- Title
- Early non-disabling relapses are important predictors of disability accumulation in people with relapsing-remitting multiple sclerosis
- Creator
- Daruwalla, Cyrus; Shaygannejad, Vahid; Eichau, Sara; Girard, Marc; Prat, Alexandre; Duquette, Pierre; Yamout, Bassem; Khoury, Samia J.; Sajedi, Seyed Aidin; Turkoglu, Recai; Altintas, Ayse; Skibina, Olga; Ozakbas, Serkan; Buzzard, Katherine; Grammond, P; Karabudak, R; van der Walt, A; Butzkueven, H; Maimone, D; Lechner-Scott, Jeannette; Soysal, A; John, N; Prevost, J; Havrdova, Eva Kubala; Spitaleri, D; Ramo-Tello, C; Gerlach, O; Iuliano, G; Foschi, M; Ampapa, R; van Pesch, V; Barnett, M; Shalaby, N; D'hooghe, M; Horakova, Dana; Kuhle, J; Sa, MJ; Fabis-Pedrini, M; Kermode, A; Mrabet, S; Gouider, R; Hodgkinson, S; Laureys, G; Van Hijfte, L; Macdonell, R; Alroughani, Raed; Oreja-Guevara, C; Cristiano, E; McCombe, P; Sanchez-Menoyo, JL; Singhal, B; Blanco, Y; Hughes, S; Garber, J; Solaro, C; McGuigan, C; Boz, Cavit; Taylor, B; de Gans, K; Habek, M; Al-Asmi, A; Mihaela, S; Castillo Triviño, T; Al-Harbi, T; Rojas, JI; Gray, O; Khurana, D; Patti, Francesco; Van Wijmeersch, B; Grigoriadis, N; Inshasi, J; Oh, J; Aguera-Morales, E; Fragoso, Y; Moore, F; Shaw, C; Baghbanian, SM; Shuey, N; Onofrj, Marco; Willekens, B; Hardy, TA; Decoo, D; Sempere, AP; Field, D; Wynford-Thomas, R; Cunniffe, NG; Roos, I; Malpas, CB; Coles, AJ; Lugaresi, Alessandra; Kalincik, T; Brown, JWL
- Relation
- Multiple Sclerosis Journal Vol. 29, Issue 7, p. 875-883
- Publisher Link
- http://dx.doi.org/10.1177/13524585231151951
- Publisher
- Sage
- Resource Type
- journal article
- Date
- 2023
- Description
- Background: The prognostic significance of non-disabling relapses in people with relapsing-remitting multiple sclerosis (RRMS) is unclear. Objective: To determine whether early non-disabling relapses predict disability accumulation in RRMS. Methods: We redefined mild relapses in MSBase as ‘non-disabling’, and moderate or severe relapses as ‘disabling’. We used mixed-effects Cox models to compare 90-day confirmed disability accumulation events in people with exclusively non-disabling relapses within 2 years of RRMS diagnosis to those with no early relapses; and any early disabling relapses. Analyses were stratified by disease-modifying therapy (DMT) efficacy during follow-up. Results: People who experienced non-disabling relapses within 2 years of RRMS diagnosis accumulated more disability than those with no early relapses if they were untreated (n = 285 vs 4717; hazard ratio (HR) = 1.29, 95% confidence interval (CI) = 1.00–1.68) or given platform DMTs (n = 1074 vs 7262; HR = 1.33, 95% CI = 1.15–1.54), but not if given high-efficacy DMTs (n = 572 vs 3534; HR = 0.90, 95% CI = 0.71–1.13) during follow-up. Differences in disability accumulation between those with early non-disabling relapses and those with early disabling relapses were not confirmed statistically. Conclusion: This study suggests that early non-disabling relapses are associated with a higher risk of disability accumulation than no early relapses in RRMS. This risk may be mitigated by high-efficacy DMTs. Therefore, non-disabling relapses should be considered when making treatment decisions.
- Subject
- multiple sclerosis; prognosis; relapsing-remitting; daily life acitivity
- Identifier
- http://hdl.handle.net/1959.13/1484170
- Identifier
- uon:51272
- Identifier
- ISSN:1352-4585
- Rights
- x
- Language
- eng
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