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First-Year Treatment Response Predicts the Following 5-Year Disease Course in Patients With Relapsing-Remitting Multiple Sclerosis Publisher Pubmed



Toscano S1, 2 ; Spelman T3, 4 ; Ozakbas S5 ; Alroughani R6 ; Chisari CG2, 7 ; Lo Fermo S2, 7 ; Prat A8 ; Girard M8 ; Duquette P8 ; Izquierdo G9 ; Eichau S9 ; Grammond P10 ; Boz C11 ; Kalincik T12, 13 Show All Authors
Authors
  1. Toscano S1, 2
  2. Spelman T3, 4
  3. Ozakbas S5
  4. Alroughani R6
  5. Chisari CG2, 7
  6. Lo Fermo S2, 7
  7. Prat A8
  8. Girard M8
  9. Duquette P8
  10. Izquierdo G9
  11. Eichau S9
  12. Grammond P10
  13. Boz C11
  14. Kalincik T12, 13
  15. Blanco Y14
  16. Buzzard K15
  17. Skibina O15
  18. Sa MJ16, 17
  19. Van Der Walt A18
  20. Butzkueven H18
  21. Terzi M19
  22. Gerlach O20, 21
  23. Grandmaison F22
  24. Foschi M23, 24
  25. Surcinelli A23
  26. Barnett M25
  27. Lugaresi A26, 27
  28. Onofrj M28
  29. Yamout B29
  30. Khoury SJ29
  31. Prevost J30
  32. Lechnerscott J31
  33. Maimone D32
  34. Amato MP33, 34
  35. Spitaleri D35
  36. Van Pesch V36
  37. Macdonell R37
  38. Cartechini E38
  39. De Gans K39
  40. Slee M40
  41. Castillotrivino T41
  42. Soysal A42
  43. Sanchezmenoyo JL43
  44. Laureys G44
  45. Van Hijfte L44
  46. Mccombe P45
  47. Altintas A46
  48. Weinstockguttman B47
  49. Agueramorales E48
  50. Etemadifar M49
  51. Ramotello C50
  52. John N51, 52
  53. Turkoglu R53
  54. Hodgkinson S54
  55. Besora S55
  56. Van Wijmeersch B56, 57
  57. Fernandezbolanos R58
  58. Patti F2, 7
Show Affiliations
Authors Affiliations
  1. 1. Department of Biomedical and Biotechnological Sciences, University of Catania, Via Santa Sofia 78, Catania, 95123, Italy
  2. 2. Multiple Sclerosis Unit, University-Hospital G. Rodolico - San Marco, Catania, Italy
  3. 3. MSBase Foundation, Melbourne, VIC, Australia
  4. 4. Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
  5. 5. Dokuz Eylul University, Konak, Izmir, Turkey
  6. 6. Division of Neurology, Department of Medicine, Amiri Hospital, Sharq, 73767, Kuwait
  7. 7. Department of Medical and Surgical Sciences and Advanced Technologies, GF Ingrassia, Catania, 95123, Italy
  8. 8. CHUM MS Center and Universite de Montreal, Montreal, H2L 4M1, Canada
  9. 9. Hospital Universitario Virgen Macarena, Sevilla, 41009, Spain
  10. 10. CISSS Chaudiere-Appalache, Levis, G6X 0A1, Canada
  11. 11. KTU Medical Faculty Farabi Hospital, Trabzon, 61080, Turkey
  12. 12. CORe, Department of Medicine, The University of Melbourne, Melbourne, 3050, Australia
  13. 13. Neuroimmunology Centre, Department of Neurology, Royal Melbourne Hospital, Melbourne, 3050, Australia
  14. 14. Center of Neuroimmunology, Service of Neurology, Hospital Clinic de Barcelona, Barcelona, Spain
  15. 15. Department of Neurology, Box Hill Hospital, Melbourne, 3128, Australia
  16. 16. Department of Neurology, Centro Hospitalar Universitario de Sao Joao, Porto, 4200-319, Portugal
  17. 17. Faculty of Health Sciences, University Fernando Pessoa, Porto, Portugal
  18. 18. Department of Neurology, The Alfred Hospital, Melbourne, 3000, Australia
  19. 19. Medical Faculty, 19 Mayis University, Samsun, 55160, Turkey
  20. 20. Academic MS Center Zuyd, Department of Neurology, Zuyderland Medical Center, Sittard-Geleen, 5500, Netherlands
  21. 21. School for Mental Health and Neuroscience, Department of Neurology, Maastricht University Medical Center, Maastricht, 6131 BK, Netherlands
  22. 22. Neuro Rive-Sud, Quebec, J4V 2J2, Canada
  23. 23. Department of Neuroscience, Multiple Sclerosis Center, Neurology Unit, S. Maria delle Croci Hospital, AUSL Romagna, Ravenna, Italy
  24. 24. Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
  25. 25. Brain and Mind Centre, Sydney, 2050, Australia
  26. 26. IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
  27. 27. Department of Biomedical and Neuromotor Science, University of Bologna, Bologna, Italy
  28. 28. Department of Neuroscience, Imaging, and Clinical Sciences, University G. D'Annunzio, Chieti, 66013, Italy
  29. 29. Nehme and Therese Tohme Multiple Sclerosis Center, American University of Beirut Medical Center, Beirut, 1107 2020, Lebanon
  30. 30. CSSS Saint-Jerome, Saint-Jerome, J7Z 5T3, Canada
  31. 31. School of Medicine and Public Health, University Newcastle, Newcastle, 2305, Australia
  32. 32. Centro Sclerosi Multipla, Garibaldi Hospital, Catania, 95124, Italy
  33. 33. Department NEUROFARBA, University of Florence, Florence, 50134, Italy
  34. 34. IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy
  35. 35. Azienda Ospedaliera di Rilievo Nazionale San Giuseppe Moscati Avellino, Avellino, 83100, Italy
  36. 36. Department of Neurology, Cliniques Universitaires Saint-Luc, Universite Catholique de Louvain (UCLouvain), Brussels, Belgium
  37. 37. Austin Health, Melbourne, 3084, Australia
  38. 38. AST 3 Macerata, Marche, Italy
  39. 39. Department of Neurology, Groene Hart Ziekenhuis, Zuid-Holland, Gouda, Netherlands
  40. 40. Flinders University, Adelaide, 5042, Australia
  41. 41. Hospital Universitario Donostia and IIS Biodonostia, San Sebastian, Spain
  42. 42. Bakirkoy Education and Research Hospital for Psychiatric and Neurological Diseases, Istanbul, 34147, Turkey
  43. 43. Department of Neurology, Galdakao-Usansolo University Hospital, Osakidetza-Basque Health Service, Biocruces, Spain
  44. 44. Department of Neurology, Ghent Universitary Hospital, Ghent, 9000, Belgium
  45. 45. Royal Brisbane and Women's Hospital, University of Queensland, Brisbane, 4000, Australia
  46. 46. Department of Neurology, School of Medicine, Koc University, Koc University Research Center for Translational Medicine (KUTTAM), Istanbul, 34450, Turkey
  47. 47. Department of Neurology, Buffalo General Medical Center, Buffalo, 14202, United States
  48. 48. University Hospital Reina Sofia, Cordoba, 14004, Spain
  49. 49. Department of Neurosurgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
  50. 50. Hospital Germans Trias i Pujol, Badalona, 08916, Spain
  51. 51. Department of Medicine, School of Clinical Sciences, Monash University, Clayton, Australia
  52. 52. Department of Neurology, Monash Health, Clayton, Australia
  53. 53. Haydarpasa Numune Training and Research Hospital, Istanbul, 34668, Turkey
  54. 54. Liverpool Hospital, Sydney, 2170, Australia
  55. 55. Hospital Universitari Mutua de Terrassa, Barcelona, Spain
  56. 56. Universitair MS Centrum, Hasselt University, Hasselt-Pelt, Belgium
  57. 57. Rehabilitation & MS Centre, Pelt, Belgium
  58. 58. Department of Neurology, Hospital Universitario Virgen de Valme, Spain

