Converting to SPMS, worse thing is uncontrolloed worsening

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Risk of secondary progressive multiple sclerosis: A longitudinal study.Fambiatos A et al. Mult Scler. 2019 Aug 9:1352458519868990

BACKGROUND:The risk factors for conversion from relapsing-remitting to secondary progressive multiple sclerosis remain highly contested.

OBJECTIVE: The aim of this study was to determine the demographic, clinical and paraclinical features that influence the risk of conversion to secondary progressive multiple sclerosis.

METHODS: Patients with adult-onset relapsing-remitting multiple sclerosis and at least four recorded disability scores were selected from MSBase, a global observational cohort. The risk of conversion to objectively defined secondary progressive multiple sclerosis was evaluated at multiple time points per patient.

RESULTS: A total of 15,717 patients were included in the primary analysis. Older age (hazard ratio (HR) = 1.02, p < 0.001), longer disease duration (HR = 1.01, p = 0.038), a higher Expanded Disability Status Scale score (HR = 1.30, p < 0.001), more rapid disability trajectory (HR = 2.82, p < 0.001) and greater number of relapses in the previous year (HR = 1.07, p = 0.010) were independently associated with an increased risk of secondary progressive multiple sclerosis. Improving disability (HR = 0.62, p = 0.039) and disease-modifying therapy exposure (HR = 0.71, p = 0.007) were associated with a lower risk. Recent cerebral magnetic resonance imaging activity, evidence of spinal cord lesions and oligoclonal bands in the cerebrospinal fluid were not associated with the risk of conversion.

CONCLUSION: Risk of secondary progressive multiple sclerosis increases with age, duration of illness and worsening disability and decreases with improving disability. Therapy may delay the onset of secondary progression.

Hazard ratio of 1.02 is a tweeny weany difference from no change

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5 comments

Leave a Reply to Tony Fonda Cancel reply

  • Another pointless study: Risk of conversion to SPMS is 100%. The word risk is mis-representative – conversion is a certainty but for the very few benign MSers.

    “Therapy may delay the onset of secondary progression”. Glad the authors spent their time and taxpayer money to reach this conclusion.

    I would like to see a study on how many crappy observational MS studies are published out there versus real science biology stuff relating to MS. That would hopefully put a lid on the funding of all this non-sense.

  • So no comment on the oligoclonal bands not showing association with progression to SPMS in 15k patients? The article is behind a paywall so we can’t see the data.

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