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Contribution of Different Relapse Phenotypes to Disability in Multiple Sclerosis Publisher Pubmed



Stewart T1 ; Spelman T1, 2 ; Havrdova E3 ; Horakova D3 ; Trojano M4 ; Izquierdo G5 ; Duquette P6 ; Girard M6 ; Prat A6 ; Lugaresi A7 ; Grandmaison F8 ; Grammond P9 ; Sola P10 ; Shaygannejad V11 Show All Authors
Authors
  1. Stewart T1
  2. Spelman T1, 2
  3. Havrdova E3
  4. Horakova D3
  5. Trojano M4
  6. Izquierdo G5
  7. Duquette P6
  8. Girard M6
  9. Prat A6
  10. Lugaresi A7
  11. Grandmaison F8
  12. Grammond P9
  13. Sola P10
  14. Shaygannejad V11
  15. Hupperts R12
  16. Alroughani R13
  17. Orejaguevara C14
  18. Pucci E15
  19. Boz C16
  20. Lechnerscott J17
  21. Bergamaschi R18
  22. Van Pesch V19
  23. Iuliano G20
  24. Ramo C21
  25. Taylor B22
  26. Slee M23
  27. Spitaleri D24
  28. Granella F25
  29. Verheul F26
  30. Mccombe P27
  31. Hodgkinson S28
  32. Amato MP29
  33. Vucic S30
  34. Gray O31
  35. Cristiano E32
  36. Barnett M33
  37. Sanchez Menoyo JL34
  38. Van Munster E35
  39. Saladino ML36
  40. Olascoaga J37
  41. Prevost J38
  42. Deri N39
  43. Shaw C40
  44. Singhal B41
  45. Moore F42
  46. Rozsa C43
  47. Shuey N44
  48. Skibina O45
  49. Kister I46
  50. Petkovskaboskova T47
  51. Ampapa R48
  52. Kermode A49, 50
  53. Butzkueven H1, 51, 52
  54. Jokubaitis V1, 2
  55. Kalincik T1, 2
Show Affiliations
Authors Affiliations
  1. 1. Department of Medicine, University of Melbourne, Melbourne, VIC, Australia
  2. 2. Department of Neurology, Melbourne Brain Centre, Royal Melbourne Hospital, Level 4, Grattan St, Parkville, 3050, VIC, Australia
  3. 3. Department of Neurology, Center of Clinical Neuroscience, General University Hospital, Charles University in Prague, Prague, Czech Republic
  4. 4. Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy
  5. 5. Hospital Universitario Virgen Macarena, Sevilla, Spain
  6. 6. Hopital Notre Dame, CHUM, Universite de Montreal, Montreal, QC, Canada
  7. 7. MS Centre, Department of Neuroscience, Imaging and Clinical Sciences, 'G. d'Annunzio', University of Chieti-Pescara, Chieti, Italy
  8. 8. Neuro Rive-Sud, Hopital Charles LeMoyne, Greenfield Park, QC, Canada
  9. 9. Hotel-Dieu de Levis, Levis, QC, Canada
  10. 10. Neurology Unit, Department of Neuroscience, Nuovo Ospedale Civile S. Agostino-Estense, Modena, Italy
  11. 11. Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
  12. 12. Zuyderland Ziekenhuis, Sittard, Netherlands
  13. 13. Department of Neurology, Amiri Hospital, Kuwait City, Kuwait
  14. 14. University Hospital San Carlos, El Instituto de Investigacion Sanitaria Del Hospital Clinico San Carlos (IdISSC), Madrid, Spain
  15. 15. Neurology Unit, ASUR Marche AV3, Macerata, Italy
  16. 16. Karadeniz Technical University, Trabzon, Turkiye
  17. 17. Hunter Medical Research Institute, University of Newcastle Australia, Callaghan, NSW, Australia
  18. 18. C. Mondino National Neurological Institute, Pavia, Italy
  19. 19. Cliniques Universitaires Saint-Luc, Brussels, Belgium
  20. 20. Ospedali Riuniti di Salerno, Salerno, Italy
  21. 21. Hospital Germans Trias i Pujol, Badalona, Spain
  22. 22. Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
  23. 23. Flinders University and Medical Centre, Adelaide, SA, Australia
  24. 24. AORN San Giuseppe Moscati, Avellino, Italy
  25. 25. University of Parma, Parma, Italy
  26. 26. Groene Hart Ziekenhuis, Gouda, Netherlands
  27. 27. Centre for Clinical Research, University of Queensland Australia, Brisbane, QLD, Australia
  28. 28. Departments of Nephrology and Neurology, Liverpool Hospital, Liverpool, NSW, Australia
  29. 29. Section of Neurosciences, NEUROFARBA, University of Florence, Florence, Italy
  30. 30. Westmead Hospital, Sydney, NSW, Australia
  31. 31. Craigavon Area Hospital, Portadown, United Kingdom
  32. 32. Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
  33. 33. Brain and Mind Centre, Camperdown, NSW, Australia
  34. 34. Department of Neurology, Hospital de Galdakao-Usansolo, Galdakao, Spain
  35. 35. Jeroen Bosch Ziekenhuis, 'S-Hertogenbosch, Netherlands
  36. 36. Ineba, Buenos Aires, Argentina
  37. 37. Department of Neurology, Donostia University Hospital, San-Sebastian, Spain
  38. 38. Centre Integre de Sante et de Services Sociaux des Laurentides, Saint-Jerome, QC, Canada
  39. 39. Hospital Fernandez, Buenos Aires, Argentina
  40. 40. Geelong Hospital, Geelong, VIC, Australia
  41. 41. Bombay Hospital Institute of Medical Sciences, Mumbai, India
  42. 42. Jewish General Hospital, Montreal, QC, Canada
  43. 43. Jahn Ferenc Teaching Hospital, Budapest, Hungary
  44. 44. St Vincent's Hospital, Melbourne, Melbourne, VIC, Australia
  45. 45. Alfred Hospital, Melbourne, VIC, Australia
  46. 46. Department of Neurology, NYU School of Medicine, New York, NY, United States
  47. 47. Clinical Neurology Clinical Center, Skopje, North Macedonia
  48. 48. Nemocnice Jihlava, Jihlava, Czech Republic
  49. 49. Western Australian Neuroscience Research Institute, University of Western Australia, Perth, WA, Australia
  50. 50. Institute of Immunology and Infectious Diseases, Murdoch University, Perth, WA, Australia
  51. 51. Department of Neurology, Melbourne Brain Centre, Royal Melbourne Hospital, Parkville, VIC, Australia
  52. 52. Department of Neurology, Box Hill Hospital, Monash University, Melbourne, VIC, Australia

