Ali Manouchehrinia1, Omid Beiki2, Jan Hillert1. 1. Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden. 2. Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden/Kermanshah University of Medical Sciences, Kermanshah, Iran.
Abstract
BACKGROUND: The course of multiple sclerosis (MS) has been studied in several cohorts; however, results have varied significantly. OBJECTIVE: To describe the clinical course of MS in a nationwide cohort of patients. METHOD: Data from the Swedish MS register (SMSreg) were used to estimate the median time to the sustained Expanded Disability Status Scale (EDSS) scores 3.0, 4.0 and 6.0, onset of secondary progressive multiple sclerosis (SPMS) and death using Kaplan-Meier method. A possible effect of first-line treatments on age at EDSS 6.0 and SPMS was estimated. RESULTS: In all, 12,703 patients were included. Median ages at EDSS scores 3.0, 4.0 and 6.0 were 55.4 (95% confidence interval (CI): 54.8-55.8), 60.7 (95% CI: 60.1-61.2) and 64.3 (95% CI: 63.6-64.7), respectively. Median age at SPMS was 57.4 (95% CI: 56.9-57.9). The median age at the time of death was 80.5 (95% CI: 79.9-81.1). Males and progressive-onset patients showed higher risks of disability worsening. On average, treated patients gained 1.6 years (95% CI: 0.2-3) to EDSS 6.0 as a result of treatment. CONCLUSION: Ages at disability milestones in this population-based cohort were higher than previously described in clinic- and regional-based samples. Nevertheless, MS patients die at younger age and live at an average almost 20 years with moderate and 30 years with severe disability.
BACKGROUND: The course of multiple sclerosis (MS) has been studied in several cohorts; however, results have varied significantly. OBJECTIVE: To describe the clinical course of MS in a nationwide cohort of patients. METHOD: Data from the Swedish MS register (SMSreg) were used to estimate the median time to the sustained Expanded Disability Status Scale (EDSS) scores 3.0, 4.0 and 6.0, onset of secondary progressive multiple sclerosis (SPMS) and death using Kaplan-Meier method. A possible effect of first-line treatments on age at EDSS 6.0 and SPMS was estimated. RESULTS: In all, 12,703 patients were included. Median ages at EDSS scores 3.0, 4.0 and 6.0 were 55.4 (95% confidence interval (CI): 54.8-55.8), 60.7 (95% CI: 60.1-61.2) and 64.3 (95% CI: 63.6-64.7), respectively. Median age at SPMS was 57.4 (95% CI: 56.9-57.9). The median age at the time of death was 80.5 (95% CI: 79.9-81.1). Males and progressive-onset patients showed higher risks of disability worsening. On average, treated patients gained 1.6 years (95% CI: 0.2-3) to EDSS 6.0 as a result of treatment. CONCLUSION: Ages at disability milestones in this population-based cohort were higher than previously described in clinic- and regional-based samples. Nevertheless, MS patients die at younger age and live at an average almost 20 years with moderate and 30 years with severe disability.
Authors: Mariana Branco; Ivânia Alves; Ana Martins da Silva; Joaquim Pinheiro; Maria José Sá; Inês Correia; Lívia Sousa; Eva Brandão; Carlos Veira; Bernardo Gomes; Luis Ruano Journal: BMC Neurol Date: 2020-05-19 Impact factor: 2.474
Authors: Olga von Bismarck; Theresa Dankowski; Björn Ambrosius; Nicole Hessler; Gisela Antony; Andreas Ziegler; Muna-Miriam Hoshi; Lilian Aly; Felix Luessi; Sergiu Groppa; Luisa Klotz; Sven G Meuth; Björn Tackenberg; Muriel Stoppe; Florian Then Bergh; Hayrettin Tumani; Tania Kümpfel; Martin Stangel; Christoph Heesen; Brigitte Wildemann; Friedemann Paul; Antonios Bayas; Clemens Warnke; Frank Weber; Ralf A Linker; Ulf Ziemann; Uwe K Zettl; Frauke Zipp; Heinz Wiendl; Bernhard Hemmer; Ralf Gold; Anke Salmen Journal: Neurol Neuroimmunol Neuroinflamm Date: 2018-03-01
Authors: Ali Manouchehrinia; Anna Karin Hedström; Lars Alfredsson; Tomas Olsson; Jan Hillert; Ryan Ramanujam Journal: Front Neurol Date: 2018-05-11 Impact factor: 4.003