Contributions
Abstract: EP1357
Type: Poster Sessions
Abstract Category: Clinical aspects of MS - Epidemiology
Background and aims: Consistent amounts of studies support the role of Vitamin D (vitD) in multiple sclerosis (MS) pathogenesis. Few however, investigated if vitamin D supplementation is able to modify MS disease course.
Our aim was to investigate the relationship between time of beginning of vitD supplementation and prognosis.
Objective: To investigate by mean of a cohort study, the relationship between time of initiation of vitamine D supplementation and MS short term prognosis.
Methods: We included consecutive MS patients who started vitD treatment, determining vitD blood levels before treatment initiation. We considered two groups according to the time of treatment initiation: within the first three years from disease onset or later. We considered the following variables: age at MS onset, age at baseline, relapse rate, new MRI gadolinium enhancing lesions and T2/FLAIR lesions, EDSS at the end of follow-up (September 1st 2017), type of disease modifying therapy initiated, baseline values of hydroxy-vitamins D. We used t test, Chi square analyses Kaplan-Meyer estimates to compare means or frequencies distribution between groups according to quartiles of vitD at baseline. We used Cox proportional analyses to calculate the effects of time to initiation of vitamin D on disease activity and progression.
Results: We included 231 MS patients. Patients starting vitamine D within the first three years from onset had a significantly lower mean EDSS score at the end of follow-up and a lower risk to reach an EDSS score of 3.5 (HR 0.86; CI 0.75-1.00; p= 0.05). Trends were similar dividing patients according to quartiles of vitamine D distribution at baseline. Patients had a lower probability to develop new MRI lesions when they started vitD earlier (p= 0.01) but we did not find a significant relationship with the probability to have Gad+ MRI scans at follow-up.
Conclusions: Our study suggests that a time window opportunity should be considered also for vitD supplementation in MS patients. If confirmed, these results would add relevant information about the time and use of vitD among MS patients.
Disclosure: Paolo Ragonese has served on advisory boards for Biogen, Roche, TEVA, Sanophy-Genzyme, Merck, and Novartis and has received travel grants and/or speaker honoraria from Merck Serono, Teva, Biogen, Sanofi, Genzyme and Novartis.
Sabrina Realmuto received travel grants from Biogen, and Novartis,
Alessia Bianchi received travel grants from Teva, Biogen, Sanofi, Genzyme and Novartis.
Erika Portera, Giulia Vazzoler, Concetta Scazzone, Marcello Ciaccio, and Giovanni Savettieri: have nothing to disclose.
Giuseppe Salemi has served on advisory boards for Biogen, Roche, TEVA, Sanophy-Genzyme, and Novartis and has received travel grants and/or speaker honoraria from Teva, Biogen, Sanofi, Genzyme and Novartis.
Abstract: EP1357
Type: Poster Sessions
Abstract Category: Clinical aspects of MS - Epidemiology
Background and aims: Consistent amounts of studies support the role of Vitamin D (vitD) in multiple sclerosis (MS) pathogenesis. Few however, investigated if vitamin D supplementation is able to modify MS disease course.
Our aim was to investigate the relationship between time of beginning of vitD supplementation and prognosis.
Objective: To investigate by mean of a cohort study, the relationship between time of initiation of vitamine D supplementation and MS short term prognosis.
Methods: We included consecutive MS patients who started vitD treatment, determining vitD blood levels before treatment initiation. We considered two groups according to the time of treatment initiation: within the first three years from disease onset or later. We considered the following variables: age at MS onset, age at baseline, relapse rate, new MRI gadolinium enhancing lesions and T2/FLAIR lesions, EDSS at the end of follow-up (September 1st 2017), type of disease modifying therapy initiated, baseline values of hydroxy-vitamins D. We used t test, Chi square analyses Kaplan-Meyer estimates to compare means or frequencies distribution between groups according to quartiles of vitD at baseline. We used Cox proportional analyses to calculate the effects of time to initiation of vitamin D on disease activity and progression.
Results: We included 231 MS patients. Patients starting vitamine D within the first three years from onset had a significantly lower mean EDSS score at the end of follow-up and a lower risk to reach an EDSS score of 3.5 (HR 0.86; CI 0.75-1.00; p= 0.05). Trends were similar dividing patients according to quartiles of vitamine D distribution at baseline. Patients had a lower probability to develop new MRI lesions when they started vitD earlier (p= 0.01) but we did not find a significant relationship with the probability to have Gad+ MRI scans at follow-up.
Conclusions: Our study suggests that a time window opportunity should be considered also for vitD supplementation in MS patients. If confirmed, these results would add relevant information about the time and use of vitD among MS patients.
Disclosure: Paolo Ragonese has served on advisory boards for Biogen, Roche, TEVA, Sanophy-Genzyme, Merck, and Novartis and has received travel grants and/or speaker honoraria from Merck Serono, Teva, Biogen, Sanofi, Genzyme and Novartis.
Sabrina Realmuto received travel grants from Biogen, and Novartis,
Alessia Bianchi received travel grants from Teva, Biogen, Sanofi, Genzyme and Novartis.
Erika Portera, Giulia Vazzoler, Concetta Scazzone, Marcello Ciaccio, and Giovanni Savettieri: have nothing to disclose.
Giuseppe Salemi has served on advisory boards for Biogen, Roche, TEVA, Sanophy-Genzyme, and Novartis and has received travel grants and/or speaker honoraria from Teva, Biogen, Sanofi, Genzyme and Novartis.