Early Clinical Features, Time to Secondary Progression, and Disability Milestones in Polish Multiple Sclerosis Patients

Abstract

Background and Objectives: Determining the clinical course of multiple sclerosis (MS) and prediction of long-term disability can be a big challenge. To determine early clinical features of MS, their influence on long-term disability progression, and time to transition from relapsing-remitting MS (RRMS) to secondary progressive MS (SPMS), a cohort of Polish patients was studied. Materials and Methods: We retrospectively evaluated 375 Polish MS patients based on data from available medical records. We assessed early clinical MS features and the relationship between demographics and time from disease onset to attainment of 4 and 6 points on the Expanded Disability Status Scale (EDSS), as well as time to conversion from RRMS to SPMS. Results: The differences between initial MS variants were significantly associated with gender, age at disease onset, number and type of the first symptoms, and rate of the disability accrual. Mean times from disease onset to attainment of EDSS 4 and 6 were significantly influenced by the disease variant, age at onset, gender, degree of recovery from the initial symptoms, and first inter-bouts interval. The mean time to secondary progression was significantly influenced by the number and type of the first symptoms of RRMS. Conclusions: Early clinical features of MS are important in determining the disease variant, the time to transition from RRMS to SPMS, as well as predicting the disability accumulation of patients. Despite the small differences regarding the first MS symptoms, the disability outcomes in the cohort of Polish patients are similar to other regions of the world.

Considering patient clinical history impacts performance of machine learning models in predicting course of multiple sclerosis

“…The raw dataset is composed of 18 574 clinical records from visits performed between 1978 and 2018 on 1 624 patients, of whom 207 (12.7%) in SP phase, now followed at the MS Center of Sant'Andrea University hospital, designated and certified as a MS center of excellence. The percentage of SP patients is just below the lower end of international reference values (13.5-32%) obtained using nationwide cohorts [33][34][35][36][37]. A likely explanation for the lower transition rate is that, as a part of the peculiar routine inherent to the excellence center, patients are treated early with second line drugs, and this approach may delay the SP transition.…”

<p>Retinal Nerve Fiber Layer Thickness and Total Macular Volume in Multiple Sclerosis Subtypes and Their Relationship with Severity of Disease, a Cross-Sectional Study</p>

“…The importance of early clinical MS parameters also showed in the time to conversion from RRMS to SPMS as well as prediction of the rate of disability in patients. 11 The present study aimed to evaluate the OCT parameters including RNFLT and TMV in MS patients and their relationship with MS subtypes, first clinical manifestation, duration, and severity of the disease.…”

Th17-Related Cytokines as Potential Discriminatory Markers between Neuromyelitis Optica (Devic’s Disease) and Multiple Sclerosis—A Review

“…There is a worse prognosis once MS patients enter a progressive phase, whether from the onset (like in PPMS) or after an initial RR phase. Most RRMS patients have only a moderate disability (Expanded Disability Status Scale (EDSS) ≤ 4.0), while in SPMS patients, severe and persistent disability develops (EDSS ≥ 5.5) [31]. The longer the disease duration, the greater the proportion of patients converting to a secondary-progressive phase, with a near 90% chance of conversion after 26 years from the onset [32].…”