Effect of Vascular Comorbidity on Visual and Disability Outcomes in a Secondary Progressive Multiple Sclerosis Clinical Trial Cohort.

Autor:	Shangraw K; Department of Neurology, Oregon Health & Science University, Portland, OR, USA (KS, ES, RIS)., Murchison CF; Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL, USA (CFM)., Silbermann E; Department of Neurology, Oregon Health & Science University, Portland, OR, USA (KS, ES, RIS)., Spain RI; Department of Neurology, Veterans Affairs Portland Health Care System, Portland, OR, USA (RIS).
Jazyk:	angličtina
Zdroj:	International journal of MS care [Int J MS Care] 2022 Jul-Aug; Vol. 24 (4), pp. 169-174. Date of Electronic Publication: 2022 Apr 18.
DOI:	10.7224/1537-2073.2021-049
Abstrakt:	Background: Vascular comorbidity (VC) is associated with multiple sclerosis (MS) disease progression and visual dysfunction. The longitudinal effect of VC in people with secondary progressive MS (SPMS) is unclear. This study explored the impact of VC on standard clinical, MRI, and visual outcomes in people with SPMS enrolled in a clinical trial. Methods: Data were extracted from a 2-year randomized controlled trial (N = 51) testing the supplement lipoic acid in people with SPMS who underwent annual Expanded Disability Status Scales, Timed 25-Foot Walk tests, MRIs, visual acuity testing, and retinal nerve fiber layer (RNFL) and ganglion cell/inner plexiform layer (GCIPL) thicknesses per optical coherence tomography (OCT). Post hoc linear mixed-effects regression analysis compared baseline and annualized outcomes between participants without VC (VC-) and with 1 or more VCs (VC+) (hypertension, dyslipidemia, obesity, diabetes, peripheral or cardiovascular disease, tobacco use). Results: The VC- (n = 19) and VC+ (n = 28) participants were similar in age, sex, and MS disease duration and had comparable MS disability, mobility, and brain atrophy at baseline and throughout the 2-year parent study. The VC+ participants had worse baseline visual acuity than those in the VC- group by 0.13 logMAR ( P = .041). No significant differences were detected in RNFL or GCIPL baseline thickness or atrophy between groups. Conclusions: In an SPMS cohort, VC had an inconsistent effect on standard clinical, MRI, and exploratory OCT outcomes, suggesting that the effect of VC may not be evident in smaller cohort studies. Using a more refined definition of VC in future, adequately powered investigations may help effectively elucidate and account for the interaction between vascular risk burden and MS disability. Competing Interests: FINANCIAL DISCLOSURES: The authors declare no conflicts of interest. (© 2022 Consortium of Multiple Sclerosis Centers.)
Databáze:	MEDLINE
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