Scott Thomas F, Desai Troy, Hackett Chris, Gettings Edward J, Hentosz Teresa, Elmalik Wisam, Schramke Carol J
Int J MS Care. 2020 May-Jun;22(3):110-114. doi: 10.7224/1537-2073.2019-005. Epub 2019 Dec 5.
Before disease-modifying therapies (DMTs) were available, the natural history of multiple sclerosis (MS) regarding attainment of accepted disability milestones was reported with fairly wide variance comparing outcomes across studies. The influence of DMTs on these outcomes is unknown. This study aimed to calculate attainment of disability milestones during the first 15 years after onset of DMT-treated relapsing forms of MS (RMS).
As a retrospective study, all available disability data (collected routinely) on all newly diagnosed patients with RMS seen and initially diagnosed in a single clinic between 1989 and 2006 were reviewed. Times from first symptoms and diagnosis until first treatment with DMTs were also reviewed. Time-to-event statistics were applied using disability milestones.
Mean follow-up of 184 adult patients from symptom onset was 13.7 years. Of patients followed up for 15 years after onset, 16 of 86 (19%) reached an Expanded Disability Status Scale (EDSS) score of 6.0. Estimated median time to reach an EDSS score of 3.0 was 10.7 years and to reach an EDSS score of 4.0 was 18.1 years.
There were striking differences between the present results and older data sets and similar results to the few available modern data sets. This analysis of a modern treated RMS cohort provides outcomes data that may be compared favorably with the natural history of RMS.
在疾病修饰疗法（DMTs）出现之前，关于多发性硬化症（MS）达到公认残疾里程碑的自然史，不同研究报告的结果差异较大。DMTs对这些结果的影响尚不清楚。本研究旨在计算DMT治疗复发型MS（RMS）发病后前15年中达到残疾里程碑的情况。
作为一项回顾性研究，我们回顾了1989年至2006年间在单一诊所初诊的所有新诊断RMS患者的所有可用残疾数据（常规收集）。还回顾了从首次出现症状和诊断到首次使用DMT治疗的时间。使用残疾里程碑应用事件发生时间统计。
184例成年患者从症状发作开始的平均随访时间为13.7年。在发病后随访15年的患者中，86例中有16例（19%）的扩展残疾状态量表（EDSS）评分达到6.0。达到EDSS评分3.0的估计中位时间为10.7年，达到EDSS评分4.0的估计中位时间为18.1年。
目前的结果与较旧的数据集存在显著差异，与少数可用的现代数据集结果相似。对现代接受治疗的RMS队列的这项分析提供了可与RMS自然史进行良好比较的结果数据。