Source: Neurotherapeutics Published:2025


Abstract

Predicting long-term prognosis and choosing the appropriate therapeutic approach in patients with Multiple Sclerosis (MS) at the time of diagnosis is crucial in view of a personalized medicine. We investigated the impact of early therapeutic response on the 5-year prognosis of patients with relapsing-remitting MS (RRMS). We recruited patients from MSBase Registry covering the period between 1996 and 2022. All patients were diagnosed with RRMS and actively followed-up for at least 5 years to explore the following outcomes: clinical relapses, confirmed disability worsening (CDW) and improvement (CDI), EDSS 3.0, EDSS 6.0, conversion to secondary progressive MS (SPMS), new MRI lesions, Progression Independent of Relapse Activity (PIRA). Predictors included demographic, clinical and radiological data, and sub-optimal response (SR) within the first year of treatment. Female sex (HR 1.27; 95 ​% CI 1.16–1.40) and EDSS at baseline (HR 1.19; 95 ​% CI 1.15–1.24) were independent risk factors for the occurrence of relapses during the first 5 years after diagnosis, while high-efficacy treatment (HR 0.78; 95 ​% CI 0.67–0.91) and age at diagnosis (HR 0.83; 95 ​% CI 0.79–0.86) significantly reduced the risk. SR predicted clinical relapses (HR ​= ​3.84; 95 ​% CI 3.51–4.19), CDW (HR ​= ​1.74; 95 ​% CI 1.56–1.93), EDSS 3.0 (HR ​= ​3.01; 95 ​% CI 2.58–3.51), EDSS 6.0 (HR ​= ​1.77; 95 ​% CI 1.43–2.20) and new brain (HR ​= ​2.33; 95 ​% CI 2.04–2.66) and spinal (HR 1.65; 95 ​% CI 1.29–2.09) MRI lesions. This study highlights the importance of selecting the appropriate DMT for each patient soon after MS diagnosis, also providing clinicians with a practical tool able to calculate personalized risk estimates for different outcomes. © 2025 The Authors
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