Recovery status may be a useful tool to predict long-term outcomes in patients with relapsing forms of multiple sclerosis.
Marinos Sotiropoulos, MD
Findings from a cohort analyses of the Comprehensive Longitudinal Investigation of Multiple Sclerosis at Brigham and Women’s Hospital (CLIMB) study suggest that incomplete recovery from multiple sclerosis (MS) relapses contributes to 10-year disability in patients with relapsing MS.
The data were presented by Marinos Sotiropoulos, MD, of Brigham and Women’s Hospital, and colleagues at the 2020 America’s Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS) Forum, February 27-29, 2020, in West Palm Beach, Florida.
Patients included in the analysis (N = 360) had relapsing MS for at least 8.5 years and were 18 or older, with MS relapses occurring within 3 years of first symptom and having a 6-month recovery interval before and after without a second attack. Recovery was calculated as the difference between Expanded Disability Status Scale (EDSS) score at least 6 months post-relapse and EDSS 5 to 90 days prior to relapse symptom onset, with changes graded as a complete recovery (change in EDSS £0) or incomplete recovery (change in EDSS >0).
Ultimately, 308 patients contributed a total of 403 eligible relapses, 50.4% of which had an incomplete recovery at 6 months. At 10-year follow-up, 27.3% of patients had a normal exam (EDSS = 0) and 64.1% had no disability (EDSS <2), with a mean 10-year EDSS of 1.52. There was a significant association between 10-year EDSS and the percentage of relapses with complete recovery (P <.001) and age at first symptom onset (P <.004).
The findings, the authors suggested, could be included in prediction models of long-term outcomes. A better understanding of the mechanisms involved in relapse recovery should be the subject of future research.
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Sotiropoulos MG, Lokhande H, Rosso M, et al. The Contribution Of Relapse Recovery To Long-term Outcomes In MS. Presented at: 2020 ACTRIMS Forum. February 27-29, 2020; West Palm Beach, FL. Abstract LB317.