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Short-term disability progression in two multiethnic multiple sclerosis centers in the treatment era

BACKGROUND: Short-term disease progression is well documented in clinical trials, but there are limited published data on disease course in real-life practice. METHODS: Patient-derived Multiple Sclerosis Severity Score (PMSSS), a disease severity rank score, was computed at each visit for consecutiv...

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Autores principales: Kister, Ilya, Bacon, Tamar E., Cutter, Gary R.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6134488/
https://www.ncbi.nlm.nih.gov/pubmed/30214486
http://dx.doi.org/10.1177/1756286418793613
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author Kister, Ilya
Bacon, Tamar E.
Cutter, Gary R.
author_facet Kister, Ilya
Bacon, Tamar E.
Cutter, Gary R.
author_sort Kister, Ilya
collection PubMed
description BACKGROUND: Short-term disease progression is well documented in clinical trials, but there are limited published data on disease course in real-life practice. METHODS: Patient-derived Multiple Sclerosis Severity Score (PMSSS), a disease severity rank score, was computed at each visit for consecutive MS patients attending two large, ethnically diverse MS centers in New York metropolitan area. Disability was assessed via Patient-Determined Disease Steps (PDDS). Clinicians recorded disease subtype and relapse status at each visit, but did not rate disability. PMSSS change from the first to the last visit was calculated for the cohort as a whole and for subgroups of interest. Multivariable regression models were constructed for predicting final PMSSS based on readily available predictor variables collected at the initial visit and relapse history during follow up. RESULTS: A total of 1740 consecutive patients from New York University (n = 1079) and Barnabas (n = 661) MS Care Centers were included. During follow up (mean 2.4 ± 0.82 years, range 1–4 years), mean PDDS score increased from 1.9 ± 2.2 to 2.3 ± 2.2 (p < 0.0001), while PMSSS remained roughly unchanged (initial PMSSS = 3.71 ± 2.73, last PMSSS = 3.81 ± 2.76, paired t test, p = 0.28). The only major predictor of final PMSSS was the initial PMSSS. Demographic variables (age, sex, race) or relapse status did not predict final severity score. CONCLUSIONS: Baseline disability in two MS clinics was much lower than in the reference population from which PMSSS was derived. We observed no discernable slowing of disability accumulation during the short-term follow up in our cohort compared with the reference cohort. Overwhelmingly the most important predictor of final disease severity rank score was the initial disease severity rank score.
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spelling pubmed-61344882018-09-13 Short-term disability progression in two multiethnic multiple sclerosis centers in the treatment era Kister, Ilya Bacon, Tamar E. Cutter, Gary R. Ther Adv Neurol Disord Original Research BACKGROUND: Short-term disease progression is well documented in clinical trials, but there are limited published data on disease course in real-life practice. METHODS: Patient-derived Multiple Sclerosis Severity Score (PMSSS), a disease severity rank score, was computed at each visit for consecutive MS patients attending two large, ethnically diverse MS centers in New York metropolitan area. Disability was assessed via Patient-Determined Disease Steps (PDDS). Clinicians recorded disease subtype and relapse status at each visit, but did not rate disability. PMSSS change from the first to the last visit was calculated for the cohort as a whole and for subgroups of interest. Multivariable regression models were constructed for predicting final PMSSS based on readily available predictor variables collected at the initial visit and relapse history during follow up. RESULTS: A total of 1740 consecutive patients from New York University (n = 1079) and Barnabas (n = 661) MS Care Centers were included. During follow up (mean 2.4 ± 0.82 years, range 1–4 years), mean PDDS score increased from 1.9 ± 2.2 to 2.3 ± 2.2 (p < 0.0001), while PMSSS remained roughly unchanged (initial PMSSS = 3.71 ± 2.73, last PMSSS = 3.81 ± 2.76, paired t test, p = 0.28). The only major predictor of final PMSSS was the initial PMSSS. Demographic variables (age, sex, race) or relapse status did not predict final severity score. CONCLUSIONS: Baseline disability in two MS clinics was much lower than in the reference population from which PMSSS was derived. We observed no discernable slowing of disability accumulation during the short-term follow up in our cohort compared with the reference cohort. Overwhelmingly the most important predictor of final disease severity rank score was the initial disease severity rank score. SAGE Publications 2018-09-11 /pmc/articles/PMC6134488/ /pubmed/30214486 http://dx.doi.org/10.1177/1756286418793613 Text en © The Author(s), 2018 http://www.creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Original Research
Kister, Ilya
Bacon, Tamar E.
Cutter, Gary R.
Short-term disability progression in two multiethnic multiple sclerosis centers in the treatment era
title Short-term disability progression in two multiethnic multiple sclerosis centers in the treatment era
title_full Short-term disability progression in two multiethnic multiple sclerosis centers in the treatment era
title_fullStr Short-term disability progression in two multiethnic multiple sclerosis centers in the treatment era
title_full_unstemmed Short-term disability progression in two multiethnic multiple sclerosis centers in the treatment era
title_short Short-term disability progression in two multiethnic multiple sclerosis centers in the treatment era
title_sort short-term disability progression in two multiethnic multiple sclerosis centers in the treatment era
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6134488/
https://www.ncbi.nlm.nih.gov/pubmed/30214486
http://dx.doi.org/10.1177/1756286418793613
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