Department of Neurology, Danish Multiple Sclerosis Center, Rigshospitalet Glostrup, Valdemar Hansens Vej 2, indgang 8, 2. sal, 2600, Glostrup, Denmark.
J Neurol. 2021 Sep;268(9):3352-3360. doi: 10.1007/s00415-021-10490-0. Epub 2021 Mar 7.
To describe patient characteristics and assess the risk of disability worsening in patients of different age groups with focus on late-onset multiple sclerosis (LOMS) defined as disease onset after the age of 50 years.
The nationwide population-based Danish Multiple Sclerosis Registry served as data source. We described baseline characteristics and analyzed rates of reaching Expanded Disability Status Scale (EDSS) milestones.
We identified 28,232 patients with MS with a known year of clinical onset, of which 2661 had LOMS. The LOMS group had a higher proportion of males and patients with primary progressive disease course, and they were less likely to receive disease-modifying therapy. The initial rate of reaching EDSS milestone 6 after diagnosis was higher in LOMS [hazard ratio (HR) 1.53; 95% confidence interval (CI) 1.14-2.06]; however, when assessing the risk of reaching EDSS 6 according to age, the HR was significantly lower for the LOMS group (HR 0.307; 95% CI 0.221-0.426).
The clinical characteristics and treatment approaches for patients with LOMS differ from their younger counterparts. Following diagnosis, patients with LOMS initially have an increased rate of reaching EDSS score 6; however, the risk of reaching EDSS score 6 at any given age is higher in patients with non-LOMS.
描述不同年龄组患者的特征，并评估其残疾恶化风险，重点关注发病年龄在 50 岁及以后的晚发型多发性硬化症（LOMS）。
本研究以全国范围内基于人群的丹麦多发性硬化症注册处为数据源。我们描述了基线特征，并分析了达到扩展残疾状态量表（EDSS）里程碑的比率。
我们确定了 28232 名具有已知临床发病年份的 MS 患者，其中 2661 名患有 LOMS。LOMS 组中男性和原发性进行性疾病病程患者的比例较高，且更不可能接受疾病修正治疗。诊断后达到 EDSS 里程碑 6 的初始速率在 LOMS 组中更高[风险比（HR）1.53；95%置信区间（CI）1.14-2.06]；然而，当根据年龄评估达到 EDSS 6 的风险时，LOMS 组的 HR 显著降低（HR 0.307；95% CI 0.221-0.426）。
LOMS 患者的临床特征和治疗方法与年轻患者不同。诊断后，LOMS 患者最初达到 EDSS 评分 6 的比率增加；然而，在任何给定年龄达到 EDSS 评分 6 的风险在非 LOMS 患者中更高。
