Contributions
Abstract: EP1349
Type: Poster Sessions
Abstract Category: Clinical aspects of MS - Epidemiology
Background: Multiple Sclerosis (MS) is the most common autoimmune disorder of the central nervous system (CNS) and a leading cause of neurologic disability in young adults. In view of the negative impact of treatment delay on disease progression and the increasing complexity of therapeutic options, it is strongly advocated that patients with suspected MS are referred to highly specialized centers.
Aims: to describe the clinico-demographic characteristic of patients referred to the MS center at Columbia University Medical Center, and explore current therapeutic strategies in a highly specialized setting.
Methods: Diagnostic codes and clinico-demographic information for patients seen at our MS center from 2012 to 2018 were collected through automatic data capture from electronic medical records and descriptive statistics were obtained.
Results: 2110 patients were referred to an MS specialist for a suspected CNS inflammatory disorder. Of these 53% eventually received a MS diagnosis and 13.4% were diagnosed with other CNS immunological disorders: 3.6% transverse myelitis, 2.6% optic neuritis, 2.2% neuromyelitis optica, 1.2% acute disseminated encephalomyelitis or viral/post-viral disorders and 3.8% unspecified demyelinating diseases. 1.3% of subjects consulting an MS neurologist had an abnormal brain scan without any clinical symptom. Among MS patients currently followed at our MS center, 2.4% had only one clinical episode consistent with a clinically isolated syndrome (CIS), 80.3% have a relapsing remitting (RR) course, while the remaining have either primary (6.3%) or secondary (11%) progressive disease. As expected, the majority of patients are female (F:M ratio 2.97) with mean age at diagnosis of 36.7 years and mean disease duration of 8.4 years; 11.3% of patients also report other autoimmune disorders. Among treated patients, 31.3% were prescribed a first line injectable therapy (12.1% interferon and 19.2% glatiramer acetate) and 41.4% an oral medication (25.5% dimethyl fumarate and 3.9% teriflunomide and 12% fingolimod). The remaining patients are treated with monoclonal antibodies (11.6% natalizumab, 9.3% monoclonal antibodies anti-CD20, anti-CD52, anti-CD25) or treated off- label with immunosuppressants (6.4%).
Conclusions: Referral of suspected MS cases to a highly specialized center is recommended to rule out alternative diagnoses and establish the most appropriate treatment, including highly effective drugs for which close monitoring is required.
Disclosure: Dr Claire Riley reports advisory or consulting work for Biogen Idec, Celgene, Genentech, Genzyme, Teva Neuroscience. Dr Laura Ferrè, Dr Rebecca Farber, Ms Libby Levine, Dr Claudiu Diaconu have nothing to disclose. Dr Wendy Vargas served as a consultant for Alexion Pharmaceuticals, advisory board for Teva Pharmaceuticals and have received grant funding from Teva Pharmaceuticals and the NMSS. Dr Philip De Jager served as a member of advisory board for Celgene, Roche, Sanofi/Genzyme, received grant funding from Eisai, Roche, Biogen, Lundbeck and speaker honorarium from GlaxoSmithKline.
Abstract: EP1349
Type: Poster Sessions
Abstract Category: Clinical aspects of MS - Epidemiology
Background: Multiple Sclerosis (MS) is the most common autoimmune disorder of the central nervous system (CNS) and a leading cause of neurologic disability in young adults. In view of the negative impact of treatment delay on disease progression and the increasing complexity of therapeutic options, it is strongly advocated that patients with suspected MS are referred to highly specialized centers.
Aims: to describe the clinico-demographic characteristic of patients referred to the MS center at Columbia University Medical Center, and explore current therapeutic strategies in a highly specialized setting.
Methods: Diagnostic codes and clinico-demographic information for patients seen at our MS center from 2012 to 2018 were collected through automatic data capture from electronic medical records and descriptive statistics were obtained.
Results: 2110 patients were referred to an MS specialist for a suspected CNS inflammatory disorder. Of these 53% eventually received a MS diagnosis and 13.4% were diagnosed with other CNS immunological disorders: 3.6% transverse myelitis, 2.6% optic neuritis, 2.2% neuromyelitis optica, 1.2% acute disseminated encephalomyelitis or viral/post-viral disorders and 3.8% unspecified demyelinating diseases. 1.3% of subjects consulting an MS neurologist had an abnormal brain scan without any clinical symptom. Among MS patients currently followed at our MS center, 2.4% had only one clinical episode consistent with a clinically isolated syndrome (CIS), 80.3% have a relapsing remitting (RR) course, while the remaining have either primary (6.3%) or secondary (11%) progressive disease. As expected, the majority of patients are female (F:M ratio 2.97) with mean age at diagnosis of 36.7 years and mean disease duration of 8.4 years; 11.3% of patients also report other autoimmune disorders. Among treated patients, 31.3% were prescribed a first line injectable therapy (12.1% interferon and 19.2% glatiramer acetate) and 41.4% an oral medication (25.5% dimethyl fumarate and 3.9% teriflunomide and 12% fingolimod). The remaining patients are treated with monoclonal antibodies (11.6% natalizumab, 9.3% monoclonal antibodies anti-CD20, anti-CD52, anti-CD25) or treated off- label with immunosuppressants (6.4%).
Conclusions: Referral of suspected MS cases to a highly specialized center is recommended to rule out alternative diagnoses and establish the most appropriate treatment, including highly effective drugs for which close monitoring is required.
Disclosure: Dr Claire Riley reports advisory or consulting work for Biogen Idec, Celgene, Genentech, Genzyme, Teva Neuroscience. Dr Laura Ferrè, Dr Rebecca Farber, Ms Libby Levine, Dr Claudiu Diaconu have nothing to disclose. Dr Wendy Vargas served as a consultant for Alexion Pharmaceuticals, advisory board for Teva Pharmaceuticals and have received grant funding from Teva Pharmaceuticals and the NMSS. Dr Philip De Jager served as a member of advisory board for Celgene, Roche, Sanofi/Genzyme, received grant funding from Eisai, Roche, Biogen, Lundbeck and speaker honorarium from GlaxoSmithKline.