Contributions
Abstract: P873
Type: Poster
Abstract Category: Clinical aspects of MS - 4 Natural course
Background: Natural history studies from the pretreatment era indicate that 30-50% of patients with MS experience significant levels of disability within 15 years of disease onset [1,2]. Median times from MS onset to Disability Status Score of 4, 6, and 7 were 11.4, 23.1, and 33.1 years, respectively [1]. The recently published EPIC study challenged this view suggesting that rates of clinical worsening nowadays are lower when compared to earlier natural history studies [3]. MS PATHS (Multiple Sclerosis Partners Advancing Technology and Health Solutions), a collaborative effort in the United States and Europe, is establishing a patient cohort of 10,000 or more patients.
Objectives: To characterize the level of clinical disability in relation to disease duration in the MS PATHS cohort and to compare this observation with published data.
Methods: All patients at participating healthcare institutions are offered entry into MS PATHS. Opt-in rate to date exceeds 90%. Clinical history was obtained by standardized questionnaires and clinical assessment was performed using the Multiple Sclerosis Performance Test, a validated iPad-based clinical assessment device.
Results: The sample comprised 1353 patients. The mean (SD) age was 48.9 (12.0), mean (SD) disease duration was 12.2 years (9.4), 72% were female and 85% were white; 70.3% had a relapsing form. After 15 years of disease duration (n=243), 28.8% reported a disability score of 4 or higher, 17.7% a score of 5 or higher, 10.7% a score of 6 or higher, and 4.1% a score of 7 or higher. After 21+ years of disease duration (n=229), 45.4% reported a disability score of 4 or higher, 31.0% a score of 5 or higher, 22.7% a score of 6 or higher, and 11.4% a score of 7 or higher. Patients with progressive MS presented higher disability scores. A total of 73.9% of all patients were currently being treated with a disease modifying therapy (DMT). More recent and comprehensive data of a larger cohort will be presented.
Conclusions: Our data document lower rates of severity compared with historical populations. Because of the high opt-in rate, the sample is presumed representative of MS patients attending MS PATHS institutions. Multiple factors (more sensitive diagnostic criteria, treatment with DMTs) might account, at least in part, for lower rates of disability progression in MS patients today as seen in the MS PATHS cohort.
References:
1. Confavreux et al, NEJM 2000
2. Tremlett et al, Neurology 2006
3. Cree et al, Ann Neurol 2016
Disclosure: Project funded by Biogen, Inc.
Author Disclosures:
Robert Naismith has received consulting fees and/or honoraria from Acorda, Alkermes, Bayer, Biogen, EMD Serono, Genentech, Genzyme, Novartis and Teva.
Megan Hyland is employed by the University of Rochester which receives funding from Biogen, Chugai and Novartis.
Himanshu Pandya, James R. Williams, Richard Rudick, Carl de Moor and Bernd C. Kieseier are employees of, and stockholders in, Biogen.
Tjalf Ziemssen has received speaker honoraria and travel expenses for scientific meetings and has been a steering committee member of clinical trials or participated in advisory boards for clinical trials for Almirall, Bayer Schering Pharma, Biogen Idec, EMD Merck Serono, Genentech, Genzyme, Novartis, Sanofi-Aventis and Teva Pharmaceuticals.
Abstract: P873
Type: Poster
Abstract Category: Clinical aspects of MS - 4 Natural course
Background: Natural history studies from the pretreatment era indicate that 30-50% of patients with MS experience significant levels of disability within 15 years of disease onset [1,2]. Median times from MS onset to Disability Status Score of 4, 6, and 7 were 11.4, 23.1, and 33.1 years, respectively [1]. The recently published EPIC study challenged this view suggesting that rates of clinical worsening nowadays are lower when compared to earlier natural history studies [3]. MS PATHS (Multiple Sclerosis Partners Advancing Technology and Health Solutions), a collaborative effort in the United States and Europe, is establishing a patient cohort of 10,000 or more patients.
Objectives: To characterize the level of clinical disability in relation to disease duration in the MS PATHS cohort and to compare this observation with published data.
Methods: All patients at participating healthcare institutions are offered entry into MS PATHS. Opt-in rate to date exceeds 90%. Clinical history was obtained by standardized questionnaires and clinical assessment was performed using the Multiple Sclerosis Performance Test, a validated iPad-based clinical assessment device.
Results: The sample comprised 1353 patients. The mean (SD) age was 48.9 (12.0), mean (SD) disease duration was 12.2 years (9.4), 72% were female and 85% were white; 70.3% had a relapsing form. After 15 years of disease duration (n=243), 28.8% reported a disability score of 4 or higher, 17.7% a score of 5 or higher, 10.7% a score of 6 or higher, and 4.1% a score of 7 or higher. After 21+ years of disease duration (n=229), 45.4% reported a disability score of 4 or higher, 31.0% a score of 5 or higher, 22.7% a score of 6 or higher, and 11.4% a score of 7 or higher. Patients with progressive MS presented higher disability scores. A total of 73.9% of all patients were currently being treated with a disease modifying therapy (DMT). More recent and comprehensive data of a larger cohort will be presented.
Conclusions: Our data document lower rates of severity compared with historical populations. Because of the high opt-in rate, the sample is presumed representative of MS patients attending MS PATHS institutions. Multiple factors (more sensitive diagnostic criteria, treatment with DMTs) might account, at least in part, for lower rates of disability progression in MS patients today as seen in the MS PATHS cohort.
References:
1. Confavreux et al, NEJM 2000
2. Tremlett et al, Neurology 2006
3. Cree et al, Ann Neurol 2016
Disclosure: Project funded by Biogen, Inc.
Author Disclosures:
Robert Naismith has received consulting fees and/or honoraria from Acorda, Alkermes, Bayer, Biogen, EMD Serono, Genentech, Genzyme, Novartis and Teva.
Megan Hyland is employed by the University of Rochester which receives funding from Biogen, Chugai and Novartis.
Himanshu Pandya, James R. Williams, Richard Rudick, Carl de Moor and Bernd C. Kieseier are employees of, and stockholders in, Biogen.
Tjalf Ziemssen has received speaker honoraria and travel expenses for scientific meetings and has been a steering committee member of clinical trials or participated in advisory boards for clinical trials for Almirall, Bayer Schering Pharma, Biogen Idec, EMD Merck Serono, Genentech, Genzyme, Novartis, Sanofi-Aventis and Teva Pharmaceuticals.