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Published in: BMC Neurology 1/2016

Open Access 01-12-2016 | Research article

Factors associated with benign multiple sclerosis in the New York State MS Consortium (NYSMSC)

Authors: Robert Zivadinov, Diane L. Cookfair, Lauren Krupp, Aaron E. Miller, Neil Lava, Patricia K. Coyle, Andrew D. Goodman, Burk Jubelt, Michael Lenihan, Joseph Herbert, Malcolm Gottesman, David H. Snyder, Brian R. Apatoff, Barbara E. Teter, Allan B. Perel, Frederick Munschauer, Bianca Weinstock-Guttman

Published in: BMC Neurology | Issue 1/2016

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Abstract

Background

This retrospective analysis explored prognostic factors associated with a benign multiple sclerosis (BMS) disease course at baseline and over the 4-year follow-up.

Methods

Patients from the centralized New York State Multiple Sclerosis Consortium registry were classified as having BMS according to 3 different criteria centered on disease duration and disability. Additional analyses explored prognostic factors associated with BMS using the most conservative disability criteria (Expanded Disability Status Scale ≤2 and disease duration ≥10 years).

Results

Among 6258 patients who fulfilled eligibility criteria, 19.8 % to 33.3 % were characterized as having BMS, at baseline depending on classification criteria used. Positive prognostic factors for BMS at baseline included female sex (p < 0.0001) and younger age at onset (p < 0.0001); negative prognostic factors included progressive-onset type of MS and African-American race. Of the 1237 BMS patients (per most conservative criteria), 742 were followed for a median of 4 years to explore effect of disease-modifying treatment (DMT) on benign status. DMT (p = 0.009) and longer disease duration (p = 0.007) were the only significant positive predictors of maintaining BMS at follow-up. The protective effect was stronger for patients taking DMT at both enrollment and follow-up (OR = 0.71; p = 0.006).

Conclusions

There is a need for development of more reliable prognostic indicators of BMS. Use of DMT was significantly associated with maintaining a benign disease state.
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Literature
4.
6.
go back to reference Lublin FD, Reingold SC. Defining the clinical course of multiple sclerosis: results of an international survey. National Multiple Sclerosis Society (USA) Advisory Committee on Clinical Trials of New Agents in Multiple Sclerosis. Neurology. 1996;46:907–11.CrossRefPubMed Lublin FD, Reingold SC. Defining the clinical course of multiple sclerosis: results of an international survey. National Multiple Sclerosis Society (USA) Advisory Committee on Clinical Trials of New Agents in Multiple Sclerosis. Neurology. 1996;46:907–11.CrossRefPubMed
8.
go back to reference Leray E, Coustans M, Le Page E, et al. ‘Clinically definite benign multiple sclerosis’, an unwarranted conceptual hodgepodge: evidence from a 30-year observational study. Mult Scler. 2013;19:458–65.CrossRefPubMed Leray E, Coustans M, Le Page E, et al. ‘Clinically definite benign multiple sclerosis’, an unwarranted conceptual hodgepodge: evidence from a 30-year observational study. Mult Scler. 2013;19:458–65.CrossRefPubMed
9.
go back to reference Ramsaransing G, Maurits N, Zwanikken C, et al. Early prediction of a benign course of multiple sclerosis on clinical grounds: a systematic review. Mult Scler. 2001;7:345–7.CrossRefPubMed Ramsaransing G, Maurits N, Zwanikken C, et al. Early prediction of a benign course of multiple sclerosis on clinical grounds: a systematic review. Mult Scler. 2001;7:345–7.CrossRefPubMed
15.
go back to reference Trojano M, Russo P, Fuiani A, et al. The Italian Multiple Sclerosis Database Network (MSDN): the risk of worsening according to IFNbeta exposure in multiple sclerosis. Mult Scler. 2006;12:578–85.CrossRefPubMed Trojano M, Russo P, Fuiani A, et al. The Italian Multiple Sclerosis Database Network (MSDN): the risk of worsening according to IFNbeta exposure in multiple sclerosis. Mult Scler. 2006;12:578–85.CrossRefPubMed
16.
go back to reference Jacobs LD, Wende KE, Brownscheidle CM, et al. A profile of multiple sclerosis: the New York State Multiple Sclerosis Consortium. Mult Scler. 1999;5:369–76.CrossRefPubMed Jacobs LD, Wende KE, Brownscheidle CM, et al. A profile of multiple sclerosis: the New York State Multiple Sclerosis Consortium. Mult Scler. 1999;5:369–76.CrossRefPubMed
19.
go back to reference Hawkins SA, McDonnell GV. Benign multiple sclerosis? Clinical course, long term follow up, and assessment of prognostic factors. J Neurol Neurosurg Psychiatry. 1999;67:148–52.CrossRefPubMedPubMedCentral Hawkins SA, McDonnell GV. Benign multiple sclerosis? Clinical course, long term follow up, and assessment of prognostic factors. J Neurol Neurosurg Psychiatry. 1999;67:148–52.CrossRefPubMedPubMedCentral
20.
go back to reference Weinstock-Guttman B, Jacobs LD, Brownscheidle CM, et al. Multiple sclerosis characteristics in African American patients in the New York State Multiple Sclerosis Consortium. Mult Scler. 2003;9:293–8.CrossRefPubMed Weinstock-Guttman B, Jacobs LD, Brownscheidle CM, et al. Multiple sclerosis characteristics in African American patients in the New York State Multiple Sclerosis Consortium. Mult Scler. 2003;9:293–8.CrossRefPubMed
22.
23.
go back to reference Freedman MS, Selchen D, Arnold DL, et al. Treatment optimization in MS: Canadian MS Working Group updated recommendations. Can J Neurol Sci. 2013;40:307–23.CrossRefPubMed Freedman MS, Selchen D, Arnold DL, et al. Treatment optimization in MS: Canadian MS Working Group updated recommendations. Can J Neurol Sci. 2013;40:307–23.CrossRefPubMed
25.
go back to reference Castrop F, Haslinger B, Hemmer B, et al. Review of the pharmacoeconomics of early treatment of multiple sclerosis using interferon beta. Neuropsychiatr Dis Treat. 2013;9:1339–49.CrossRefPubMedPubMedCentral Castrop F, Haslinger B, Hemmer B, et al. Review of the pharmacoeconomics of early treatment of multiple sclerosis using interferon beta. Neuropsychiatr Dis Treat. 2013;9:1339–49.CrossRefPubMedPubMedCentral
28.
go back to reference Cree BA, Khan O, Bourdette D, et al. Clinical characteristics of African Americans vs Caucasian Americans with multiple sclerosis. Neurology. 2004;63:2039–45.CrossRefPubMed Cree BA, Khan O, Bourdette D, et al. Clinical characteristics of African Americans vs Caucasian Americans with multiple sclerosis. Neurology. 2004;63:2039–45.CrossRefPubMed
Metadata
Title
Factors associated with benign multiple sclerosis in the New York State MS Consortium (NYSMSC)
Authors
Robert Zivadinov
Diane L. Cookfair
Lauren Krupp
Aaron E. Miller
Neil Lava
Patricia K. Coyle
Andrew D. Goodman
Burk Jubelt
Michael Lenihan
Joseph Herbert
Malcolm Gottesman
David H. Snyder
Brian R. Apatoff
Barbara E. Teter
Allan B. Perel
Frederick Munschauer
Bianca Weinstock-Guttman
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Neurology / Issue 1/2016
Electronic ISSN: 1471-2377
DOI
https://doi.org/10.1186/s12883-016-0623-2

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