Save
Early clinical predictors of severe MS
Author(s): ,
C. Malpas
Affiliations:
The University of Melbourne | CORe, Department of Medicine | Royal Melbourne Hospital
,
S. Sharmin
Affiliations:
Department of Neurology, CORe Unit, Department of Medicine, University of Melbourne, Royal Melbourne Hospital, Melbourne, VIC, Australia
,
D. Horakova
Affiliations:
Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University in Prague and General University Hospital, Prague, Czech Republic
,
E.K. Havrdova
Affiliations:
Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University in Prague and General University Hospital, Prague, Czech Republic
,
M. Trojano
Affiliations:
Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari, Bari, Italy
,
G. Izquierdo
Affiliations:
Hospital Universitario Virgen Macarena, Sevilla, Spain
,
R. Bergamaschi
Affiliations:
IRCCS Mondino Foundation, Pavia
,
P. Sola
Affiliations:
Department of Neuroscience, Azienda Ospedaliera Universitaria, Modena
,
D. Ferraro
Affiliations:
Department of Neuroscience, Azienda Ospedaliera Universitaria, Modena
,
A. Lugaresi
Affiliations:
Department of Biomedical and Neuromotor Science, University of Bologna, Bologna, Italy
,
A. Prat
Affiliations:
Hopital Notre Dame, Montreal, Canada
,
M. Girard
Affiliations:
Hopital Notre Dame, Montreal, Canada
,
P. Duquette
Affiliations:
Hopital Notre Dame, Montreal, Canada
,
P. Grammond
Affiliations:
CISSS ChaudiËre-Appalache, Levis
,
F. Grand`Maison
Affiliations:
Neuro Rive-Sud, Quebec, QC, Canada
,
S. Ozakbas
Affiliations:
Dokuz Eylul University, Konak/Izmir, Turkey
,
V. Van Pesch
Affiliations:
Cliniques Universitaires Saint-Luc; UniversitÈ Catholique de Louvain, Brussels, Belgium
,
F. Granella
Affiliations:
Department of Medicine and Surgery, University of Parma, Parma, Italy
,
R. Hupperts
Affiliations:
Zuyderland Ziekenhuis, Sittard, The Netherlands
,
E. Pucci
Affiliations:
UOC Neurologia, Azienda Sanitaria Unica Regionale Marche - AV3, Macerata, Italy
,
C. Boz
Affiliations:
KTU Medical Faculty Farabi Hospital, Trabzon, Turkey
,
G. Iuliano
Affiliations:
Ospedali Riuniti di Salerno, Salerno, Italy
,
Y. Sidhom
Affiliations:
Department of Neurology, Razi Hospital, Manouba, Tunisia
,
R. Gouider
Affiliations:
Department of Neurology, Razi Hospital, Manouba, Tunisia
,
D. Spitaleri
Affiliations:
Azienda Ospedaliera di Rilievo Nazionale San Giuseppe Moscati, Avellino, Italy
,
H. Butzkueven
Affiliations:
Central Clinical School, Monash University; Department of Neurology, The Alfred Hospital; Department of Neurology, Box Hill Hospital, Monash University, Melbourne, VIC, Australia
,
A. Soysal
Affiliations:
Bakirkoy Education and Research Hospital for Psychiatric and Neurological Diseases, Istanbul, Turkey
,
T. Petersen
Affiliations:
Kommunehospitalet, Arhus C, Denmark
,
F. Verheul
Affiliations:
Groene Hart Ziekenhuis, Gouda, The Netherlands
,
R. Karabudak
Affiliations:
Hacettepe University, Ankara
,
R. Turkoglu
Affiliations:
Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
,
C. Ramo-Tello
Affiliations:
Hospital Germans Trias i Pujol, Badalona, Spain
,
M. Terzi
Affiliations:
Medical Faculty, 19 Mayis University, Samsun, Turkey
,
E. Cristiano
Affiliations:
Hospital Italiano, Buenos Aires, Argentina
,
M. Slee
Affiliations:
Flinders University, Adelaide, SA
,
P. McCombe
Affiliations:
University of Queensland, Brisbane, QLD
,
R. Macdonell
Affiliations:
Austin Health, Melbourne, VIC, Australia
,
Y. Fragoso
Affiliations:
Universidade Metropolitana de Santos, Santos, Brazil
,
J. Olascoaga
Affiliations:
Instituto de InvestigaciÛn Sanitaria Biodonostia, Hospital Universitario Donostia, San Sebastian, Spain
,
A. Altintas
Affiliations:
Istanbul University Cerrahpasa School of Medicine, Istanbul, Turkey
,
T. Kalincik
Affiliations:
CORe Unit, Department of Medicine, University of Melbourne; Department of Neurology, Royal Melbourne Hospital, Melbourne, VIC, Australia
MSBase Study Group
MSBase Study Group
Affiliations:
ECTRIMS Online Library. Malpas C. Oct 12, 2018; 228824
Charles Malpas
Charles Malpas
Login now to access Regular content available to all registered users.

