Abstract Details

Title Onset of Secondary Progressive Phase and Disability Accumulation in Multiple Sclerosis

Topic MS and Related Diseases

Presentation(s) P04 - (-)

Poster/Presentation
Number 125

Objective

Background BACKGROUND: The onset of the SP phase is the key determinant of long term prognosis in relapsing-remitting (RR) MS.

Design/Methods DESIGN/METHODS: Among 806 RR patients from the London Ontario database, using Logistic Regression, Cox regression and Kaplan Meier analyses we assessed: 1) the risk of becoming disabled (DSS 6-8) according to RR phase duration, 2) the effect of baseline features on times to SP and from SP onset to DSS 8. Multiple logistic models calculated the variation, according to disease duration, of the risk of SP given by baseline features.

Results RESULTS: Longer latency to SP phase predicted lower risk of reaching DSS 6 (OR= 0.76 for 5 years and OR= 0.44 for 15 years latency); the same predictive effect was seen in patients matched for early relapses number. However, RR phase duration did not influence SP evolution. Significantly shorter time to and higher risk of becoming SP were associated to male sex (HR= 1.41), older age at onset (age >30y HR vs ?20y and 21-30y = 0.52, 0.65 respectively) and high early relapse frequency (? 3 HR attacks vs 1, 2 attacks = 0.63, 0.75 respectively). The probability of becoming SP based on early relapse number (OR= 1.11) and age at onset (OR= 1.05) varied according to disease duration (OR= 1.08). At baseline, OR for risk of SP yielded by 3 relapses were 3.6, 5.8, 9.5 in patients aged 20, 30 or 40 at onset respectively, and increased by 2-fold at 10 years (OR 7.5, 12.1, 19.8 respectively) and by 5-fold at 20 years (OR 15.6, 25.5, 41.4 respectively) from onset.

Conclusions CONCLUSIONS: Prevention/delay of SP onset represents a potential outcome measure for clinical trials. Early relapse number and age at onset can be used for selecting groups at higher risk of developing severe disability.

Authors/Disclosures
Antonio Scalfari, MD PRESENTER	Dr. Scalfari has nothing to disclose.
	No disclosure on file
Martin Daumer, PhD	No disclosure on file
Thomas Leist, MD, PhD, FAAN (Thomas Jefferson University)	Dr. Leist has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen. Dr. Leist has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Novartis. Dr. Leist has received personal compensation in the range of $500-$4,999 for serving as a Consultant for BMS. Dr. Leist has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for EMD Serono. Dr. Leist has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Horizon. Dr. Leist has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Genentech. Dr. Leist has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Sanofi. Dr. Leist has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Biogen. Dr. Leist has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Genentech. Dr. Leist has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Sanofi. Dr. Leist has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Horizon. Dr. Leist has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for EMD Seono. Dr. Leist has received personal compensation in the range of $10,000-$49,999 for serving as a Expert Wittness with DHHS HRSA.
Paolo A. Muraro, MD, PhD (Neuroimmunolofy/Branch/NINDS/NIH)	No disclosure on file
George C. Ebers, MD	No disclosure on file

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