Abstract Details

Title Early Clinical Remission as a Prognostic Factor for Medium Term Disability Progression in Multiple Sclerosis?

Topic MS and Related Diseases

Presentation(s) P04 - (-)

Poster/Presentation
Number 123

Objective

Background BACKGROUND: With recent disease-modifying therapeutics, remission in MS has become conceivable.

Design/Methods DESIGN/METHODS: The study population included all patients (n= 7725) diagnosed since 1995 with a relapsing-remitting MS in nine French EDMUS centres. Patients had to be followed at least 5 years after their diagnosis (Poser criteria) and have an EDSS<4 at that time. Remission was defined as a 3-year period without any relapse or disability progression during the first 5 years following diagnosis. We used Cox proportional hazards model and Abrahamowicz and MacKenzie flexible model. The outcome was the progression to residual EDSS?4. The baseline date was defined as the date of diagnosis +5 years. Endpoint date was December 2011.

Results RESULTS: Overall, 3383 patients fulfilled eligibility criteria. The median follow-up after diagnosis was 9.2 years (Inter-quartile range [IQR]=6.9-12.0 years). The median of the first-inter-attack interval was 18 months (IQR=7-48 months). Immunomodulating or immunosuppressive drugs were prescribed to 70.6% of patients in the first 5 years. Overall, 614 patients (18.1%) evolved to an EDSS 4, with a median delay of 2.8 years after the baseline date (IQR=1.2-5.0 years). Remission was observed in 45.0% of cases. In multivariate analysis, a better prognosis was associated with remission (RR=0.69; 95%-CI=0.58-0.81; p<10-4) and brain stem dysfunction at disease onset (p=0.02). Conversely, a poorer prognosis was associated with male gender (p=0.001), increasing age (p<0.001) and increasing first-inter-attack interval (p=0.027). Furthermore, each additional month of remission was associated with 1% decrease in the risk of medium term disability progression (95%-CI=0.5%-1.5%).

Conclusions CONCLUSIONS: A 3-year remission in the 5 years following the diagnosis of MS is significantly associated with delayed disability progression, with a reduced risk of 31% to reach EDSS?4.

Authors/Disclosures
Thibault Moreau PRESENTER	Thibault Moreau has nothing to disclose.
Marc Debouverie, MD (Hospital Central)	Dr. Debouverie has nothing to disclose.
	No disclosure on file
	No disclosure on file
Michel G. Clanet, Prof	No disclosure on file
	No disclosure on file
	No disclosure on file
Richard B. Lipton, MD, FAAN (Albert Einstein College of Medicine)	Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Allergan/Abbvie. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Amgen. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Biohaven. Dr. Lipton has received personal compensation in the range of $50,000-$99,999 for serving as a Consultant for Eli Lilly. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Lundbeck. Dr. Lipton has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for GlaxoSmithKline. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Teva. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Vedanta. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Merck. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Grifols. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Pfizer. Dr. Lipton has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Axon. Dr. Lipton has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Satsuma. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genentech. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Cool Tech. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for BDSI. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Linpharma. Dr. Lipton has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Axsome. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Clexio. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Shiratronics. Dr. Lipton has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Allergan/Abbvie. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biohaven. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Eli Lilly. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Lundbeck. Dr. Lipton has or had stock in Biohaven.Dr. Lipton has or had stock in Manistee.Dr. Lipton has or had stock in Axon.Dr. Lipton has or had stock in CoolTech. The institution of Dr. Lipton has received research support from Teva. The institution of Dr. Lipton has received research support from Amgen. The institution of Dr. Lipton has received research support from Allergan/Abbvie. The institution of Dr. Lipton has received research support from Gammacore. The institution of Dr. Lipton has received research support from Axsome. The institution of Dr. Lipton has received research support from Charleston Labs. The institution of Dr. Lipton has received research support from Eli Lilly. The institution of Dr. Lipton has received research support from Satsuma. The institution of Dr. Lipton has received research support from NIH . The institution of Dr. Lipton has received research support from Veterans Administration. Dr. Lipton has received publishing royalties from a publication relating to health care.
Pierre Clavelou, MD, PhD (Hopital Gabriel Montpied)	Dr. Clavelou has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Clavelou has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Janssen. Dr. Clavelou has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck.
David Laplaud	No disclosure on file
Caroline Papeix (GH Pitie Salpetriere)	Caroline Papeix has received personal compensation in the range of $500-$4,999 for serving as a Consultant for BIOGEN . Caroline Papeix has received personal compensation in the range of $500-$4,999 for serving as a Consultant for ROCHE . Caroline Papeix has received personal compensation in the range of $500-$4,999 for serving as a Consultant for MERCK. Caroline Papeix has received personal compensation in the range of $0-$499 for serving as a Consultant for NOVARTIS .
Patrick Vermersch (CHR de Lille)	Patrick Vermersch has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen. Patrick Vermersch has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Merck. Patrick Vermersch has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Sanofi. Patrick Vermersch has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Patrick Vermersch has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Roche. Patrick Vermersch has received personal compensation in the range of $500-$4,999 for serving as a Consultant for AB Science. Patrick Vermersch has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Imcyse. Patrick Vermersch has received personal compensation in the range of $500-$4,999 for serving as a Consultant for BMS-Celgene. Patrick Vermersch has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Ad Scientiam. Patrick Vermersch has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Patrick Vermersch has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Patrick Vermersch has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Patrick Vermersch has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi. Patrick Vermersch has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Teva. Patrick Vermersch has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for La revue des microbiotes. The institution of Patrick Vermersch has received research support from Roche. The institution of Patrick Vermersch has received research support from Sanofi.
Olivier F. Gout, MD (Hôpital Fondation A de Rothschild)	Dr. Gout has nothing to disclose.
Bruno Stankoff, MD, PhD (Hopital De La Pitie Salpetriere)	The institution of Bruno Stankoff, MD, PhD has received research support from Roche, Sanofi, Serono . The institution of Bruno Stankoff, MD, PhD has received research support from Novartis.
	No disclosure on file
	No disclosure on file
	No disclosure on file

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