem symptoms at onset were also associated with an 8.1 and 13.1 fold increased risk to EDSS 6, respectively (p=0.04 and p=0.01). The number of relapses in five and ten years of disease onset was associated with a slightly increased risk to EDSS 8 (1.28 and 1.19, respectively; p=0.032 and p=0.015). CONCLUSIONS: Male patients presenting with frequent relapses, especially those with motor and brainstem involvement, deserve close observation and should be cautiously monitored to early signs of treatment failure.
Authors: Riley Bove; Alexander Musallam; Brian C Healy; Maria Houtchens; Bonnie I Glanz; Samia Khoury; Charles R Guttmann; Philip L De Jager; Tanuja Chitnis Journal: BMC Neurol Date: 2013-07-03 Impact factor: 2.474
Authors: Vilija G Jokubaitis; Tim Spelman; Tomas Kalincik; Guillermo Izquierdo; François Grand'Maison; Pierre Duquette; Marc Girard; Alessandra Lugaresi; Pierre Grammond; Raymond Hupperts; José Cabrera-Gomez; Celia Oreja-Guevara; Cavit Boz; Giorgio Giuliani; Ricardo Fernández-Bolaños; Gerardo Iuliano; Jeannette Lechner-Scott; Freek Verheul; Vincent van Pesch; Tatjana Petkovska-Boskova; Marcela Fiol; Fraser Moore; Edgardo Cristiano; Raed Alroughani; Roberto Bergamaschi; Michael Barnett; Mark Slee; Norbert Vella; Joseph Herbert; Cameron Shaw; Maria Laura Saladino; Maria Pia Amato; Danny Liew; Damiano Paolicelli; Helmut Butzkueven; Maria Trojano Journal: Ann Clin Transl Neurol Date: 2015-03-27 Impact factor: 4.511
Authors: Regina Maria Papais-Alvarenga; Claudia Cristina Ferreira Vasconcelos; Adriana Carra; Ibis Soto de Castillo; Sara Florentin; Fernando Hamuy Diaz de Bedoya; Raul Mandler; Luiza Campanella de Siervi; Maria Lúcia Vellutini Pimentel; Marina Papais Alvarenga; Marcos Papais Alvarenga; Anderson Kuntz Grzesiuk; Ana Beatriz Calmon Gama Pereira; Antonio Pereira Gomes Neto; Carolina Velasquez; Carlos Soublette; Cynthia Veronica Fleitas; Denise Sisteroli Diniz; Elizabeth Armas; Elizabeth Batista; Freda Hernandez; Fernanda Ferreira Chaves da Costa Pereira; Heloise Helena Siqueira; Hideraldo Cabeça; Jose Sanchez; Joseph Bruno Bidin Brooks; Marcus Vinicius Gonçalves; Maria Cristina Del Negro Barroso; Maria Elena Ravelo; Maria Carlota Castillo; Maria Lúcia Brito Ferreira; Maria Sheila Guimarães Rocha; Monica Koncke Fiuza Parolin; Omaira Molina; Patricia Beatriz Christino Marinho; Paulo Pereira Christo; Renata Brant de Souza; Silvio Pessanha Neto; Solange Maria das Graças Camargo; Suzana Costa Machado; Vanderson Carvalho Neri; Yara Dadalti Fragoso; Helcio Alvarenga; Luiz Claudio Santos Thuler Journal: PLoS One Date: 2015-07-29 Impact factor: 3.240