Correlates and trajectories of relapses in relapsing-remitting multiple sclerosis
Correlates and trajectories of relapses in relapsing-remitting multiple sclerosis
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.
Multiple sclerosis, Patient-reported outcome measure, Rasch, Relapse, Trajectories of Outcome in Neurological Conditions-MS
2181-2189
Young, Carolyn A.
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Rog, David J.
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Sharrack, Basil
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Tanasescu, Radu
afec4f25-18ce-4d75-a5e8-1e2a72424e64
Kalra, Seema
c44d33fc-96ba-406b-a99d-24b049529879
Harrower, Timothy
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Tennant, Alan
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Mills, Roger J.
f3b4e69f-c21b-4cd3-9e5a-e4c3b92bad6c
Kipps, Chris
e43be016-2dc2-45e6-9a02-ab2a0e0208d5
Trajectories of Outcome in Neurological Conditions-MS Study Group
May 2024
Young, Carolyn A.
64aa8c02-fe71-4522-9ec6-f8d3ecd62c33
Rog, David J.
5d3277ad-873b-4473-8a20-b1060d1ac365
Sharrack, Basil
fac78735-95ce-434c-8d17-4a95af166bee
Tanasescu, Radu
afec4f25-18ce-4d75-a5e8-1e2a72424e64
Kalra, Seema
c44d33fc-96ba-406b-a99d-24b049529879
Harrower, Timothy
622aef99-ac5d-4ec5-8c02-03a78cbaebcb
Tennant, Alan
d51e5c93-5f17-48c4-a3f3-eeffc63bac06
Mills, Roger J.
f3b4e69f-c21b-4cd3-9e5a-e4c3b92bad6c
Kipps, Chris
e43be016-2dc2-45e6-9a02-ab2a0e0208d5
Young, Carolyn A., Rog, David J., Sharrack, Basil, Tanasescu, Radu, Kalra, Seema, Harrower, Timothy, Tennant, Alan and Mills, Roger J.
,
Trajectories of Outcome in Neurological Conditions-MS Study Group
(2024)
Correlates and trajectories of relapses in relapsing-remitting multiple sclerosis.
Neurological Sciences, 45 (5), .
(doi:10.1007/s10072-023-07155-3).
Abstract
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.
Text
s10072-023-07155-3
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More information
Accepted/In Press date: 21 October 2023
e-pub ahead of print date: 17 November 2023
Published date: May 2024
Additional Information:
© 2023. The Author(s).
Keywords:
Multiple sclerosis, Patient-reported outcome measure, Rasch, Relapse, Trajectories of Outcome in Neurological Conditions-MS
Identifiers
Local EPrints ID: 490304
URI: http://eprints.soton.ac.uk/id/eprint/490304
ISSN: 1590-1874
PURE UUID: 391141d3-c71c-4fab-96f7-5b3ccd818230
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Date deposited: 23 May 2024 16:41
Last modified: 24 May 2024 01:55
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Contributors
Author:
Carolyn A. Young
Author:
David J. Rog
Author:
Basil Sharrack
Author:
Radu Tanasescu
Author:
Seema Kalra
Author:
Timothy Harrower
Author:
Alan Tennant
Author:
Roger J. Mills
Author:
Chris Kipps
Corporate Author: Trajectories of Outcome in Neurological Conditions-MS Study Group
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