Andrius Kavaliunas1, Ali Manouchehrinia1, Leszek Stawiarz1, Ryan Ramanujam2, Jonas Agholme1, Anna Karin Hedström3, Omid Beiki4, Anna Glaser1, Jan Hillert1. 1. Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden. 2. Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden/Department of Mathematics, KTH Royal Institute of Technology, Stockholm, Sweden. 3. Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden. 4. Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden/Kermanshah University of Medical Sciences, Kermanshah, Iran.
Abstract
OBJECTIVES: The aim of this study was to identify factors influencing the long-term clinical progression of multiple sclerosis (MS). A special objective was to investigate whether early treatment decisions influence outcome. METHODS: We included 639 patients diagnosed with MS from 2001 to 2007. The median follow-up time was 99 months (8.25 years). Cox regression models were applied to identify factors correlating with the outcome variable defined as time from treatment start to irreversible score 4 of the Expanded Disability Status Scale (EDSS). RESULTS: Patients initiated on treatment later had a greater risk of reaching EDSS 4 (hazard ratio of 1.074 (95% confidence interval (CI), 1.048-1.101)), increased by 7.4% for every year of delay in treatment start after MS onset. Patients who started treatment after 3 years from MS onset reached the outcome sooner with hazard ratio of 2.64 (95% CI, 1.71-4.08) compared with the patients who started treatment within 1 year from MS onset. Baseline EDSS and age at onset were found to be predictive factors of disability progression. CONCLUSION: Early treatment initiation was associated with a better clinical outcome. In addition, we confirmed the well-established prognostic factors of late age at onset and early disability.
OBJECTIVES: The aim of this study was to identify factors influencing the long-term clinical progression of multiple sclerosis (MS). A special objective was to investigate whether early treatment decisions influence outcome. METHODS: We included 639 patients diagnosed with MS from 2001 to 2007. The median follow-up time was 99 months (8.25 years). Cox regression models were applied to identify factors correlating with the outcome variable defined as time from treatment start to irreversible score 4 of the Expanded Disability Status Scale (EDSS). RESULTS:Patients initiated on treatment later had a greater risk of reaching EDSS 4 (hazard ratio of 1.074 (95% confidence interval (CI), 1.048-1.101)), increased by 7.4% for every year of delay in treatment start after MS onset. Patients who started treatment after 3 years from MS onset reached the outcome sooner with hazard ratio of 2.64 (95% CI, 1.71-4.08) compared with the patients who started treatment within 1 year from MS onset. Baseline EDSS and age at onset were found to be predictive factors of disability progression. CONCLUSION: Early treatment initiation was associated with a better clinical outcome. In addition, we confirmed the well-established prognostic factors of late age at onset and early disability.
Authors: Tomas Kalincik; Ibrahima Diouf; Sifat Sharmin; Charles Malpas; Tim Spelman; Dana Horakova; Eva Kubala Havrdova; Maria Trojano; Guillermo Izquierdo; Alessandra Lugaresi; Alexandre Prat; Marc Girard; Pierre Duquette; Pierre Grammond; Vilija Jokubaitis; Anneke van der Walt; Francois Grand'Maison; Patrizia Sola; Diana Ferraro; Vahid Shaygannejad; Raed Alroughani; Raymond Hupperts; Murat Terzi; Cavit Boz; Jeannette Lechner-Scott; Eugenio Pucci; Vincent Van Pesch; Franco Granella; Roberto Bergamaschi; Daniele Spitaleri; Mark Slee; Steve Vucic; Radek Ampapa; Pamela McCombe; Cristina Ramo-Tello; Julie Prevost; Javier Olascoaga; Edgardo Cristiano; Michael Barnett; Maria Laura Saladino; Jose Luis Sanchez-Menoyo; Suzanne Hodgkinson; Csilla Rozsa; Stella Hughes; Fraser Moore; Cameron Shaw; Ernest Butler; Olga Skibina; Orla Gray; Allan Kermode; Tunde Csepany; Bhim Singhal; Neil Shuey; Imre Piroska; Bruce Taylor; Magdolna Simo; Carmen-Adella Sirbu; Attila Sas; Helmut Butzkueven Journal: Neurology Date: 2020-12-28 Impact factor: 9.910
Authors: Andrius Kavaliunas; Ali Manouchehrinia; Virginija Danylaite Karrenbauer; Hanna Gyllensten; Anna Glaser; Kristina Alexanderson; Jan Hillert Journal: PLoS One Date: 2017-01-12 Impact factor: 3.240