Ferreira Vasconcelos Claudia Cristina, Cruz Dos Santos Gutemberg Augusto, Thuler Luiz Claudio, Camargo Solange Maria, Papais Alvarenga Regina Maria
Departamento de Neurologia, Hospital Universitário Gaffrée e Guinle, Rua Mariz e Barros 775, 2° andar, Maracanã-Tijuca, 20270-004 Rio de Janeiro, RJ, Brazil.
ISRN Neurol. 2012;2012:410629. doi: 10.5402/2012/410629. Epub 2012 Nov 25.
Background. Studies on the clinical course of multiple sclerosis have indicated that certain initial clinical factors are predictive of disease progression. Regions with a low prevalence for disease, which have environmental and genetic factors that differ from areas of high prevalence, lack studies on the progressive course and disabling characteristics of the disease. Objective. To analyse the long-term evolution to the progressive phase of the relapsing-remitting multiple sclerosis and its prognosis factors in mixed population. Methods. We performed a survival study and logistic regression to examine the influence of demographic and initial clinical factors on disease progression. Among 553 relapsing-remitting patients assisted at a Brazilian reference centre for multiple sclerosis, we reviewed the medical records of 150 patients who had a disease for ten or more years. Results. African ancestry was a factor that conferred more risk for secondary progression followed by age at the onset of the disease and the number of relapses in the year after diagnosis. A greater understanding of the influence of ancestry on prognosis serves to stimulate genetics and pharmacogenomics research and may clarify the poorly understood neurodegenerative progression of MS.
背景。对多发性硬化症临床病程的研究表明，某些初始临床因素可预测疾病进展。疾病患病率较低的地区，其环境和遗传因素与高患病率地区不同，缺乏对该疾病进展过程和致残特征的研究。目的。分析复发缓解型多发性硬化症进展期的长期演变及其在混合人群中的预后因素。方法。我们进行了一项生存研究和逻辑回归分析，以检验人口统计学和初始临床因素对疾病进展的影响。在巴西一家多发性硬化症参考中心接受治疗的553例复发缓解型患者中，我们回顾了150例病程达十年或更长时间患者的病历。结果。非洲血统是继发进展风险更高的一个因素，其次是发病年龄和诊断后一年内的复发次数。深入了解血统对预后的影响有助于推动遗传学和药物基因组学研究，并可能阐明多发性硬化症尚不清楚的神经退行性进展。
