By accepting you will be accessing a service provided by a third-party external to https://mschristian.org/

Long term effect of delayed treatment on disability in patients with paediatric onset Multiple Sclerosis: A prospective Danish cohort study.

Long term effect of delayed treatment on disability in patients with paediatric onset multiple sclerosis: A prospective Danish cohort study.

Abstract

BACKGROUND:

A consensus of early treatment with disease-modifying therapies (DMT) in Multiple Sclerosis (MS) has been reached based on several observational and experimental studies in adults. However, paediatric onset (PO)MS appears phenotypically different from adult onset MS, characterized by increased relapse rate and pronounced radiological activity on MRI. The objective of this study was to investigate the long-term consequences of delayed treatment start in POMS on disability in a real-world, population-based setting.

METHODS:

Based on prospectively collected data from The Danish Multiple Sclerosis Registry, we defined a cohort of MS patients with onset before the age of 18 years, who were born in 1980 or later, and started treatment with a DMT between 1998 and 2018. The POMS cohort was stratified according to treatment start within 2 years of onset (N = 140) or later (N = 151). Annualised relapse rate in each study group was compared using a negative binomial regression; and Cox proportional hazard model was used to estimate hazard ratios (HR) of time to sustained Expanded disability Status Scale (EDSS) score 4, 6-month confirmed EDSS Worsening and 6-month confirmed EDSS improvement, respectively, according to disease duration.

Click HERE to Register for the MS Beacon Newsletter


RESULTS:

The POMS cohort had a total median follow-up time of 7.7 years (interquartile range 4.6-11.6). There was no association between risk of relapses in patients with delayed treatment start compared to earlier treatment start. Patients starting on a DMT later than 2 years after onset had a 2.52-fold increased risk of reaching sustained EDSS 4 compared to those starting within 2 years of onset (HR=2.52, 95% confidence interval (CI)=1.01-6.34). For every year increment from onset to start of first DMT, the risk of reaching sustained EDSS 4 increased by 17% (HR=1.17, 95% CI=1.05-1.30). In line with this, the risk of reaching confirmed EDSS Worsening was increased by 44% compared to those starting earlier, although not statistically significant (HR=1.44, 95% CI=0.95-2.19). Starting on a DMT later was associated with 61% decreased chance of confirmed EDSS improvement compared to those starting earlier (HR=0.39, 95% CI=0.26-0.59). For every year increment from onset to starting DMT, the risk of confirmed EDSS improvement decreased by 10% (HR=0.90, 95% CI=0.84-0.96).

To Read the CONCLUSIONS:


.................................................................................................

CLICK Red BOX to SUBSCRIBE to the MS Learning Channel on YouTube

2017
Click Red Box on banner to opt-in
........................................................................................................

This Article is Provided by:  #MSViewsandNews
::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::
Visit our MS Learning Channel on YouTube: http://www.youtube.com/msviewsandnews
2017
(Originally posted by Stuart)
A new way to estimate neurologic disease prevalenc...
Kent State University launches redesigned Ph.D. pr...
 

Comments

No comments made yet. Be the first to submit a comment
Already Registered? Login Here
Guest
Friday, 07 August 2020

Captcha Image

MSChristian.org RSS Statement

Most of the information found on this website comes from RSS Feeds. It is an automated task that provides the information to you. We try to limit items that are duplicates, but with many feeds this can be difficult. Since the owner of this website also has MS and is legally blind this service was necessary to keep the website running with as much automation as possible. Volunteers help from time to time but many have disabilities themselves. We thank you for visiting us and hope that MSC can be of service to you and your loved ones.