Contribution of different relapse phenotypes to disability in multiple sclerosis

Tamasine Stewart; Tim Spelman; Eva Havrdova; Dana Horakova; Maria Trojano; Guillermo Izquierdo; Pierre Duquette; Marc Girard; Alexandre Prat; Alessandra Lugaresi; Francois Grand' Maison; Pierre Grammond; Patrizia Sola; Vahid Shaygannejad; Raymond Hupperts; Raed Alroughani; Celia Oreja-Guevara; Eugenio Pucci; Cavit Boz; Jeannette Lechner-Scott; Roberto Bergamaschi; Vincent Van Pesch; Gerardo Iuliano; Cristina Ramo; Bruce Taylor; Mark Slee; Daniele Spitaleri; Franco Granella; Freek Verheul; Pamela McCombe; Suzanne Hodgkinson; Maria Amato; Steve Vucic; Orla Gray; Edgardo Cristiano; Michael Barnett; Jose Menoyo; Erik van Munster; Maria Saladino; Javier Olascoaga; Julie Prevost; Norma Deri; Cameron Shaw; Bhim Singhal; Fraser Moore; Csilla Rozsa; Neil Shuey; Olga Skibina; Ilya Kister; Tatjana Petkovska-Boskova; Radek Ampapa; Allan Kermode; Helmut Butzkueven; Vilija Jokubaitis; Tomas Kalincik

doi:10.1177/1352458516643392

Contribution of different relapse phenotypes to disability in multiple sclerosis

Tamasine Stewart, Tim Spelman, Eva Havrdova, Dana Horakova, Maria Trojano, Guillermo Izquierdo, Pierre Duquette, Marc Girard, Alexandre Prat, Alessandra Lugaresi, Francois Grand' Maison, Pierre Grammond, Patrizia Sola, Vahid Shaygannejad, Raymond Hupperts, Raed Alroughani, Celia Oreja-Guevara, Eugenio Pucci, Cavit Boz, Jeannette Lechner-ScottRoberto Bergamaschi, Vincent Van Pesch, Gerardo Iuliano, Cristina Ramo, Bruce Taylor, Mark Slee, Daniele Spitaleri, Franco Granella, Freek Verheul, Pamela McCombe, Suzanne Hodgkinson, Maria Amato, Steve Vucic, Orla Gray, Edgardo Cristiano, Michael Barnett, Jose Menoyo, Erik van Munster, Maria Saladino, Javier Olascoaga, Julie Prevost, Norma Deri, Cameron Shaw, Bhim Singhal, Fraser Moore, Csilla Rozsa, Neil Shuey, Olga Skibina, Ilya Kister, Tatjana Petkovska-Boskova, Radek Ampapa, Allan Kermode, Helmut Butzkueven, Vilija Jokubaitis, Tomas Kalincik

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Abstract

Objective: This study evaluated the effect of relapse phenotype on disability accumulation in multiple sclerosis. Methods: Analysis of prospectively collected data was conducted in 19,504 patients with relapse-onset multiple sclerosis and minimum 1-year prospective follow-up from the MSBase cohort study. Multivariable linear regression models assessed associations between relapse incidence, phenotype and changes in disability (quantified with Expanded Disability Status Scale and its Functional System scores). Sensitivity analyses were conducted. Results: In 34,858 relapses recorded during 136,462 patient-years (median follow-up 5.9 years), higher relapse incidence was associated with greater disability accumulation (β = 0.16, p < 0.001). Relapses of all phenotypes promoted disability accumulation, with the most pronounced increase associated with pyramidal (β = 0.27 (0.25-0.29)), cerebellar (β = 0.35 (0.30-0.39)) and bowel/bladder (β = 0.42 (0.35-0.49)) phenotypes (mean (95% confidence interval)). Higher incidence of each relapse phenotype was associated with an increase in disability in the corresponding neurological domain, as well as anatomically related domains. Conclusion: Relapses are associated with accumulation of neurological disability. Relapses in pyramidal, cerebellar and bowel/bladder systems have the greatest association with disability change. Therefore, prevention of these relapses is an important objective of disease-modifying therapy. The differential impact of relapse phenotypes on disability outcomes could influence management of treatment failure in multiple sclerosis.

Original language	English
Pages (from-to)	266-276
Number of pages	11
Journal	Multiple Sclerosis
Volume	23
Issue number	2
DOIs	https://doi.org/10.1177/1352458516643392
Publication status	Published - 1 Feb 2017

Keywords

cohort studies
multiple sclerosis
observational study
outcome research
Prognosis
relapse phenotype

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Stewart, T., Spelman, T., Havrdova, E., Horakova, D., Trojano, M., Izquierdo, G., Duquette, P., Girard, M., Prat, A., Lugaresi, A., Grand' Maison, F., Grammond, P., Sola, P., Shaygannejad, V., Hupperts, R., Alroughani, R., Oreja-Guevara, C., Pucci, E., Boz, C., ... Kalincik, T. (2017). Contribution of different relapse phenotypes to disability in multiple sclerosis. Multiple Sclerosis, 23(2), 266-276. https://doi.org/10.1177/1352458516643392

