Preditores de falha terapêutica na esclerose múltipla: experiência de um centro brasileiro

Abstract

Objective: To trace the profile of patients with MS who experienced TF and, subsequently, identify TF predictors. Methods: The medical records of 289 patients were reviewed retrospectively and longitudinally. The patients were divided into two groups (target population [1st group, TF ≥ 1, n = 46] and the control [2nd group, without TF, n = 46]); the groups were compared. Results: There were significant differences between the groups in terms of diagnosis, pulse therapy/1st relapse, number of drugs administered, severity of initial symptoms, disability sequelae, imaging characteristics, number of relapses in the first two years of MS, and annual relapse rate. The 1st group has an increased chance of 18.5% of developing a worse prognosis (EDSS > 4.0). The worst prognoses were associated with male sex and a diagnosis age of ≥ 30 years. Conclusion: Compared to the controls, 46 patients in the target population had at least one TF (16.6%), with an increased risk (2x) of secondary progressive multiple sclerosis, depression, and increased disability (2x). The initial features of the disease, as well as the annual relapse rate, can be an early indicator of TF.