You may also access this content "anytime, anywhere" with the Free MULTILEARNING App for iOS and Android
Abstract
Discussion Forum (0)
Rate & Comment (0)

Abstract: P982

Type: Poster Sessions

Abstract Category: Clinical aspects of MS - MS Variants

Introduction: The course of disability progression in MS varies across individuals. A subset of patients will rapidly accrue disability relatively early in the course of the disease. This phenotypic profile has been described as 'severe MS'. The early detection of such patients is critical to accurate prognosis, and may inform optimal treatment strategies. A number of possible clinical predictors have been identified, however a consensus is yet to emerge regarding early diagnostic criteria for severe MS.
Aims: To evaluate whether clinical factors observed in the first year since symptom onset can identify patients who will develop severe MS.
Methods: Patient data were obtained from MSBase. Inclusion criteria were (a) first recorded disability score (EDSS) within 12 months of symptom onset, (b) at least 2 recorded EDSS scores, and (c) at least 10 years of observation time. Patients were classified as having 'severe MS' if they: (a) reached EDSS >= 6 within 10 years of symptom onset, (b) EDSS >=6 was confirmed and sustained over >=6 months, and (c) EDSS >=6 was sustained until the end of follow-up. Clinical predictors included patient variables (sex, age at onset, baseline EDSS, disease duration at first visit) and recorded relapses in the first 12 months since disease onset (count, pyramidal signs, bowel-bladder symptoms, cerebellar signs, incomplete relapse recovery, steroid administration, hospitalisation). A subset of patients with documented cerebral MRI findings (McDonald criteria) and CSF oligoclonal band results. Predictors were evaluated via generalised linear models.
Results: Of the 2502 patients identified, 194 were classified as having severe MS (8%). Statistically significant predictors of severe MS were age at symptom onset (b = 0.07, p < .001), disease duration at first visit (b = 0.01, p < .001), EDSS at first visit (b = 0.52, p < .001), and any relapse with bowel or bladder symptoms in the first year (b = 1.03, p = .014). A subgroup of 372 patients had cerebral MRI examinations in the first year since symptom onset with documented McDonald criteria. 1193 patients had CSF oligoclonal band (OCB) results. In these subgroups, neither cerebral MRI findings nor OCB results were statistically significant predictors of severe MS.
Conclusions: Older age at symptom onset, greater disability at first visit, and relapses with bowel of bladder symptoms in the first 12 months facilitate early diagnosis of severe MS.
Disclosure: Charles Malpas: nothing to disclose.
Sifat Sharmin: nothing to disclose
Dana Horakova received speaker honoraria and consulting fees from Biogen, Merck , Teva and Novartis, as well as support for research activities from Biogen and research grants from Charles University in Prague [PRVOUK-P26/LF1/4], Czech Minsitry of Education [PROGRES Q27/LF1] and Czech Ministry of Health [NT13237-4/2012].
Eva Kubala Havrdova received speaker honoraria and consultant fees from Actelion, Biogen, Celgene, Merck, Novartis, Roche, Sanofi and Teva, and support for research activities from Czech Ministry of Education [project Progres Q27/LF1].
Maria Trojano received speaker honoraria from Biogen-Idec, Bayer-Schering, Sanofi Aventis, Merck, Teva , Novartis and Almirall; has received research grants for her Institution from Biogen-Idec, Merck, and Novartis.
Guillermo Izquierdo received speaking honoraria from Biogen, Novartis, Sanofi, Merck, Roche, Almirall and Teva.
Sara Eichau did not declare any competing interests.
