Long-term disease development in multiple sclerosis is not necessarily predicted by early symptoms.
A large study of multiple sclerosis patients (MS) came to the conclusion that clinical and brain imaging assessments drawn from magnetic resonance imaging (MRI) scans are poor measures of long-term prognosis for patients.
The study, “Long-term evolution of multiple sclerosis disability in the treatment era,” published in the journal Annals of Neurology, also showed that a lack of disease activity in the immediate years following disease onset does not predict later outcomes, and questions the use of yearly MRI assessments and whether aggressive early treatment to halt disease activity can actually ensure lower disability over time.
Researchers at the University of California San Francisco followed 517 MS patients over time. The vast majority (91%) were followed for up to 1o years. The team wanted to determine if brain scans and clinical assessments could be used to set a prognosis of disability development.
Results showed that in patients with relapsing MS, disability level at study start, as measured by the Extended Disability Status Scale (EDSS), did not impact how the disease progressed over the following decade, and only 55.3% had a worse disability score at the study’s end. For patients with progressive MS forms, worsening occurred in 75% of the patients. Those with EDSS scores lower than 3 at study start all worsened during the 10-year period.
Women had a slightly smaller risk of transitioning from relapsing to secondary progressive MS, while people who had become ill later in life had a higher risk.
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