Correlates and trajectories of relapses in relapsing-remitting multiple sclerosis.

Autor: Young CA; Walton Centre NHS Foundation Trust, Lower Lane, Fazakerley, Liverpool L9 7LJ, UK, University of Liverpool, Liverpool, UK. Cayoung@liverpool.ac.uk., Rog DJ; Manchester Centre for Clinical Neurosciences, Northern Care Alliance NHS Foundation Trust, Salford, UK., Sharrack B; Academic Department of Neurology, University of Sheffield, Sheffield, UK., Tanasescu R; University of Nottingham, Nottingham, UK., Kalra S; University Hospital of North Midlands NHS Trust, Stoke-On-Trent, UK., Harrower T; University of Exeter Medical School, Exeter, UK., Tennant A; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK., Mills RJ; Walton Centre NHS Foundation Trust, Lower Lane, Fazakerley, Liverpool L9 7LJ, UK, University of Liverpool, Liverpool, UK.
Jazyk: angličtina
Zdroj: Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology [Neurol Sci] 2024 May; Vol. 45 (5), pp. 2181-2189. Date of Electronic Publication: 2023 Nov 17.
DOI: 10.1007/s10072-023-07155-3
Abstrakt: Background and Aims: In people with relapsing-remitting multiple sclerosis (pwRRMS), data from studies on non-pharmacological factors which may influence relapse risk, other than age, are inconsistent. There is a reduced risk of relapses with increasing age, but little is known about other trajectories in real-world MS care.
Methods: We studied longitudinal questionnaire data from 3885 pwRRMS, covering smoking, comorbidities, disease-modifying therapy (DMT), and patient-reported outcome measures, as well as relapses during the past year. We undertook Rasch analysis, group-based trajectory modelling, and multilevel negative binomial regression.
Results: The regression cohort of 6285 data sets from pwRRMS over time showed that being a current smoker was associated with 43.9% greater relapse risk; having 3 or more comorbidities increased risk and increasing age reduced risk. Those diagnosed within the last 2 years showed two distinct trajectories, both reducing in relapse frequency but 25.8% started with a higher rate and took 4 years to reduce to the rate of the second group. In the cohort with at least three data points completed, there were three groups: 73.7% followed a low stable relapse rate, 21.6% started from a higher rate and decreased, and 4.7% had an increasing then decreasing pattern. These different trajectory groups showed significant differences in fatigue, neuropathic pain, disability, health status, quality of life, self-efficacy, and DMT use.
Conclusions: These results provide additional evidence for supporting pwRRMS to stop smoking and underline the importance of timely DMT decisions and treatment initiation soon after diagnosis with RRMS.
(© 2023. The Author(s).)
Databáze: MEDLINE
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