@article{1ceae6b8c30e49acabc08e6ce5508a6b,

title = "Contribution of different relapse phenotypes to disability in multiple sclerosis",

abstract = "Objective: This study evaluated the effect of relapse phenotype on disability accumulation in multiple sclerosis. Methods: Analysis of prospectively collected data was conducted in 19,504 patients with relapse-onset multiple sclerosis and minimum 1-year prospective follow-up from the MSBase cohort study. Multivariable linear regression models assessed associations between relapse incidence, phenotype and changes in disability (quantified with Expanded Disability Status Scale and its Functional System scores). Sensitivity analyses were conducted. Results: In 34,858 relapses recorded during 136,462 patient-years (median follow-up 5.9 years), higher relapse incidence was associated with greater disability accumulation (β = 0.16, p < 0.001). Relapses of all phenotypes promoted disability accumulation, with the most pronounced increase associated with pyramidal (β = 0.27 (0.25-0.29)), cerebellar (β = 0.35 (0.30-0.39)) and bowel/bladder (β = 0.42 (0.35-0.49)) phenotypes (mean (95% confidence interval)). Higher incidence of each relapse phenotype was associated with an increase in disability in the corresponding neurological domain, as well as anatomically related domains. Conclusion: Relapses are associated with accumulation of neurological disability. Relapses in pyramidal, cerebellar and bowel/bladder systems have the greatest association with disability change. Therefore, prevention of these relapses is an important objective of disease-modifying therapy. The differential impact of relapse phenotypes on disability outcomes could influence management of treatment failure in multiple sclerosis.",

keywords = "cohort studies, multiple sclerosis, observational study, outcome research, Prognosis, relapse phenotype",

author = "Tamasine Stewart and Tim Spelman and Eva Havrdova and Dana Horakova and Maria Trojano and Guillermo Izquierdo and Pierre Duquette and Marc Girard and Alexandre Prat and Alessandra Lugaresi and {Grand' Maison}, Francois and Pierre Grammond and Patrizia Sola and Vahid Shaygannejad and Raymond Hupperts and Raed Alroughani and Celia Oreja-Guevara and Eugenio Pucci and Cavit Boz and Jeannette Lechner-Scott and Roberto Bergamaschi and {Van Pesch}, Vincent and Gerardo Iuliano and Cristina Ramo and Bruce Taylor and Mark Slee and Daniele Spitaleri and Franco Granella and Freek Verheul and Pamela McCombe and Suzanne Hodgkinson and Maria Amato and Steve Vucic and Orla Gray and Edgardo Cristiano and Michael Barnett and Jose Menoyo and {van Munster}, Erik and Maria Saladino and Javier Olascoaga and Julie Prevost and Norma Deri and Cameron Shaw and Bhim Singhal and Fraser Moore and Csilla Rozsa and Neil Shuey and Olga Skibina and Ilya Kister and Tatjana Petkovska-Boskova and Radek Ampapa and Allan Kermode and Helmut Butzkueven and Vilija Jokubaitis and Tomas Kalincik",

year = "2017",

month = feb,

day = "1",

doi = "10.1177/1352458516643392",

language = "English",

volume = "23",

pages = "266--276",

journal = "Multiple Sclerosis",

issn = "1352-4585",

publisher = "SAGE Publications Ltd",

number = "2",

}

Stewart, T, Spelman, T, Havrdova, E, Horakova, D, Trojano, M, Izquierdo, G, Duquette, P, Girard, M, Prat, A, Lugaresi, A, Grand' Maison, F, Grammond, P, Sola, P, Shaygannejad, V, Hupperts, R, Alroughani, R, Oreja-Guevara, C, Pucci, E, Boz, C, Lechner-Scott, J, Bergamaschi, R, Van Pesch, V, Iuliano, G, Ramo, C, Taylor, B, Slee, M, Spitaleri, D, Granella, F, Verheul, F, McCombe, P, Hodgkinson, S, Amato, M, Vucic, S, Gray, O, Cristiano, E, Barnett, M, Menoyo, J, van Munster, E, Saladino, M, Olascoaga, J, Prevost, J, Deri, N, Shaw, C, Singhal, B, Moore, F, Rozsa, C, Shuey, N, Skibina, O, Kister, I, Petkovska-Boskova, T, Ampapa, R, Kermode, A, Butzkueven, H, Jokubaitis, V & Kalincik, T 2017, 'Contribution of different relapse phenotypes to disability in multiple sclerosis', Multiple Sclerosis, vol. 23, no. 2, pp. 266-276. https://doi.org/10.1177/1352458516643392

TY - JOUR

T1 - Contribution of different relapse phenotypes to disability in multiple sclerosis

