Abstract Details

Title Cognitive Processing Speed Predicts Disability Milestones in Multiple Sclerosis

Topic Multiple Sclerosis

Presentation(s) P5 - Poster Session 5 (11:45 AM-12:45 PM)

Poster/Presentation
Number 3-014

Objective To evaluate the predictive value of cognitive processing speed (CPS) via the Symbol Digit Modalities Test (SDMT) on time to disease progression as determined by the Expanded Disability Status Scale (EDSS) in people living with multiple sclerosis (PlwMS).

Background CPS correlates with multiple physical, emotional, and functional outcomes in PlwMS. Recent studies suggest that CPS can be predictive of long-term physical disability. Clarification of the predictive value of CPS on physical disability in MS would improve the process of making a disease course prognosis and could aid in identifying opportunities for early therapeutic intervention.

Design/Methods Eligible participants were PlwMS enrolled in the Comprehensive Longitudinal Investigation of Multiple Sclerosis at the Brigham (CLIMB) Study with relapsing-remitting, secondary progressive, or primary progressive MS, with regular EDSS assessments, and who had SDMT values at 2 timepoints at least 2-years apart. The association between baseline SDMT scores and time to EDSS values of 3.0, 4.0, 6.0 and 7.0 was estimated using Cox proportional hazards models.

Results A total of 624 PlwMS had at least 2 SDMT scores separated by at least 2 years, with an average (Standard Deviation [SD]) baseline SDMT score of 53.1 (10.7). 75.1% of patients were female, and average (SD) age was 42.3 (10.8) years. Average (SD) EDSS at time of baseline SDMT score was 1.7 (1.6). When adjusted for age, sex, and baseline EDSS, an increase in baseline SDMT score by 10 points (i.e., better CPS) was associated with lower risk of progression to EDSS 3.0 (adjusted HR=0.75 (95% CI: 0.64, 0.87); p<0.001), 4.0 (adjusted HR=0.81 (0.65, 0.99); p=0.044), and 7.0 (adjusted HR=0.67 (0.50, 0.89); p=0.006).

Conclusions In this study CPS predicted disability milestones in PlwMS and could be used by clinicians as a prognostic tool to inform earlier therapeutic intervention, which in turn may delay long-term disability accrual.

Authors/Disclosures
Danielle M. Howard, MD (Tufts Medical Center) PRESENTER	The institution of Dr. Howard has received research support from Genentech. The institution of Dr. Howard has received research support from Novartis. Dr. Howard has received personal compensation in the range of $50,000-$99,999 for serving as a Clinical Fellow with National Multiple Sclerosis Society.
Hrishikesh A. Lokhande (Brigham and Womens Hospital)	Mr. Lokhande has nothing to disclose.
Brian C. Healy	The institution of Mr. Healy has received research support from Analysis Group. The institution of Mr. Healy has received research support from Bristol-Myers Squibb. The institution of Mr. Healy has received research support from Verily Life Sciences. The institution of Mr. Healy has received research support from Novartis. The institution of Mr. Healy has received research support from Merck Serono. The institution of Mr. Healy has received research support from Genzyme.
Virginia DeLasHeras	Virginia DeLasHeras has received personal compensation for serving as an employee of NOVARTIS.
	No disclosure on file
Bonnie Glanz (Brigham and Women'S Hospital)	The institution of Ms. Glanz has received research support from CMSC. The institution of Ms. Glanz has received research support from NIH.
Jonathan D. Zurawski, MD (Brigham & Women's Hospital)	The institution of Dr. Zurawski has received research support from The Race to Erase MS Foundation. The institution of Dr. Zurawski has received research support from Novartis Pharmaceuticals. The institution of Dr. Zurawski has received research support from I-Mab Biopharma . The institution of Dr. Zurawski has received research support from Elizabeth A. Kremer MS Research Foundation. The institution of Dr. Zurawski has received research support from Novartis.
Mariann Polgar-Turcsanyi (Brigham and Women's Hospital)	No disclosure on file
Taylor J. Saraceno (Brigham and Women'S Hospital)	Ms. Saraceno has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Cumming Foundation. The institution of Ms. Saraceno has received research support from I-Mab Biopharma.
Howard L. Weiner, MD (Brigham and Women'S Hospital)	Dr. Weiner has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genentech. Dr. Weiner has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Medday Pharmaceuticals. Dr. Weiner has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for vTv Therapeutics. Dr. Weiner has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Tiziana Life Sciences. Dr. Weiner has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for vTv Therapeutics. Dr. Weiner has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Medday Pharmaceuticals. Dr. Weiner has received personal compensation in the range of $10,000-$49,999 for serving as an officer or member of the Board of Directors for vTv Therapeutics. Dr. Weiner has stock in vTv Therapeutics. The institution of Dr. Weiner has received research support from National Institute of Health. The institution of Dr. Weiner has received research support from National MS Society. The institution of Dr. Weiner has received research support from Genzyme Corp. The institution of Dr. Weiner has received research support from Genentech, Inc. . The institution of Dr. Weiner has received research support from Verily Life Sciences LLC. The institution of Dr. Weiner has received research support from EMD Serono, Inc..
Tanuja Chitnis, MD, FAAN (Brigham and Women's Hospital)	Dr. Chitnis has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Novartis. Dr. Chitnis has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Roche-Genentech. Dr. Chitnis has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Octave Biosciences. Dr. Chitnis has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Sanofi. The institution of Dr. Chitnis has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. The institution of Dr. Chitnis has received research support from Novartis. The institution of Dr. Chitnis has received research support from Sanofi. The institution of Dr. Chitnis has received research support from Octave. The institution of Dr. Chitnis has received research support from Genentech-Roche. The institution of Dr. Chitnis has received research support from Tiziana Life Sciences. The institution of Dr. Chitnis has received research support from Bristol-Myers Squibb. The institution of Dr. Chitnis has received research support from Wesley Clover.

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