The long-term outcomes of CIS patients in the Barcelona inception cohort : Looking back to recognize aggressive MS
Tintoré, Mar (Hospital Universitari Vall d'Hebron)
Arrambide, Georgina (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Otero-Romero, Susana (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Carbonell-Mirabent, Pere (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Río, Jordi (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Tur, Carmen (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Comabella, Manuel (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Nos, Carlos (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Arévalo, María Jesús (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Anglada, Elisenda (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Menendez, Rebeca (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Midaglia, Luciana (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Galan, Ingrid (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Vidal-Jordana, Angela (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Castilló, Joaquín (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Mulero, P. (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Zabalza, Ana (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Rodríguez-Acevedo, Breogán (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Rodriguez, Marta (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Espejo, Carmen (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Sequeira, Joao (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Mitjana, Raquel (Hospital Universitari Vall d'Hebron. Institut de Recerca)
de Barros, Andrea (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Pareto, Deborah (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Auger, Cristina (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Pérez-Hoyos, Santiago (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Sastre-Garriga, Jaume (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Rovira, Alex (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Montalban, Xavier (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Universitat Autònoma de Barcelona

Data:	2019
Resum:	To explore the long-term outcomes of patients with clinically isolated syndromes from the Barcelona cohort. We selected patients with a follow-up longer than 10 years to (1) estimate the risks of multiple sclerosis (MS) and disability accumulation according to the baseline number of T2 lesions and to compare treated versus untreated patients and early versus delayed treatment, and (2) to study baseline features of patients with aggressive MS (Expanded Disability Status Scale (EDSS) ⩾6. 0 at 10 years). In all, 401 patients were included (mean follow-up of 14. 4 (standard deviation of 2. 9) years). A higher number of T2 lesions was associated with an earlier MS diagnosis and an earlier risk of irreversible disability. Early treatment was associated with a decreased risk of EDSS of 3. 0: adjusted hazard ratio = 0. 4, 95% confidence interval = (0. 2, 0. 7). Patients with aggressive MS differed in their baseline brain magnetic resonance images: The median (interquartile range) number of T2 lesions and contrast-enhancing lesions (CEL) was 71 (28-95) versus 7 (1-19) and 3 (1-24) versus 0 (0-1), respectively. The cut-offs that better classified patients with aggressive MS were 20 for T2 lesions and 2 for CEL. Although MS natural history is changing, a high lesion load at onset is helpful to identify patients at risk of presenting an aggressive MS.
Ajuts:	Instituto de Salud Carlos III PI15-00170 Instituto de Salud Carlos III PI14-01439
Nota:	Altres ajuts: This study has been funded by European Regional Development Fund and co-funded by Instituto Carlos III. It has also received support by a grant from Genzyme foundation (GENZYME-2015-01) granted to M.T. and from the 'Red Española de Esclerosis Múltiple (REEM)', which is sponsored by FIS, the Instituto de Salud Carlos III, the Ministry of Economy and Competitiveness in Spain, and the 'Ajuts per donar Suport als Grups de Recerca de Catalunya', which is sponsored by the 'Agència de Gestió d'Ajuts Universitaris i de Recerca' (AGAUR) of the Generalitat de Catalunya in Spain.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Clinically isolated syndromes ; Multiple sclerosis ; MRI ; Prognosis ; Disease-modifying treatment ; Prediction
Publicat a:	Multiple sclerosis, Vol. 26 (october 2019) , p. 1658-1669, ISSN 1477-0970

DOI: 10.1177/1352458519877810
PMID: 31610739

12 p, 2.1 MB

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