Abstract: P277
Type: Poster
Abstract Category: Clinical aspects of MS - MS Variants
Introduction: In multiple sclerosis (MS) certain patients reach greater degrees of disability within a short period of time. This severe progressive form is referred to as malignant multiple sclerosis (MMS) when an Expanded Disability Status Scale (EDSS) score of 6 is reached within five years of disease onset.
Objective: To analyzed a cohort of Brazilian patients to identify cases of MMS and potential prognostic factors related to more severe progression.
Methods: In this observational study was performed a retrospective analysis of demographic and clinical data collected from medical records of 293 MS patients according to McDonald et al criteria. The patients have been regularly followed up at the Hospital Federal da Lagoa in Rio de Janeiro, Brazil. Based on time to reach EDSS 6, patients were classified as malignant-MS (MMS) up to five years, or non-malignant-MS (NMMS) above five years. Student"s t-test, Kaplan-Meier analysis, odds ratios and 95% confidence intervals were used.
Results: Twenty-five (8,53%) patients were found to have MMS and were compared with the remaining 268 (91,47%). Women (52%), non-white patients (52%). Relapsing Remitting MS (RRMS) was more common than primary-progressive form (PPMS) in non-malignant-MS (93.7% versus 68%; p< 0.001), whereas PPMS was more prevalent in malignant-MS (32% versus 5.2%; p< 0.001). Between the groups, significant differences were found for sex, ethnicity, recovery after the first attack, number of relapses during first year and time between the first two attacks. Regarding to clinical progression, the risk for progression was 10-fold greater for patients with MMS (OR=14.5; 95%CI: 4.4-48.1) and 35.5% of MMS patients had reached secondary progression versus 3.6% in NMMS (p< 0.001).
Conclusions: According to the generally accepted concept of MMS, less than 10% of patients in this Brazilian cohort were MMS. Identifying demographic and clinical prognostic factors may make early treatment with more effective drugs more feasible.
Disclosure:
Claudia Vasconcelos: nothing to disclose
Fabricio Hampshire-Araújo: nothing to disclose
Juliana CK Aurenção: nothing to disclose
Anke Bergmann: nothing to disclose
Regina M Papais-Alvarenga: nothing to disclose
Abstract: P277
Type: Poster
Abstract Category: Clinical aspects of MS - MS Variants
Introduction: In multiple sclerosis (MS) certain patients reach greater degrees of disability within a short period of time. This severe progressive form is referred to as malignant multiple sclerosis (MMS) when an Expanded Disability Status Scale (EDSS) score of 6 is reached within five years of disease onset.
Objective: To analyzed a cohort of Brazilian patients to identify cases of MMS and potential prognostic factors related to more severe progression.
Methods: In this observational study was performed a retrospective analysis of demographic and clinical data collected from medical records of 293 MS patients according to McDonald et al criteria. The patients have been regularly followed up at the Hospital Federal da Lagoa in Rio de Janeiro, Brazil. Based on time to reach EDSS 6, patients were classified as malignant-MS (MMS) up to five years, or non-malignant-MS (NMMS) above five years. Student"s t-test, Kaplan-Meier analysis, odds ratios and 95% confidence intervals were used.
Results: Twenty-five (8,53%) patients were found to have MMS and were compared with the remaining 268 (91,47%). Women (52%), non-white patients (52%). Relapsing Remitting MS (RRMS) was more common than primary-progressive form (PPMS) in non-malignant-MS (93.7% versus 68%; p< 0.001), whereas PPMS was more prevalent in malignant-MS (32% versus 5.2%; p< 0.001). Between the groups, significant differences were found for sex, ethnicity, recovery after the first attack, number of relapses during first year and time between the first two attacks. Regarding to clinical progression, the risk for progression was 10-fold greater for patients with MMS (OR=14.5; 95%CI: 4.4-48.1) and 35.5% of MMS patients had reached secondary progression versus 3.6% in NMMS (p< 0.001).
Conclusions: According to the generally accepted concept of MMS, less than 10% of patients in this Brazilian cohort were MMS. Identifying demographic and clinical prognostic factors may make early treatment with more effective drugs more feasible.
Disclosure:
Claudia Vasconcelos: nothing to disclose
Fabricio Hampshire-Araújo: nothing to disclose
Juliana CK Aurenção: nothing to disclose
Anke Bergmann: nothing to disclose
Regina M Papais-Alvarenga: nothing to disclose