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Early Non-Disabling Relapses Are Important Predictors of Disability Accumulation in People With Relapsing-Remitting Multiple Sclerosis Publisher Pubmed



Daruwalla C1 ; Shaygannejad V2 ; Ozakbas S3 ; Havrdova EK4 ; Horakova D4 ; Alroughani R5 ; Boz C6 ; Patti F7, 80 ; Onofrj M8 ; Lugaresi A9, 99 ; Eichau S10 ; Girard M11 ; Prat A11 ; Duquette P11 Show All Authors
Authors
  1. Daruwalla C1
  2. Shaygannejad V2
  3. Ozakbas S3
  4. Havrdova EK4
  5. Horakova D4
  6. Alroughani R5
  7. Boz C6
  8. Patti F7, 80
  9. Onofrj M8
  10. Lugaresi A9, 99
  11. Eichau S10
  12. Girard M11
  13. Prat A11
  14. Duquette P11
  15. Yamout B12
  16. Khoury SJ12
  17. Sajedi SA13
  18. Turkoglu R14
  19. Altintas A15
  20. Skibina O16, 19, 87
  21. Buzzard K16, 19, 92
  22. Grammond P17
  23. Karabudak R18
  24. Van Der Walt A19, 87
  25. Butzkueven H19
  26. Maimone D20
  27. Lechnerscott J21, 86
  28. Soysal A22
  29. John N23, 91
  30. Prevost J24
  31. Spitaleri D25
  32. Ramotello C26
  33. Gerlach O27, 95
  34. Iuliano G28
  35. Foschi M29
  36. Ampapa R30
  37. Van Pesch V31, 90
  38. Barnett M32
  39. Shalaby N33
  40. Dhooghe M34
  41. Kuhle J35
  42. Sa MJ36, 84
  43. Fabispedrini M37, 89
  44. Kermode A37, 96, 97
  45. Mrabet S38, 94
  46. Gouider R38
  47. Hodgkinson S39
  48. Laureys G40
  49. Van Hijfte L40
  50. Macdonell R41
  51. Orejaguevara C42
  52. Cristiano E43
  53. Mccombe P44, 85
  54. Sanchezmenoyo JL45
  55. Singhal B46
  56. Blanco Y47
  57. Hughes S48
  58. Garber J49
  59. Solaro C50, 88
  60. Mcguigan C51
  61. Taylor B52
  62. De Gans K53
  63. Habek M54, 98
  64. Alasmi A55
  65. Mihaela S56
  66. Castillo Trivino T57
  67. Alharbi T58
  68. Rojas JI59
  69. Gray O60
  70. Khurana D61
  71. Van Wijmeersch B62, 93
  72. Grigoriadis N63
  73. Inshasi J64
  74. Oh J65
  75. Agueramorales E66
  76. Fragoso Y67
  77. Moore F68
  78. Shaw C69
  79. Baghbanian SM70
  80. Shuey N71
  81. Willekens B72, 79
  82. Hardy TA73
  83. Decoo D74
  84. Sempere AP75
  85. Field D76
  86. Wynfordthomas R77, 83
  87. Cunniffe NG1
  88. Roos I78, 81
  89. Malpas CB78, 81, 82
  90. Coles AJ1
  91. Kalincik T78, 81
  92. Brown JWL1

Source: Multiple Sclerosis Journal Published:2023


Abstract

Background: The prognostic significance of non-disabling relapses in people with relapsing-remitting multiple sclerosis (RRMS) is unclear. Objective: To determine whether early non-disabling relapses predict disability accumulation in RRMS. Methods: We redefined mild relapses in MSBase as ‘non-disabling’, and moderate or severe relapses as ‘disabling’. We used mixed-effects Cox models to compare 90-day confirmed disability accumulation events in people with exclusively non-disabling relapses within 2 years of RRMS diagnosis to those with no early relapses; and any early disabling relapses. Analyses were stratified by disease-modifying therapy (DMT) efficacy during follow-up. Results: People who experienced non-disabling relapses within 2 years of RRMS diagnosis accumulated more disability than those with no early relapses if they were untreated (n = 285 vs 4717; hazard ratio (HR) = 1.29, 95% confidence interval (CI) = 1.00–1.68) or given platform DMTs (n = 1074 vs 7262; HR = 1.33, 95% CI = 1.15–1.54), but not if given high-efficacy DMTs (n = 572 vs 3534; HR = 0.90, 95% CI = 0.71–1.13) during follow-up. Differences in disability accumulation between those with early non-disabling relapses and those with early disabling relapses were not confirmed statistically. Conclusion: This study suggests that early non-disabling relapses are associated with a higher risk of disability accumulation than no early relapses in RRMS. This risk may be mitigated by high-efficacy DMTs. Therefore, non-disabling relapses should be considered when making treatment decisions. © The Author(s), 2023.
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