Heterogeneity on long-term disability trajectories in patients with secondary progressive MS: a latent class analysis from Big MS Data network.
Journal: Journal of neurology, neurosurgery, and psychiatry
Volume: 94
Issue: 1
Year of Publication: 2022
Affiliated Institutions:
Department of Health Sciences, University of Genoa, Genoa, Italy alessio.signori@medicina.unige.it.
Neurologic Clinic and Policlinic, Departments of Medicine, Biomedicine and Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland.
Service de Neurologie A, Hopital Neurologique, Hospices Civils de Lyon, Lyon Bron, France.
Department of Basic Medical Sciences, Neurosciences and Sense Organs, University of Bari Aldo Moro, Bari, Italy.
Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden.
Biogen International, Zurich, Switzerland.
Department of Neurology, Danish Multiple Sclerosis Center, Rigshospitalet, Copenhagen, Denmark.
Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.
Monash University Central Clinical School, Melbourne, Victoria, Australia.
Department of Neurology and Center of Clinical Neuroscience, Charles University in Prague, st Faculty of Medicine and General University Hospital in Prague, Prague, Czech Republic.
CHUM and Universite de Montreal, Montreal, Quebec, Canada.
Neurology, Hospital Universitario Virgen Macarena, Sevilla, Spain.
Neuro Rive-Sud, Quebec, Quebec, Canada.
Department of Neurology, Zuyderland Medical Center, Sittard-Geleen, The Netherlands.
Ondokuz Mayis Üniversitesi, Samsun, Turkey.
Dokuz Eylul University, İzmir, Turkey.
Neurology, Box Hill Hospital, Melbourne, Victoria, Australia.
Neurology, Cliniques Universitaires Saint-Luc, Brussels, Belgium.
Neurology, Centro Hospitalar de São João, Porto, Portugal.
Centre integre de sante et de services sociaux des Laurentides point de service de Saint-Jerome, Saint-Jerome, Quebec, Canada.
Amiri Hospital, Kuwait City, Kuwait.
UQCCR, The University of Queensland, Brisbane, Queensland, Australia.
Department of Neurology, Razi Hospital, Manouba, Tunisia.
Department of Neurology, Razi University Hospital, Manouba, Tunisia.
Neurology, Donostia University Hospital, San Sebastian, Spain.
Neuroscience, Centre Clinical School, Monash University, Victoria, Australia.
Groene Hart Ziekenhuis, Gouda, The Netherlands.
Neurology, Galdakao Hospital, Vizcaya, Spain.
Nehme and Therese Tohme Multiple Sclerosis Center, American University of Beirut Medical Center, Beirut, Lebanon.
Department of Health Sciences, University of Genoa, Genoa, Italy.
CORe, Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia.
Abstract summary
Over the decades, several natural history studies on patients with primary (PPMS) or secondary progressive multiple sclerosis (SPMS) were reported from international registries. In PPMS, a consistent heterogeneity on long-term disability trajectories was demonstrated. The aim of this study was to identify subgroups of patients with SPMS with similar longitudinal trajectories of disability over time.All patients with MS collected within Big MS registries who received an SPMS diagnosis from physicians (cohort 1) or satisfied the Lorscheider criteria (cohort 2) were considered. Longitudinal Expanded Disability Status Scale (EDSS) scores were modelled by a latent class growth analysis (LCGA), using a non-linear function of time from the first EDSS visit in the range 3-4.A total of 3613 patients with SPMS were included in the cohort 1. LCGA detected three different subgroups of patients with a mild (n=1297; 35.9%), a moderate (n=1936; 53.6%) and a severe (n=380; 10.5%) disability trajectory. Median time to EDSS 6 was 12.1, 5.0 and 1.7 years, for the three groups, respectively; the probability to reach EDSS 6 at 8 years was 14.4%, 78.4% and 98.3%, respectively. Similar results were found among 7613 patients satisfying the Lorscheider criteria.Contrary to previous interpretations, patients with SPMS progress at greatly different rates. Our identification of distinct trajectories can guide better patient selection in future phase 3 SPMS clinical trials. Additionally, distinct trajectories could reflect heterogeneous pathological mechanisms of progression.
Authors & Co-authors:
Signori Alessio A
Lorscheider Johannes J
Vukusic Sandra S
Trojano Maria M
Iaffaldano Pietro P
Hillert Jan J
Hyde Robert R
Pellegrini Fabio F
Magyari Melinda M
Koch-Henriksen Nils N
Sørensen Per Soelberg PS
Spelman Tim T
van der Walt Anneke A
Horakova Dana D
Havrdova Eva E
Girard Marc M
Eichau Sara S
Grand'Maison Francois F
Gerlach Oliver O
Terzi Murat M
Ozakbas Serkan S
Skibina Olga O
Van Pesch Vincent V
Sa Maria Jose MJ
Prevost Julie J
Alroughani Raed R
McCombe Pamela A PA
Gouider Riadh R
Mrabet Saloua S
Castillo-Trivino Tamara T
Zhu Chao C
de Gans Koen K
Sánchez-Menoyo José Luis JL
Yamout Bassem B
Khoury Samia S
Sormani Maria Pia MP
Kalincik Tomas T
Butzkueven Helmut H
Study Outcome
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