Jacobs Comprehensive MS Treatment & Research Center, Department of Neurology, Jacobs School of Medicine & Biomedical Sciences University at Buffalo, Buffalo, NY 14202, USA.
Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine & Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY 14203, USA.
Neurodegener Dis Manag. 2023 Jun;13(3):151-159. doi: 10.2217/nmt-2022-0008. Epub 2023 Feb 13.
Patient-reported outcomes (PROs) are valuable measures for routine clinical care of people with multiple sclerosis (pwMS). 646 pwMS treated with interferon-β-1a (IFN-β-1a) were retrospectively included from the New York State Multiple Sclerosis Consortium. Clinical and PRO data at enrollment and 3 year follow-up were collected. PwMS with stable disease and disability worsening were matched (1:1) based on age, Expanded Disability Status Scale (EDSS) scores and disease duration. Disability worsening was determined based on trial criteria. PwMS with future EDSS worsening had higher baseline and follow-up timed-25-foot walk (6.6 vs 5.5 s; 9.1 vs 5.5 s; p < 0.001) when compared with stable pwMS. Worsening pwMS reported higher baseline difficulties in getting up (odds ratio [OR] = 2.4; p = 0.009), climbing stairs (OR = 1.6; p = 0.024) and standing (OR = 2.2; p < 0.001). Worsening pwMS reported greater lower limb limitations (OR = 2.3; p = 0.004) and fatigue (OR = 1.8; p = 0.002). Higher fatigue and lower limb functional limitations are significant predictors of future disability worsening in pwMS.
患者报告的结局 (PROs) 是多发性硬化症 (pwMS) 患者常规临床护理的重要衡量指标。从纽约州多发性硬化症联合会回顾性纳入了 646 例接受干扰素-β-1a (IFN-β-1a) 治疗的 pwMS。收集了入组时和 3 年随访时的临床和 PRO 数据。根据年龄、扩展残疾状况量表 (EDSS) 评分和疾病持续时间,对稳定疾病和残疾恶化的 pwMS 进行了 1:1 匹配。根据试验标准确定残疾恶化。与稳定 pwMS 相比,未来 EDSS 恶化的 pwMS 基线和随访时的 timed-25-foot walk 时间更长 (6.6 秒比 5.5 秒;9.1 秒比 5.5 秒;p<0.001)。恶化 pwMS 在基线时报告起床 (优势比 [OR] = 2.4;p = 0.009)、爬楼梯 (OR = 1.6;p = 0.024) 和站立 (OR = 2.2;p<0.001) 更困难。恶化 pwMS 报告下肢活动受限 (OR = 2.3;p = 0.004) 和疲劳 (OR = 1.8;p = 0.002) 更严重。更高的疲劳和下肢功能受限是 pwMS 未来残疾恶化的重要预测因素。