Predicting secondary progression in relapsing–remitting multiple sclerosis: a Bayesian analysis

Bergamaschi, Roberto; Berzuini, Carlo; Romani, Alfredo; Cosi, V.

doi:10.1016/s0022-510x(01)00572-x

Cited by 101 publications

(108 citation statements)

References 29 publications

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“…Finally, in accordance with the vast majority of the literature [8][9][10] , our fi ndings confi rmed that clinical factors, such as onset at a late age and a short interval between onset and secondary progression, increased the risk of an unfavourable course. …”

Section: Discussionsupporting

confidence: 89%

Disability and Mortality in a Cohort of Multiple Sclerosis Patients: A Reappraisal

Bergamaschi¹,

Montomoli

Candeloro

et al. 2005

Neuroepidemiology

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The aim of the study was to evaluate how the natural history of multiple sclerosis (MS) had changed over a 15-year period. We compared disability and mortality in a cohort of 83 MS patients hospitalised in the Neurological Institute of Pavia, northern Italy, from January 1, 1990, to December 31, 1991, with a similar cohort of 52 patients analysed in the past. After the follow-up, an unfavourable course (death or relevant disability) was observed in 41% of the patients in the new cohort, compared to 63.5% of the patients in the old one. The percentage of deceased patients was reduced from 25 to 6%. The analysis of the pooled data of the two cohorts indicates a recent tendency of firstly hospitalised patients having a shorter disease duration and a lower disability level, which could explain the relevant decrease both in mortality and disability. Finally, our findings confirmed that age at onset, early disability and a short interval between onset and secondary progression increase the risk of an unfavourable course.

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Section: Discussionsupporting

confidence: 89%

Disability and Mortality in a Cohort of Multiple Sclerosis Patients: A Reappraisal

Bergamaschi¹,

Montomoli

Candeloro

et al. 2005

Neuroepidemiology

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“…Most were consistent with either observations from previously published natural history studies 17,21 or with clinical expectations. For instance, consistent with the wider literature, 47 those who were older at MS onset tended to have greater disability (higher EDSS scores) and worsened somewhat more rapidly over time. Consistent with clinical expectations, those with SP disease had a higher EDSS score at ABN eligibility.…”

Section: Key Findingssupporting

confidence: 79%

Modelling disease progression in relapsing–remitting onset multiple sclerosis using multilevel models applied to longitudinal data from two natural history cohorts and one treated cohort

Tilling

Lawton

Robertson

et al. 2016

Health Technol Assess

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Declared competing interests of authors: Kate Tilling has received non-financial support from the Multiple Sclerosis (MS) Trust during the conduct of the study, and had her expenses paid by the MS Trust to attend meetings of the UK MS risk-sharing scheme (RSS) scientific advisory group in order to outline the plan for these analyses. Michael Lawton has had his expenses paid by the MS Trust to attend meetings of the UK MS RSS scientific advisory group in order to outline the plan for these analyses, and also his travel and accommodation expenses for visiting Vancouver to analyse the British Columbia MS data set. Neil Robertson has received travel grants and honoraria from Biogen, Novartis, Serono, Sanofi, Genzyme and Bayer and holds grants for unrelated work from Genzyme and Novartis. Helen Tremlett is funded by the MS Society of Canada (Don Paty Career Development Award), Michael Smith Foundation for Health Research and is the Canada Research Chair for Neuroepidemiology and MS. She has received research support from the National MS Society, the Canadian Institutes of Health Research and the UK MS Trust; and speaker honoraria and/or travel expenses to attend conferences from the Consortium of MS Centres (2013), the National MS Society (2012, 2014), Bayer Pharmaceuticals (2010), Teva Pharmaceuticals (2011), European Committee for Treatment and Research in MS (2011, 2013 and 2014, UK MS Trust (2011), the Chesapeake Health Education Program, US Veterans Affairs (2012), Novartis Canada (2012), Biogen Idec (2014) and the American Academy of Neurology (2013, 2014 and 2015). Unless otherwise stated, all speaker honoraria are either donated to a MS charity or to an unrestricted grant for use by her research group. Yoav Ben-Shlomo has had his expenses paid by the MS Trust to attend meetings of the UK MS RSS Scientific Advisory Group in order to outline the plan for these analyses, and has a relative with MS who is currently on treatment for the disease. He is a member of the UK MS RSS Scientific Advisory Group. This journal is a member of and subscribes to the principles of the Committee on Publication Ethics (COPE) (www.publicationethics.org/). PublishedEditorial contact: nihredit@southampton.ac.ukThe full HTA archive is freely available to view online at www.journalslibrary.nihr.ac.uk/hta. Print-on-demand copies can be purchased from the report pages of the NIHR Journals Library website: www.journalslibrary.nihr.ac.uk Criteria for inclusion in the Health Technology Assessment journalReports are published in Health Technology Assessment (HTA) if (1) they have resulted from work for the HTA programme, and (2) they are of a sufficiently high scientific quality as assessed by the reviewers and editors.Reviews in Health Technology Assessment are termed 'systematic' when the account of the search appraisal and synthesis methods (to minimise biases and random errors) would, in theory, permit the replication of the review by others. HTA programmeThe HTA programme, part of the National Institute for Health Research (NIHR), was ...

