Abstract Details

Title Modifiable Risk Factors and Risk of Disability Progression after a First Demyelinating Event: a Long Term Follow-Up Study

Topic Multiple Sclerosis

Presentation(s) P4 - Poster Session 4 (5:30 PM-6:30 PM)

Poster/Presentation
Number 15-084

Objective

to explore the effect of modifiable factors on long term risk of disability progression after a first demyelinating event.

Background As the current paradigm in multiple sclerosis is that axonal damage occurs early in the course of the disease, the identification of early predictors of long term disability progression is of critical importance in everyday clinical practice.

Design/Methods patients admitted to San Raffaele Hospital between 2000 and 2013 for a first demyelinating event and with a minimum follow up of 2 years have been included. We evaluated baseline clinical, MRI, neurophysiological and CSF data as well as modifiable risk factors and assessed their prognostic value for subsequent development of disability worsening.

Results a total of 255 patients (median follow-up 138.8 months) were included in the study: after the first demyelinating event, 160 (63%) had relapses in the follow-up while 214 (84%) developed new subclinical lesions. Multivariate logistic regression showed that older age, female sex, presence of spinal cord lesions at disease onset, partial recovery from the first clinical episode, presence of OCBs, elevated abnormal evoked potential scores, lower vitamin D levels in association to hard smoking during follow up are predictive factors of disability progression over medium and long term follow-up.

Conclusions our study shows that the early spinal cord involvement, especially when associated with partial recovery from first clinical episode was the single most important prognostic factor for long term disability occurrence. Also, low vitamin D levels at onset, in association with smoking during the observational period were related to worse outcomes, supporting the recommendation of vitamin D supplementation and of abstention from smoking for all patients from the early phases of the disease.

Authors/Disclosures
Gloria Dalla Costa PRESENTER	No disclosure on file
	No disclosure on file
Francesca Sangalli	No disclosure on file
Bruno Colombo	Bruno Colombo has nothing to disclose.
Lucia Moiola, MD, PhD (Fondazione Centro San Raffaele)	Dr. Moiola has nothing to disclose.
	No disclosure on file
Vittorio Martinelli (S. Raffaele Hospital)	Dr. Martinelli has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis, Biogen, Sanofi Genzyme, TEVA and Merck. Dr. Martinelli has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck .

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