Prediction of long-term disability in Chinese patients with multiple sclerosis: a prospective cohort study
Abstract
Background:
Much information about outcomes of multiple sclerosis (MS) has been studied in Caucasian cohorts. However, little is known about the predictors of long-term disability in Chinese patients with MS. The aim of this prospective, observational study is to identify the prognostic factors associated with long-term disability progression (expanded disability status scale, EDSS=6.0) in Chinese patients with relapsing-onset MS.
Methods:
Based on data from the MSNMOBase registry within the neurology department of Peking Union Medical College Hospital (PUMCH) in China, this hospital-based cohort study was conducted to estimate the median time of attaining disability endpoint (EDSS = 6.0) by Kaplan-Meier curves, and identify factors that associated with disability progression by Cox proportional regression analysis.
Results:
A total of 415 consecutive, eligible patients with MS were registered in the MSNMOBase of PUMCH and prospectively followed from 2011 to 2019. Of these patients, 365 patients with relapsing-onset MS were analyzed. The median time to reach an EDSS of 6.0 was 22.0 (95% CI 16.5-27.5) years. Age at disease onset greater than 50 years (HR 3.846, 95% CI 1.240–11.932, P=0.020), incomplete recovery from first attack (HR 2.107, 95% CI 1.168–3.800, P=0.013), and ≥2 relapses during the first 2 years after onset (HR 2.217, 95% CI 1.148–4.281, P=0.018) significantly associated with a higher hazard ratio to reach an EDSS of 6.0.
Conclusions:
Our results confirm the importance of age at onset, recovery from the first attack, and number of relapses during the first 2 years after disease onset as predictors of disability progression in Chinese patients with relapsing-onset MS.
Key words:
multiple sclerosis, disability, prognostic factors, expanded disability status scale
Abbreviations:
MS, multiple sclerosis; RRMS, relapsing-remitting multiple sclerosis; PPMS, primary progressive MS; EDSS, expanded disability status scale; MRI, magnetic resonance imaging; SD, mean with standard deviation; IQR, median with interquartile range; HR, hazard ratio; CI, confidence intervals; LOMS, late onset MS