BACKGROUND:Symptom changes may serve as a risk factor for relapse activity and disability progression, which could facilitate multiple sclerosis (MS) treatment decisions.
OBJECTIVE:To assess the relationship of symptom change with RA and DP.
METHODS:We evaluated the relationship of symptom change with subsequent RA and DP using NARCOMS registry data reported over a five-year period. Symptom change was evaluated using both symptom worsening and average of Performance Scales scores. Disability progression was defined as a one-point or more increase in Patient-Determined Disease Steps score between two consecutive updates.
RESULTS:Symptom worsening and performance score were both significant predictors of subsequent relapse activity and disease progression. Both symptom worsening and performance scores have a significant interaction with levels of disability (Mildly Impaired versus Highly Impaired) for the prediction of the subsequent relapse activity and disease progression. For Mildly Impaired MS subjects, both Symptom worsening and performance score were significant predictors of both relapse activity and progression. However, for Highly Impaired MS subjects, symptom worsening did not significantly predict future relapse activity and neither symptom worsening nor performance score predicted disability progression.
CONCLUSION:Changes in self-reported overall symptomatology may precede and predict clinical relapse and future disability progression. The predictive power of symptom changes may only be present at lower levels of disability.(Edited to remove abbreviations)
This is another study looking at disease activity and disease activity, and finds that if your symptoms are worsening then if you are not impaired it is more likely that you will have a relapse and progress. This is surely a sign that you are not NEDA. If you are not NEDA=No Evidence of Disease Activity then have a talk with your team to see if that can make you NEDA. If you are worsening and more disabled the prediction is less clear, you are perhaps more likely to be transitioning into progression where may be come less frequent. There it is important to act earl to ensure that you remain NEDA and do not accumulate the disabilities.