Source: Multiple Sclerosis Published:2017


Abstract

Objective: This study evaluated the effect of relapse phenotype on disability accumulation in multiple sclerosis. Methods: Analysis of prospectively collected data was conducted in 19,504 patients with relapse-onset multiple sclerosis and minimum 1-year prospective follow-up from the MSBase cohort study. Multivariable linear regression models assessed associations between relapse incidence, phenotype and changes in disability (quantified with Expanded Disability Status Scale and its Functional System scores). Sensitivity analyses were conducted. Results: In 34,858 relapses recorded during 136,462 patient-years (median follow-up 5.9 years), higher relapse incidence was associated with greater disability accumulation (β = 0.16, p < 0.001). Relapses of all phenotypes promoted disability accumulation, with the most pronounced increase associated with pyramidal (β = 0.27 (0.25-0.29)), cerebellar (β = 0.35 (0.30-0.39)) and bowel/bladder (β = 0.42 (0.35-0.49)) phenotypes (mean (95% confidence interval)). Higher incidence of each relapse phenotype was associated with an increase in disability in the corresponding neurological domain, as well as anatomically related domains. Conclusion: Relapses are associated with accumulation of neurological disability. Relapses in pyramidal, cerebellar and bowel/bladder systems have the greatest association with disability change. Therefore, prevention of these relapses is an important objective of disease-modifying therapy. The differential impact of relapse phenotypes on disability outcomes could influence management of treatment failure in multiple sclerosis. © SAGE Publications.
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