AU - Stewart, Tamasine

AU - Spelman, Tim

AU - Havrdova, Eva

AU - Horakova, Dana

AU - Trojano, Maria

AU - Izquierdo, Guillermo

AU - Duquette, Pierre

AU - Girard, Marc

AU - Prat, Alexandre

AU - Lugaresi, Alessandra

AU - Grand' Maison, Francois

AU - Grammond, Pierre

AU - Sola, Patrizia

AU - Shaygannejad, Vahid

AU - Hupperts, Raymond

AU - Alroughani, Raed

AU - Oreja-Guevara, Celia

AU - Pucci, Eugenio

AU - Boz, Cavit

AU - Lechner-Scott, Jeannette

AU - Bergamaschi, Roberto

AU - Van Pesch, Vincent

AU - Iuliano, Gerardo

AU - Ramo, Cristina

AU - Taylor, Bruce

AU - Slee, Mark

AU - Spitaleri, Daniele

AU - Granella, Franco

AU - Verheul, Freek

AU - McCombe, Pamela

AU - Hodgkinson, Suzanne

AU - Amato, Maria

AU - Vucic, Steve

AU - Gray, Orla

AU - Cristiano, Edgardo

AU - Barnett, Michael

AU - Menoyo, Jose

AU - van Munster, Erik

AU - Saladino, Maria

AU - Olascoaga, Javier

AU - Prevost, Julie

AU - Deri, Norma

AU - Shaw, Cameron

AU - Singhal, Bhim

AU - Moore, Fraser

AU - Rozsa, Csilla

AU - Shuey, Neil

AU - Skibina, Olga

AU - Kister, Ilya

AU - Petkovska-Boskova, Tatjana

AU - Ampapa, Radek

AU - Kermode, Allan

AU - Butzkueven, Helmut

AU - Jokubaitis, Vilija

AU - Kalincik, Tomas

PY - 2017/2/1

Y1 - 2017/2/1

N2 - Objective: This study evaluated the effect of relapse phenotype on disability accumulation in multiple sclerosis. Methods: Analysis of prospectively collected data was conducted in 19,504 patients with relapse-onset multiple sclerosis and minimum 1-year prospective follow-up from the MSBase cohort study. Multivariable linear regression models assessed associations between relapse incidence, phenotype and changes in disability (quantified with Expanded Disability Status Scale and its Functional System scores). Sensitivity analyses were conducted. Results: In 34,858 relapses recorded during 136,462 patient-years (median follow-up 5.9 years), higher relapse incidence was associated with greater disability accumulation (β = 0.16, p < 0.001). Relapses of all phenotypes promoted disability accumulation, with the most pronounced increase associated with pyramidal (β = 0.27 (0.25-0.29)), cerebellar (β = 0.35 (0.30-0.39)) and bowel/bladder (β = 0.42 (0.35-0.49)) phenotypes (mean (95% confidence interval)). Higher incidence of each relapse phenotype was associated with an increase in disability in the corresponding neurological domain, as well as anatomically related domains. Conclusion: Relapses are associated with accumulation of neurological disability. Relapses in pyramidal, cerebellar and bowel/bladder systems have the greatest association with disability change. Therefore, prevention of these relapses is an important objective of disease-modifying therapy. The differential impact of relapse phenotypes on disability outcomes could influence management of treatment failure in multiple sclerosis.

AB - Objective: This study evaluated the effect of relapse phenotype on disability accumulation in multiple sclerosis. Methods: Analysis of prospectively collected data was conducted in 19,504 patients with relapse-onset multiple sclerosis and minimum 1-year prospective follow-up from the MSBase cohort study. Multivariable linear regression models assessed associations between relapse incidence, phenotype and changes in disability (quantified with Expanded Disability Status Scale and its Functional System scores). Sensitivity analyses were conducted. Results: In 34,858 relapses recorded during 136,462 patient-years (median follow-up 5.9 years), higher relapse incidence was associated with greater disability accumulation (β = 0.16, p < 0.001). Relapses of all phenotypes promoted disability accumulation, with the most pronounced increase associated with pyramidal (β = 0.27 (0.25-0.29)), cerebellar (β = 0.35 (0.30-0.39)) and bowel/bladder (β = 0.42 (0.35-0.49)) phenotypes (mean (95% confidence interval)). Higher incidence of each relapse phenotype was associated with an increase in disability in the corresponding neurological domain, as well as anatomically related domains. Conclusion: Relapses are associated with accumulation of neurological disability. Relapses in pyramidal, cerebellar and bowel/bladder systems have the greatest association with disability change. Therefore, prevention of these relapses is an important objective of disease-modifying therapy. The differential impact of relapse phenotypes on disability outcomes could influence management of treatment failure in multiple sclerosis.

KW - cohort studies

KW - multiple sclerosis

KW - observational study

KW - outcome research

KW - Prognosis

KW - relapse phenotype

UR - http://www.scopus.com/inward/record.url?scp=85011879247&partnerID=8YFLogxK

U2 - 10.1177/1352458516643392

DO - 10.1177/1352458516643392

M3 - Article

SN - 1352-4585

VL - 23

SP - 266

EP - 276

JO - Multiple Sclerosis

JF - Multiple Sclerosis

IS - 2

ER -

Contribution of different relapse phenotypes to disability in multiple sclerosis

Abstract

Keywords

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