Roberto Bergamaschi received speaker honoraria from Bayer Schering, Biogen, Genzyme, Merck , Novartis, Sanofi-Aventis, Teva; research grants from Bayer Schering, Biogen, Merck , Novartis, Sanofi-Aventis, Teva; congress and travel/accommodation expense compensations by Almirall, Bayer Schering, Biogen, Genzyme, Merck , Novartis, Sanofi-Aventis, Teva.
Patrizia Sola served on scientific advisory boards for Biogen Idec and TEVA, she has received funding for travel and speaker honoraria from Biogen Idec, Merck , Teva, Sanofi Genzyme, Novartis and Bayer and research grants for her Institution from Bayer, Biogen, Merck , Novartis, Sanofi, Teva.
Diana Ferraro received travel grants and/or speaker honoraria from Merck, TEVA,†Novartis, Biogen and Sanofi-Genzyme.
Alessandra Lugaresi is a Bayer, Biogen, Genzyme, Merck Advisory Board Member. She received travel grants and honoraria from Roche, Bayer, Biogen, Merck, Novartis, Sanofi, Teva and Fondazione Italiana Sclerosi Multipla (FISM). Her institution received research grants from Bayer, Biogen, Merck, Novartis, Sanofi , Teva and Fondazione Italiana Sclerosi Multipla (FISM).
Alexandre Prat did not declare any competing interests.
Marc Girard received consulting fees from Teva Canada Innovation, Biogen, Novartis and Genzyme Sanofi; lecture payments from Teva Canada Innovation, Novartis and EMD .† He has also received a research grant from Canadian Institutes of Health Research.
Pierre Duquette served on editorial boards and has been supported to attend meetings by EMD, Biogen, Novartis, Genzyme, and TEVA Neuroscience. He holds grants from the CIHR and the MS Society of Canada and has received funding for investigator-initiated trials from Biogen, Novartis, and Genzyme.
Pierre Grammond is a Merck, Novartis, Teva-neuroscience, Biogen and Genzyme advisory board member, consultant for Merck , received payments for lectures by Merck , Teva-Neuroscience and Canadian Multiple sclerosis society, and received grants for travel from Teva-Neuroscience and Novartis.
Francois Grand´Maison received honoraria or research funding from Biogen, Genzyme, Novartis, Teva Neurosciences, Mitsubishi and ONO Pharmaceuticals.
Serkan Ozakbas did not declare any competing interests.
Vincent Van Pesch received travel grants from Biogen, Bayer Schering, Genzyme, Merck, Teva and Novartis Pharma. His institution receives honoraria for consultancy and lectures from Biogen, Bayer Schering, Genzyme, Merck, Roche, Teva and Novartis Pharma as well as research grants from Novartis Pharma and Bayer Schering.
Franco Granella received research grant from Biogen, served on scientific advisory boards for Biogen, Novartis, Merck, and Sanofi-Aventis and received funding for travel and speaker honoraria from Biogen, Merck, Sanofi-Aventis, and Almirall.
Raymond Hupperts received honoraria as consultant on scientific advisory boards from Merck, Biogen, Genzyme-Sanofi and Teva, research funding from Merck and Biogen, and speaker honoraria from Sanofi-Genzyme and Novartis.
Eugenio Pucci served on scientific advisory boards for Merck, Genzyme and Biogen; he has received honoraria and travel grants from Sanofi Aventis, Novartis, Biogen, Merck, Genzyme and Teva; he has received travel grants and equipment from "Associazione Marchigiana Sclerosi Multipla e altre malattie neurologiche".
Tomas Kalincik served on scientific advisory boards for Roche, Genzyme-Sanofi, Novartis, Merck and Biogen, steering committee for Brain Atrophy Initiative by Genzyme, received conference travel support and/or speaker honoraria from WebMD Global, Novartis, Biogen, Genzyme-Sanofi, Teva, BioCSL and Merck and received research support from Biogen.
Cavit Boz received conference travel support from Biogen, Novartis, Bayer-Schering, Merck and Teva; has participated in clinical trials by Sanofi Aventis, Roche and Novartis.
Gerardo Iuliano had travel/accommodations/meeting expenses funded by Bayer Schering, Biogen, Merck , Novartis, Sanofi Aventis, and Teva.
Youssef Sidhom did not declare any competing interests.
Riadh Gouider did not declare any competing interests.
