| Title: |
Progression is independent of relapse activity in early multiple sclerosis: a real-life cohort study |
| Authors: |
Portaccio, Emilio; Bellinvia, Angelo; Fonderico, Mattia; Pastò, Luisa; Razzolini, Lorenzo; Totaro, Rocco; Spitaleri, Daniele; Lugaresi, Alessandra; Cocco, Eleonora; Onofrj, Marco; Di Palma, Franco; Patti, Francesco; Maimone, Davide; Valentino, Paola; Confalonieri, Paolo; Protti, Alessandra; Sola, Patrizia; Lus, Giacomo; Maniscalco, Giorgia Teresa; Brescia Morra, Vincenzo; Salemi, Giuseppe; Granella, Franco; Pesci, Ilaria; Bergamaschi, Roberto; Aguglia, Umberto; Vianello, Marika; Simone, Marta; Lepore, Vito; Iaffaldano, Pietro; Filippi, Massimo; Trojano, Maria; Amato, Maria Pia |
| Contributors: |
Portaccio, Emilio; Bellinvia, Angelo; Fonderico, Mattia; Pastò, Luisa; Razzolini, Lorenzo; Totaro, Rocco; Spitaleri, Daniele; Lugaresi, Alessandra; Cocco, Eleonora; Onofrj, Marco; Di Palma, Franco; Patti, Francesco; Maimone, Davide; Valentino, Paola; Confalonieri, Paolo; Protti, Alessandra; Sola, Patrizia; Lus, Giacomo; Maniscalco, Giorgia Teresa; Brescia Morra, Vincenzo; Salemi, Giuseppe; Granella, Franco; Pesci, Ilaria; Bergamaschi, Roberto; Aguglia, Umberto; Vianello, Marika; Simone, Marta; Lepore, Vito; Iaffaldano, Pietro; Filippi, Massimo; Trojano, Maria; Amato, Maria Pia |
| Publication Year: |
2022 |
| Collection: |
IRIS Università degli Studi di Bologna (CRIS - Current Research Information System) |
| Subject Terms: |
progression independent of relapse activity; relapse-associated worsening; relapsing multiple sclerosis |
| Description: |
Disability accrual in multiple sclerosis may occur as relapse-associated worsening or progression independent of relapse activity. The role of progression independent of relapse activity in early multiple sclerosis is yet to be established. The objective of this multicentre, observational, retrospective cohort study was to investigate the contribution of relapse-associated worsening and progression independent of relapse activity to confirmed disability accumulation in patients with clinically isolated syndrome and early relapsing-remitting multiple sclerosis, assessed within one year from onset and with follow-up ≥5 years (n = 5169). Data were extracted from the Italian Multiple Sclerosis Register. Confirmed disability accumulation was defined by an increase in Expanded Disability Status Scale score confirmed at 6 months, and classified per temporal association with relapses. Factors associated with progression independent of relapse activity and relapse-associated worsening were assessed using multivariable Cox regression models. Over a follow-up period of 11.5 ± 5.5 years, progression independent of relapse activity occurred in 1427 (27.6%) and relapse-associated worsening in 922 (17.8%) patients. Progression independent of relapse activity was associated with older age at baseline [hazard ratio (HR) = 1.19; 95% confidence interval (CI) 1.13-1.25, P < 0.001], having a relapsing-remitting course at baseline (HR = 1.44; 95% CI 1.28-1.61, P < 0.001), longer disease duration at baseline (HR = 1.56; 95% CI 1.28-1.90, P < 0.001), lower Expanded Disability Status Scale at baseline (HR = 0.92; 95% CI 0.88-0.96, P < 0.001) and lower number of relapses before the event (HR = 0.76; 95% CI 0.73-0.80, P < 0.001). Relapse-associated worsening was associated with younger age at baseline (HR = 0.87; 95% CI 0.81-0.93, P < 0.001), having a relapsing-remitting course at baseline (HR = 1.55; 95% CI 1.35-1.79, P < 0.001), lower Expanded Disability Status Scale at baseline (HR = 0.94; 95% CI 0.89-0.99, P = ... |
| Document Type: |
article in journal/newspaper |
| File Description: |
ELETTRONICO |
| Language: |
English |
| Relation: |
info:eu-repo/semantics/altIdentifier/pmid/35325059; info:eu-repo/semantics/altIdentifier/wos/WOS:000834297600001; volume:145; issue:8; firstpage:2796; lastpage:2805; numberofpages:10; journal:BRAIN; https://hdl.handle.net/11585/913912; https://academic.oup.com/brain/article/145/8/2796/6553893?login=false |
| DOI: |
10.1093/brain/awac111 |
| Availability: |
https://hdl.handle.net/11585/913912; https://doi.org/10.1093/brain/awac111; https://academic.oup.com/brain/article/145/8/2796/6553893?login=false |
| Rights: |
info:eu-repo/semantics/openAccess |
| Accession Number: |
edsbas.4D1910D8 |
| Database: |
BASE |