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Abstract Details

A Method To Identify the Risk of Transition to the Secondary Progressive Course in Multiple Sclerosis Patients
MS and Related Diseases
P04 - (-)
131
BACKGROUND: Prediction of the time to secondary progression has often been based on clinical and demographic features from the early phases of the disease. However, the hazard ratios have been moderate and suitable for stratification rather than for individual prognosis.
DESIGN/METHODS: A continuous hazard function produced by Poisson regression was used to estimate the risk of secondary progression at a given point in time. In the model we included cumulative data up to that point, notably information on the predictive features (afferent/efferent, monofocal/multifocal, complete remission or not) of all relapses. Patients with a distinct second attack (N = 157) were selected from a temporally and geographically defined untreated incidence cohort with MS.
RESULTS: Significant factors in the model were gender, current age, predictors of the most recent relapse and time since that relapse. Of the 157 patients, 118 converted to a secondary progressive course. The risk of progression had an age related maximum around 30 years of age. Immediately after a new relapse the risk increased abruptly, provided the relapse had the unfavourable predictors, efferent symptoms and incomplete remission. The model identified periods with less than 2%, more than 6% and more than 10% yearly risk of secondary progression in 367, 620 and 144 patient years respectively.
CONCLUSIONS: This model facilitates the decision for continued low-risk or second-line therapy, based on the current individual prognosis of secondary progression. Furthermore this method can be used to study the relationship or dissociation between relapses and secondary progression in treated patients.
Authors/Disclosures

PRESENTER 		No disclosure on file
Bengt Skoog (Sahlgenska sjukhuset Gbg) No disclosure on file
No disclosure on file
Peter A. LeWitt, MD (Henry Ford Hospital - Franklin Pointe) Dr. LeWitt has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Amneal. Dr. LeWitt has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for ONO Pharmaceuticals. Dr. LeWitt has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Supernus. The institution of Dr. LeWitt has received research support from Michael J Fox Foundation.