Contributions
Abstract: EP1321
Type: ePoster
Abstract Category: Clinical aspects of MS - 4 Natural course
Objective: Current approved disease modifying therapies (DMTs) are effective to prevent relapses but are not effective to arrest the accumulation of disability once the progressive phase of MS (SPMS) have started. Phase III trials in relapsing-remitting multiple sclerosis (RRMS) are not long enough to answer whether DMTs have an influence in reaching SPMS or in the long-term course of the disease. The objective of this study was to evaluate if current DMT are preventing the transition to SPMS or changing the evolution of the progressive phase of these patients.
Methods: RRMS patients later diagnosed of SPMS, followed in the MS Unit of two tertiary hospitals,
(La Fe and Clinic, in Valencia, Spain), since the first relapse of the disease to the present, were selected. All patients received DMTs after a definitive diagnosis of RRMS. A second cohort of primary progressive multiple sclerosis (PPMS) patients were selected. Age at disease onset, type of DMTs administrated, basal EDSS, time to SPMS diagnosis and time to reach an EDSS of 3.0, 6.0, 8.0 and 10.0 was recorded. A comparison of the age and the time to reach a fixed disability for all groups was done by the Kaplan-Meier survival analysis. A Cox regression multivariate analysis in order to explore predictive variable of progression was realized.
Results: A total of 204 RRMS patients were selected and 77 (37.7%) of them were diagnosed of SPMS. A second cohort of 139 PPMS was selected, so a total of 217 progressive MS (PMS) were followed-up for a mean time of 16 years (sd 7.3). SPMS patients were all treated with first-line DMTs and 47 of them (61.0%) with second line therapy because of treatment failure. The mean time under treatment was of 12.9 years (sd 5.0). Progressive MS was initiated at a mean age of 42.7 year, without significant differences between PPMS and SPMS. Reaching an EDSS score of 3.0 in less time predicted a worse evolution in SPMS. Mean time to reach an EDSS score of 6.0, 8.0 and 10.0 was 8.8, 13.1 and 15.4 years respectively, without differences between SPMS and PPMS.
Conclusion: The course of progressive MS (SPMS and PPMS) is very homogeneous, independently of has received current treatments from first relapse in SPMS form. Treatment could prevent disability related to relapses but has a limited influence to prevent the transition to SP or to modify the posterior evolution.
Disclosure:
Carmen Alcalá: nothing to disclose
Abstract: EP1321
Type: ePoster
Abstract Category: Clinical aspects of MS - 4 Natural course
Objective: Current approved disease modifying therapies (DMTs) are effective to prevent relapses but are not effective to arrest the accumulation of disability once the progressive phase of MS (SPMS) have started. Phase III trials in relapsing-remitting multiple sclerosis (RRMS) are not long enough to answer whether DMTs have an influence in reaching SPMS or in the long-term course of the disease. The objective of this study was to evaluate if current DMT are preventing the transition to SPMS or changing the evolution of the progressive phase of these patients.
Methods: RRMS patients later diagnosed of SPMS, followed in the MS Unit of two tertiary hospitals,
(La Fe and Clinic, in Valencia, Spain), since the first relapse of the disease to the present, were selected. All patients received DMTs after a definitive diagnosis of RRMS. A second cohort of primary progressive multiple sclerosis (PPMS) patients were selected. Age at disease onset, type of DMTs administrated, basal EDSS, time to SPMS diagnosis and time to reach an EDSS of 3.0, 6.0, 8.0 and 10.0 was recorded. A comparison of the age and the time to reach a fixed disability for all groups was done by the Kaplan-Meier survival analysis. A Cox regression multivariate analysis in order to explore predictive variable of progression was realized.
Results: A total of 204 RRMS patients were selected and 77 (37.7%) of them were diagnosed of SPMS. A second cohort of 139 PPMS was selected, so a total of 217 progressive MS (PMS) were followed-up for a mean time of 16 years (sd 7.3). SPMS patients were all treated with first-line DMTs and 47 of them (61.0%) with second line therapy because of treatment failure. The mean time under treatment was of 12.9 years (sd 5.0). Progressive MS was initiated at a mean age of 42.7 year, without significant differences between PPMS and SPMS. Reaching an EDSS score of 3.0 in less time predicted a worse evolution in SPMS. Mean time to reach an EDSS score of 6.0, 8.0 and 10.0 was 8.8, 13.1 and 15.4 years respectively, without differences between SPMS and PPMS.
Conclusion: The course of progressive MS (SPMS and PPMS) is very homogeneous, independently of has received current treatments from first relapse in SPMS form. Treatment could prevent disability related to relapses but has a limited influence to prevent the transition to SP or to modify the posterior evolution.
Disclosure:
Carmen Alcalá: nothing to disclose