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Open Access 17-11-2023 | Multiple Sclerosis | Original Article

Correlates and trajectories of relapses in relapsing–remitting multiple sclerosis

Authors: Carolyn A. Young, David J. Rog, Basil Sharrack, Radu Tanasescu, Seema Kalra, Timothy Harrower, Alan Tennant, Roger J. Mills, on behalf of the Trajectories of Outcome in Neurological Conditions-MS Study Group

Published in: Neurological Sciences | Issue 5/2024

Abstract

Background and aims

In people with relapsing–remitting multiple sclerosis (pwRRMS), data from studies on non-pharmacological factors which may influence relapse risk, other than age, are inconsistent. There is a reduced risk of relapses with increasing age, but little is known about other trajectories in real-world MS care.

Methods

We studied longitudinal questionnaire data from 3885 pwRRMS, covering smoking, comorbidities, disease-modifying therapy (DMT), and patient-reported outcome measures, as well as relapses during the past year. We undertook Rasch analysis, group-based trajectory modelling, and multilevel negative binomial regression.

Results

The regression cohort of 6285 data sets from pwRRMS over time showed that being a current smoker was associated with 43.9% greater relapse risk; having 3 or more comorbidities increased risk and increasing age reduced risk. Those diagnosed within the last 2 years showed two distinct trajectories, both reducing in relapse frequency but 25.8% started with a higher rate and took 4 years to reduce to the rate of the second group. In the cohort with at least three data points completed, there were three groups: 73.7% followed a low stable relapse rate, 21.6% started from a higher rate and decreased, and 4.7% had an increasing then decreasing pattern. These different trajectory groups showed significant differences in fatigue, neuropathic pain, disability, health status, quality of life, self-efficacy, and DMT use.

Conclusions

These results provide additional evidence for supporting pwRRMS to stop smoking and underline the importance of timely DMT decisions and treatment initiation soon after diagnosis with RRMS.

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Title: Correlates and trajectories of relapses in relapsing–remitting multiple sclerosis
Authors: Carolyn A. Young
David J. Rog
Basil Sharrack
Radu Tanasescu
Seema Kalra
Timothy Harrower
Alan Tennant
Roger J. Mills
on behalf of the Trajectories of Outcome in Neurological Conditions-MS Study Group
Publication date: 17-11-2023
Publisher: Springer International Publishing
Keyword: Multiple Sclerosis
Published in: Neurological Sciences / Issue 5/2024
Print ISSN: 1590-1874
Electronic ISSN: 1590-3478
DOI: https://doi.org/10.1007/s10072-023-07155-3

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Correlates and trajectories of relapses in relapsing–remitting multiple sclerosis

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Background and aims

Methods

Results

Conclusions

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