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“…Relapses presenting with pyramidal tract and sphincter disorders have a poor long-term prognosis when compared with relapses without involvement of these systems (39,40,41,42).…”

mentioning

confidence: 99%

Relapses in Multiple Sclerosis: Definition, Pathophysiology, Features, Imitators, and Treatment

Sevim¹

2016

tnd

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Relapse in multiple sclerosis (MS) is defined as a neurologic deficit associated with an acute inflammatory demyelinating event that lasts at least 24 hours in the absence of fever and infection. Myelinoclasis and axonal transection occur in relapses. Diagnosis, prognosis, treatment, and many other features of the disease are directly related to the relapses. MS starts as the relapsing-remitting (RRMS) form in 85% of patients. A large number of relapses in the first years, polysymptomatic relapses, and pyramidal system, brain stem, and spinal cord involvement are signs of a poor outcome. The average frequency of relapses is approximately one per year during the first years of RRMS. The frequency of relapses increases during systemic infections, psychological stress, and in the first 3 months after birth. Seventy-five percent of relapses are monosymptomatic. Pseudo-relapses and paroxysmal symptoms are distinguished from relapses by their sudden onset, sudden termination, and shorter duration. Contrast enhancement is valuable in imaging, but undetectable in most relapses. The regression in the first few weeks of relapses is explained by reduction of the edema, and by remyelination in the following months. Relapses and their features are also among the main determinants of treatment. High-dose methylprednisolone and early treatment with adrenocorticotropic hormone reduce post-relapse disability and shorten the duration of relapses. Plasmapheresis is a good option for patients who do not respond to steroid treatment. Identification of relapses by patients and physicians, distinguishing them from imitators, proper evaluation, treatment when necessary, and monitoring the results are of great importance for patients with MS. The educational levels of patients and physicians regarding these parameters should be increased. Well-designed studies that evaluate the long-term effect of relapse treatment on disability are needed. Keywords: Multiple sclerosis, relapse, definition, features, treatmentMultipl sklerozda (MS) ateş ve enfeksiyon yokken en az 24 saat süren akut enflamatuvar demiyelinizan süreçle uyumlu nörolojik defisitler atak olarak tanımlanır. Ataklarda miyelin yıkımı ve aksonal transeksiyon oluşur. Hastalığın tanısı, seyri, tedavisi ve diğer birçok özelliği ataklarla doğrudan ilişkilidir. MS hastaların %85'inde atak ve düzelmelerle giden formda başlar. İlk yıllarda atak sayısının fazla olması, atakların birden çok semptomla ortaya çıkması, motor sistemi içermesi, beyin sapı ya da spinal atak formunda olması kötü prognoz göstergeleridir. Atak ve düzelmelerle giden formun başlangıç yıllarında yıllık ortalama atak sayısı 1'dir.Sistemik enfeksiyonlar, psişik stres ve postpartum 3 aylık dönemde atak sıklığı artar. Atakların %75'i monosemptomatiktir. Yalancı ataklar ve paroksismal bulgular genellikle ani başlayıp ani sonlanmalarıyla ve kısa sürmeleriyle ataklardan ayrılır. Görüntülemede kontrast tutulumu değerlidir, ancak atakların çoğunda saptanamaz. Ataklarda ilk birkaç hafta içindeki düzelme ödem etkisinin azalması...

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Predicting secondary progression in relapsing–remitting multiple sclerosis: a Bayesian analysis

Cited by 101 publications

References 29 publications

Disability and Mortality in a Cohort of Multiple Sclerosis Patients: A Reappraisal

Disability and Mortality in a Cohort of Multiple Sclerosis Patients: A Reappraisal

Modelling disease progression in relapsing–remitting onset multiple sclerosis using multilevel models applied to longitudinal data from two natural history cohorts and one treated cohort

Relapses in Multiple Sclerosis: Definition, Pathophysiology, Features, Imitators, and Treatment

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