L A Benson1, B C Healy2, M P Gorman3, N F Baruch4, T Gholipour5, A Musallam6, T Chitnis7. 1. Partners Pediatric Multiple Sclerosis Center, Massachusetts General Hospital, Boston, MA, USA; Partners Multiple Sclerosis Center, Brigham and Women's Hospital, 1 Brookline Place, Boston, MA, USA; Department of Neurology, Boston Children's Hospital, Boston, MA, USA. Electronic address: leslie.benson@childrens.harvard.edu. 2. Partners Multiple Sclerosis Center, Brigham and Women's Hospital, 1 Brookline Place, Boston, MA, USA. Electronic address: bchealy@parterns.org. 3. Department of Neurology, Boston Children's Hospital, Boston, MA, USA. Electronic address: mark.gorman@childrens.harvard.edu. 4. Partners Pediatric Multiple Sclerosis Center, Massachusetts General Hospital, Boston, MA, USA; Partners Multiple Sclerosis Center, Brigham and Women's Hospital, 1 Brookline Place, Boston, MA, USA; Department of Neurology, Boston Children's Hospital, Boston, MA, USA. Electronic address: nbaruch@partners.org. 5. Partners Multiple Sclerosis Center, Brigham and Women's Hospital, 1 Brookline Place, Boston, MA, USA. Electronic address: tgholipour@partners.org. 6. Partners Multiple Sclerosis Center, Brigham and Women's Hospital, 1 Brookline Place, Boston, MA, USA. Electronic address: amusallam@partners.org. 7. Partners Pediatric Multiple Sclerosis Center, Massachusetts General Hospital, Boston, MA, USA; Partners Multiple Sclerosis Center, Brigham and Women's Hospital, 1 Brookline Place, Boston, MA, USA. Electronic address: tchitnis@rics.bwh.harvard.edu.
Abstract
OBJECTIVE: To compare relapse rates in pediatric-onset multiple sclerosis (POMS) and adult-onset multiple sclerosis (AOMS) over the first 6-years of disease. METHODS: Patients with relapsing-remitting disease onset were identified from the Partners Pediatric MS Center, Massachusetts General Hospital and Partners MS Center, Brigham and Women's Hospital. 84 POMS and 258 AOMS patients were included. Annualized relapse rates (ARR) for each individual year from year 1 to year 6, after first attack were compared using Poisson regression, as was expanded disability status scale (EDSS) score at the visit closest to each year interval. RESULTS: ARR was significantly higher in POMS compared to AOMS at individual years (except year 4), and was not significantly affected by adjustment for gender, race and proportion of time on treatment. Despite a 2.30 times higher relapse rate over 6-years, EDSS between groups did not differ. ARR in years 1-5 did not impact year 5 disability measured by EDSS in POMS. CONCLUSIONS: Our findings demonstrate that higher ARR in POMS relative to AOMS is sustained over 6-years, suggesting a more inflammatory nature and potential disconnect between relapses and disability measured by EDSS early in POMS. This data may be useful when designing clinical trials for POMS.
OBJECTIVE: To compare relapse rates in pediatric-onset multiple sclerosis (POMS) and adult-onset multiple sclerosis (AOMS) over the first 6-years of disease. METHODS:Patients with relapsing-remitting disease onset were identified from the Partners Pediatric MS Center, Massachusetts General Hospital and Partners MS Center, Brigham and Women's Hospital. 84 POMS and 258 AOMS patients were included. Annualized relapse rates (ARR) for each individual year from year 1 to year 6, after first attack were compared using Poisson regression, as was expanded disability status scale (EDSS) score at the visit closest to each year interval. RESULTS: ARR was significantly higher in POMS compared to AOMS at individual years (except year 4), and was not significantly affected by adjustment for gender, race and proportion of time on treatment. Despite a 2.30 times higher relapse rate over 6-years, EDSS between groups did not differ. ARR in years 1-5 did not impact year 5 disability measured by EDSS in POMS. CONCLUSIONS: Our findings demonstrate that higher ARR in POMS relative to AOMS is sustained over 6-years, suggesting a more inflammatory nature and potential disconnect between relapses and disability measured by EDSS early in POMS. This data may be useful when designing clinical trials for POMS.
Authors: Muhammad Taimur Malik; Brian C Healy; Leslie A Benson; Pia Kivisakk; Alexander Musallam; Howard L Weiner; Tanuja Chitnis Journal: Neurology Date: 2014-05-21 Impact factor: 9.910
Authors: Amy T Waldman; Salim Chahin; Amy M Lavery; Geraldine Liu; Brenda L Banwell; Grant T Liu; Laura J Balcer Journal: Mult Scler Relat Disord Date: 2016-08-26 Impact factor: 4.339