ArticleAnnals of clinical and translational neurology2015
Predictors of disability worsening in clinically isolated syndrome.
Article in Annals of clinical and translational neurology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Treatment with disease-modifying drugs for people with a first clinical attack suggestive of multiple sclerosis.The Cochrane database of systematic reviews · 2017Pooled it
- Matching proposed clinical and MRI criteria of aggressive multiple sclerosis to serum and cerebrospinal fluid markers of neuroaxonal and glial injury.Journal of neurology · 2024Article
- Article
- Ensemble machine learning identifies genetic loci associated with future worsening of disability in people with multiple sclerosis.Scientific reports · 2022Article
- Determinants of disability development in patients with multiple sclerosis.Arquivos de neuro-psiquiatria · 2021Article
- A focus on secondary progressive multiple sclerosis (SPMS): challenges in diagnosis and definition.Journal of neurology · 2021Review
- Effect of Disease-Modifying Therapy on Disability in Relapsing-Remitting Multiple Sclerosis Over 15 Years.Neurology · 2021Article
- The long-term outcomes of CIS patients in the Barcelona inception cohort: Looking back to recognize aggressive MS.Multiple sclerosis (Houndmills, Basingstoke, England) · 2020Article
- The Pharmacogenetics of Rituximab: Potential Implications for Anti-CD20 Therapies in Multiple Sclerosis.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2020Review
- Aggressive multiple sclerosis (1): Towards a definition of the phenotype.Multiple sclerosis (Houndmills, Basingstoke, England) · 2020Article
- Does CSF pleocytosis have a predictive value for disease course in MS?Neurology(R) neuroimmunology & neuroinflammation · 2019Article
- High neurofilament levels are associated with clinically definite multiple sclerosis in children and adults with clinically isolated syndrome.Multiple sclerosis (Houndmills, Basingstoke, England) · 2019Article
- Application of the 2017 Revised McDonald Criteria for Multiple Sclerosis to Patients With a Typical Clinically Isolated Syndrome.JAMA neurology · 2018Article
- Genotype and Phenotype in Multiple Sclerosis-Potential for Disease Course Prediction?Current treatment options in neurology · 2018Review
- Achievements and obstacles of remyelinating therapies in multiple sclerosis.Nature reviews. Neurology · 2017Review
- Treatment decisions in multiple sclerosis - insights from real-world observational studies.Nature reviews. Neurology · 2017Review
- The importance of collecting structured clinical information on multiple sclerosis.BMC medicine · 2016Article
- Onset of secondary progressive multiple sclerosis is not influenced by current relapsing multiple sclerosis therapies.Multiple sclerosis journal - experimental, translational and clinicalArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
36 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo assess demographic, clinical, magnetic resonance imaging, and treatment exposure predictors of time to 3 or 12-month confirmed disability worsening in clinically isolated syndrome (CIS) and early multiple sclerosis (MS).
methodsWe utilized the MSBase Incident Study (MSBasis), a prospective cohort study of outcome after CIS. Predictors of time to first 3 and 12-month confirmed expanded disability status scale worsening were analyzed using Cox proportional hazards regression.
resultsAbout 1989 patients were analyzed, the largest seen-from-onset cohort reported to-date. A total of 391 patients had a first 3-month confirmed disability worsening event, of which 307 were sustained for 12 months. Older age at CIS onset (adjusted hazard ratio: aHR 1.17, 95% 1.06, 1.30), pyramidal (aHR 1.45, 95% CI 1.13, 1.89) and ambulation (HR 1.60, 95% CI 1.09, 2.34) system dysfunction, annualized relapse rate (aHR 1.20, 95% CI 1.18, 1.22), and lower proportion of observation time on treatment were associated with 3-month confirmed worsening. Predictors of time to 12-month sustained worsening included pyramidal system dysfunction (Hazard ratio: aHR 1.38, 95% CI 1.05, 1.83), and older age at CIS onset (aHR 1.17, 95% CI 1.04, 1.31). Greater proportion of follow-up time exposed to treatment was associated with greater reductions in the rate of worsening.
interpretationThis study provides class IV evidence for a strong protective effect of disease-modifying treatment to reduce disability worsening events in patients with CIS and early MS, and confirms age and pyramidal dysfunction at onset as risk factors.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.