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Predictors of disability worsening in clinically isolated syndrome

Jokubaitis, Vilija G, Spelman, Tim, Kalincik, Tomas, Izquierdo, Guillermo, Grand'Maison, Francois, Duquette, Pierre, Girard, Marc, Lugaresi, Alessandra, Grammond, Pierre, Hupperts, Raymond, Cabrera-Gomez, Jose, Oreja-Guevara, Celia, Boz, Cavit, Giuliani, Giorgio, Fernández-Bolaños, Ricardo, Iuliano, Gerardo, Lechner-Scott, Jeannette, Verheul, Freek, van Pesch, Vincent, Petkovska-Boskova, Tatjana, Fiol, Marcela, Moore, Fraser, Cristiano, Edgardo, Alroughani, Raed, Bergamaschi, Roberto, Barnett, Michael, Slee, Mark, Vella, Norbert, Herbert, Joseph, Shaw, Cameron, Saladino, Maria Laura, Amato, Maria Pia, Liew, Danny, Paolicelli, Damiano, Butzkueven, Helmut, Trojano, Maria and MSBasis Study Group 2015, Predictors of disability worsening in clinically isolated syndrome, Annals of clinical and translational neurology, vol. 2, no. 5, pp. 479-491, doi: 10.1002/acn3.187.

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Title Predictors of disability worsening in clinically isolated syndrome
Author(s) Jokubaitis, Vilija G
Spelman, Tim
Kalincik, Tomas
Izquierdo, Guillermo
Grand'Maison, Francois
Duquette, Pierre
Girard, Marc
Lugaresi, Alessandra
Grammond, Pierre
Hupperts, Raymond
Cabrera-Gomez, Jose
Oreja-Guevara, Celia
Boz, Cavit
Giuliani, Giorgio
Fernández-Bolaños, Ricardo
Iuliano, Gerardo
Lechner-Scott, Jeannette
Verheul, Freek
van Pesch, Vincent
Petkovska-Boskova, Tatjana
Fiol, Marcela
Moore, Fraser
Cristiano, Edgardo
Alroughani, Raed
Bergamaschi, Roberto
Barnett, Michael
Slee, Mark
Vella, Norbert
Herbert, Joseph
Shaw, CameronORCID iD for Shaw, Cameron orcid.org/0000-0002-1966-5200
Saladino, Maria Laura
Amato, Maria Pia
Liew, Danny
Paolicelli, Damiano
Butzkueven, Helmut
Trojano, Maria
MSBasis Study Group
Journal name Annals of clinical and translational neurology
Volume number 2
Issue number 5
Start page 479
End page 491
Total pages 13
Publisher John Wiley & Sons
Place of publication Chichester, Eng.
Publication date 2015-05
ISSN 2328-9503
Keyword(s) magnetic resonance imaging
disability worsening
clinically isolated syndrome
multiple sclerosis
demographic
clinical
Summary Objective
To assess demographic, clinical, magnetic resonance imaging, and treatment exposure predictors of time to 3 or 12-month confirmed disability worsening in clinically isolated syndrome (CIS) and early multiple sclerosis (MS).

Methods
We utilized the MSBase Incident Study (MSBasis), a prospective cohort study of outcome after CIS. Predictors of time to first 3 and 12-month confirmed expanded disability status scale worsening were analyzed using Cox proportional hazards regression.

Results
About 1989 patients were analyzed, the largest seen-from-onset cohort reported to-date. A total of 391 patients had a first 3-month confirmed disability worsening event, of which 307 were sustained for 12 months. Older age at CIS onset (adjusted hazard ratio: aHR 1.17, 95% 1.06, 1.30), pyramidal (aHR 1.45, 95% CI 1.13, 1.89) and ambulation (HR 1.60, 95% CI 1.09, 2.34) system dysfunction, annualized relapse rate (aHR 1.20, 95% CI 1.18, 1.22), and lower proportion of observation time on treatment were associated with 3-month confirmed worsening. Predictors of time to 12-month sustained worsening included pyramidal system dysfunction (Hazard ratio: aHR 1.38, 95% CI 1.05, 1.83), and older age at CIS onset (aHR 1.17, 95% CI 1.04, 1.31). Greater proportion of follow-up time exposed to treatment was associated with greater reductions in the rate of worsening.

Interpretation
This study provides class IV evidence for a strong protective effect of disease-modifying treatment to reduce disability worsening events in patients with CIS and early MS, and confirms age and pyramidal dysfunction at onset as risk factors.
Language eng
DOI 10.1002/acn3.187
Field of Research 110399 Clinical Sciences not elsewhere classified
HERDC Research category C1.1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2015, The Authors
Free to Read? Yes
Use Rights Creative Commons Attribution Non-Commercial No-Derivatives licence
Persistent URL http://hdl.handle.net/10536/DRO/DU:30103919

Document type: Journal Article
Collections: Faculty of Health
School of Medicine
Open Access Collection
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Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.