Natural history of secondary-progressive multiple sclerosis

Multiple Sclerosis : Clinical and Laboratory Research
Helen TremlettVirginia Devonshire

Abstract

To examine prognosis and risk factors for progression to and from secondary-progressive multiple sclerosis (SPMS). Patients with definite relapsing-remitting MS (RRMS), onset before July 1988, attending a British-Columbian MS clinic before July 1998, and at least one Expanded Disability Status Scale (EDSS) scores were selected from the population-based database. Time to SPMS (from onset and birth) and the subsequent time to EDSS 8 were examined, as were potential risk factors. In all, 2484/2837 (87.6%) were relapsing-remitting (RR) at onset, with 1445/2484 (58.2%) reaching SPMS, taking a median 18.9 years (95% CI: 18.2-19.7). Those younger at onset took longer to reach SPMS (P < 0.0005), but did so at a younger age (P < 0.0005). Males reached SPMS more rapidly from onset and at a younger age (P < 0.0005), but were around the same age as females at EDSS 8 (P = 0.975). Characteristics at SPMS onset associated with a longer time from SPMS to EDSS 8 and an older age at EDSS 8 were: longer disease duration (P < 0.02), older age (P < 0.01) and lower EDSS (P < 0.0005). Onset symptoms had little influence on time to SPMS or subsequent progression. The RR phase lasted on average almost two decades, being shorter for males and those olde...Continue Reading

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