P002 - Clinical predictors of disease progression in multiple sclerosis patients with relapsing onset in a Nation-Wide Cohort

Abstract

Background Prognosis of multiple sclerosis (MS) is variable. Predicting the progression of disability over time is challengeable despite the florid clinical and paraclinical data provided. Objective We aimed to assess whether baseline clinical variables of MS patients would predict the conversion to progressive phase of the disease. Method Utilizing the national MS registry, patients who had relapsing onsets and had confirmed EDSS score at baseline and follow-up visits were included. Primary progressive MS and CIS patients were excluded. Clinical variables (gender, age at onset, disease duration, number of relapses, and EDSS score) were collected. The end point was conversion to secondary progressive MS or reaching the stage of sustained irreversible neurological disability (EDSS 4). Chi square and multivariable logistic regression were used to determine the influence of clinical variables on disease progression. Results Data of 803 MS patients with relapsing onset were analyzed. Mean age at onset and mean disease duration were 26.62 and 8.12 years respectively. Eighty five (10.6%) patients reached the end point at last follow-up visit; 43.5% of whom were men. The risk of disease progression was significantly higher in men (adjusted odds ratio (aOR)=2.02; 95% confidence interval (CI): 1.16–4.16; P =0.015), in patients who developed MS? 40 years of age (aOR=4.36; 95% CI: 1.35–14.09; P =0.041) and who had? 3 relapses during their disease course ( P P =0.06) while optic neuritis at onset was associated with lower risk of progression (aOR=0.30, 95% CI: 0.10–0.87; P =0.03). Conclusion Men and patients who presented at age 40 years or beyond had increased risk of MS progression. Spinal cord symptoms at onset and 3 or more relapses were predictive of progression.