Contributions
Abstract: P605
Type: Poster
Abstract Category: Pathology and pathogenesis of MS - 22 OCT
Background: Cognitive impairment (CI) is frequent in pediatric and juvenile multiple sclerosis (MS) onset patients. In adult onset MS, it predicts a worse clinical outcome. We aimed at evaluating the role of CI as predictor of disease severity in early-onset MS.
Methods: This is a 5-year longitudinal retrospective study including pediatric (< =18 years) and juvenile (< =25 years) onset RR-MS. Socio-demographic and clinical data (age, sex and education level, age at onset, disease duration, expanded disability status scale [EDSS], disease modifying therapy, DMT) were collected at baseline. Patients were assessed through the Brief Repeatable Battery (BRB) and the presence of CI has been defined when patients failed in 1 or more tests. Clinical outcomes were the occurrence of a relapse, a therapeutic switch, the achievement of EDSS 4.0, the sustained increase in the EDSS of at least 1 point and the conversion to SP over 5 years of follow-up. The time to the occurrence of each of these clinical outcomes was collected. Binary logistic models and Cox models were run to explore the presumptive role of CI as predictor for each of the clinical outcomes.
Results: We included 51 subjects (26 females), 33 paediatric and 18 juvenile onset RRMS, with a mean age at baseline of 19.8 ± 3.8 years, and a mean age at onset of 17.2 ± 3.9 years. Median baseline EDSS was 2.5 (1 - 6) with a median disease duration of 2 (0 - 12) years. At NPS evaluation 32/51 (62.75%) patients were CI. After 5 years, 11,8% experienced an increase of 1 point in the EDSS and 12,5% patients reached EDSS 4. Twenty-seven patients experienced at least one relapse over the follow-up period after 32.2 ± 22.5 months. The clinical outcomes were not related to the presence of CI at baseline nor to any single NPS score.
Discussion: In the short-medium term the presence of CI does not predict clinical outcomes in early-onset MS patients. These results seem to confirm the previous findings for adult MS patients, in which CI began to influence clinical outcome only after 5 years from baseline evaluation. However, we can not exclude that juvenile MS patients could experience a more marked inflammatory process than neuro-degeneration, which is strictly related to cognitive functions. Cognitive follow up and extension of observation time is on-going.
Disclosure:
Roberta Lanzillo and Vincenzo Brescia Morra received personal compensations for speaking or consultancy from Biogen, Teva, Genzyme, Merck, Novartis, Almirall
Marcello Moccia has received salary from Federico II University of Naples, grant from the ECTRIMS-MAGMNISM fellowship program, honoraria and travel support form Almirall, Coloplast, Genzyme, and Merck-Serono.
Dr. Cocozza reports personal fees from Sanofi Genzyme.
Dr Paolicelli has received honoraria for consultancy and/or speaking from Biogen Idec, Merck-Serono, Almirall, Sanofi-Aventis, TEVA, Novartis and Genzyme.
Dr. Lus has received personal compensation for activities with Biogen Idec, Merck Serono, Novartis, Sanofi-Aventis Pharmaceuticals, Teva neuroscience as a consultant and speaker; has received research support from Biogen Idec, Merck Serono, and Novartis.
Dr. Elisabetta Signoriello has received personal compensation for activities with Biogen Idec, Roche, Merck Serono, Novartis as a consultant; has received support for travelling from Biogen Idec, Merck Serono, Novartis, Teva, Roche, Genzyme
Carotenuto Antonio, Teresa costabile, Anna Maria Barbarulo, Marta Simone and Rosa Gemma Viterbo have nothing to disclose.
Abstract: P605
Type: Poster
Abstract Category: Pathology and pathogenesis of MS - 22 OCT
Background: Cognitive impairment (CI) is frequent in pediatric and juvenile multiple sclerosis (MS) onset patients. In adult onset MS, it predicts a worse clinical outcome. We aimed at evaluating the role of CI as predictor of disease severity in early-onset MS.
Methods: This is a 5-year longitudinal retrospective study including pediatric (< =18 years) and juvenile (< =25 years) onset RR-MS. Socio-demographic and clinical data (age, sex and education level, age at onset, disease duration, expanded disability status scale [EDSS], disease modifying therapy, DMT) were collected at baseline. Patients were assessed through the Brief Repeatable Battery (BRB) and the presence of CI has been defined when patients failed in 1 or more tests. Clinical outcomes were the occurrence of a relapse, a therapeutic switch, the achievement of EDSS 4.0, the sustained increase in the EDSS of at least 1 point and the conversion to SP over 5 years of follow-up. The time to the occurrence of each of these clinical outcomes was collected. Binary logistic models and Cox models were run to explore the presumptive role of CI as predictor for each of the clinical outcomes.
Results: We included 51 subjects (26 females), 33 paediatric and 18 juvenile onset RRMS, with a mean age at baseline of 19.8 ± 3.8 years, and a mean age at onset of 17.2 ± 3.9 years. Median baseline EDSS was 2.5 (1 - 6) with a median disease duration of 2 (0 - 12) years. At NPS evaluation 32/51 (62.75%) patients were CI. After 5 years, 11,8% experienced an increase of 1 point in the EDSS and 12,5% patients reached EDSS 4. Twenty-seven patients experienced at least one relapse over the follow-up period after 32.2 ± 22.5 months. The clinical outcomes were not related to the presence of CI at baseline nor to any single NPS score.
Discussion: In the short-medium term the presence of CI does not predict clinical outcomes in early-onset MS patients. These results seem to confirm the previous findings for adult MS patients, in which CI began to influence clinical outcome only after 5 years from baseline evaluation. However, we can not exclude that juvenile MS patients could experience a more marked inflammatory process than neuro-degeneration, which is strictly related to cognitive functions. Cognitive follow up and extension of observation time is on-going.
Disclosure:
Roberta Lanzillo and Vincenzo Brescia Morra received personal compensations for speaking or consultancy from Biogen, Teva, Genzyme, Merck, Novartis, Almirall
Marcello Moccia has received salary from Federico II University of Naples, grant from the ECTRIMS-MAGMNISM fellowship program, honoraria and travel support form Almirall, Coloplast, Genzyme, and Merck-Serono.
Dr. Cocozza reports personal fees from Sanofi Genzyme.
Dr Paolicelli has received honoraria for consultancy and/or speaking from Biogen Idec, Merck-Serono, Almirall, Sanofi-Aventis, TEVA, Novartis and Genzyme.
Dr. Lus has received personal compensation for activities with Biogen Idec, Merck Serono, Novartis, Sanofi-Aventis Pharmaceuticals, Teva neuroscience as a consultant and speaker; has received research support from Biogen Idec, Merck Serono, and Novartis.
Dr. Elisabetta Signoriello has received personal compensation for activities with Biogen Idec, Roche, Merck Serono, Novartis as a consultant; has received support for travelling from Biogen Idec, Merck Serono, Novartis, Teva, Roche, Genzyme
Carotenuto Antonio, Teresa costabile, Anna Maria Barbarulo, Marta Simone and Rosa Gemma Viterbo have nothing to disclose.