Daniele Spitaleri received honoraria as a consultant on scientific advisory boards by Bayer-Schering, Novartis and Sanofi-Aventis and compensation for travel from Novartis, Biogen, Sanofi Aventis, Teva and Merck.
Helmut Butzkueven served on scientific advisory boards for Biogen, Novartis and Sanofi-Aventis and has received conference travel support from Novartis, Biogen and Sanofi Aventis. He serves on steering committees for trials conducted by Biogen and Novartis, and has received research support from Merck , Novartis and Biogen.
Aysun Soysal did not declare any competing interests.
Thor Petersen received funding or speaker honoraria from Biogen, Merck , Novartis, Bayer Schering, Sanofi-Aventis, Roche, and Genzyme.
Freek Verheul is an advisory board member for Teva Biogen Merck and Novartis.
Rana Karabudak did not declare any competing interests.
Recai Turkoglu did not declare any competing interests.
Cristina Ramo-Tello received research funding, compensation for travel or speaker honoraria from Biogen, Novartis, Genzyme and Almirall.
Murat Terzi received travel grants from Novartis, Bayer-Schering, Merck and Teva; has participated in clinical trials by Sanofi Aventis, Roche and Novartis.
Edgardo Cristiano received honoraria as consultant on scientific advisory boards by Biogen, Bayer-Schering, Merck, Genzyme and Novartis; has participated in clinical trials/other research projects by Merck, Roche and Novartis.
Mark Slee has participated in, but not received honoraria for, advisory board activity for Biogen, Merck , Bayer Schering, Sanofi Aventis and Novartis.
Pamela McCombe did not declare any competing interests.
Richard Macdonell did not declare any competing interests.
Yara Fragoso received honoraria as a consultant on scientific advisory boards by Novartis, Teva, Roche and Sanofi-Aventis and compensation for travel from Novartis, Biogen, Sanofi Aventis, Teva, Roche and Merck.
Javier Olascoaga serves on scientific advisory boards for Biogen, Novartis, Sanofi and Roche; has received speaker honoraria from Almirall, Biogen, Bayer, Sanofi, Merck, Novartis and Roche and research grants from Biogen, Merck , Novartis and Teva.
Ayse Altintas received personal fees and speaker honoraria from Teva, Merck, Biogen - Gen Pharma, Roche, Novartis, Bayer, Sanofi-Genzyme; received travel and registration grants from Merck, Biogen - Gen Pharma, Roche, Sanofi-Genzyme and Bayer.
Tomas Kalincik served on scientific advisory boards for Roche, Genzyme-Sanofi, Novartis, Merck and Biogen, steering committee for Brain Atrophy Initiative by Genzyme, received conference travel support and/or speaker honoraria from WebMD Global, Novartis, Biogen, Genzyme-Sanofi, Teva, BioCSL and Merck and received research support from Biogen.

Code of conduct/disclaimer available in General Terms & Conditions
Anonymous User Privacy Preferences

Strictly Necessary Cookies (Always Active)

MULTILEARNING platforms and tools hereinafter referred as “MLG SOFTWARE” are provided to you as pure educational platforms/services requiring cookies to operate. In the case of the MLG SOFTWARE, cookies are essential for the Platform to function properly for the provision of education. If these cookies are disabled, a large subset of the functionality provided by the Platform will either be unavailable or cease to work as expected. The MLG SOFTWARE do not capture non-essential activities such as menu items and listings you click on or pages viewed.


Performance Cookies

Performance cookies are used to analyse how visitors use a website in order to provide a better user experience.



Google Analytics is used for user behavior tracking/reporting. Google Analytics works in parallel and independently from MLG’s features. Google Analytics relies on cookies and these cookies can be used by Google to track users across different platforms/services.


Save Settings