Barcutean Laura, Maier Smaranda, Bajko Zoltan, Stoian Adina, Mosora Oana, Sarmasan Emanuela, Manescu Ion-Bogdan, Balasa Rodica
Department of Neurology, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540142 Targu Mures, Romania.
Neurology 1 Clinic, Emergency Clinical County Hospital, 540136 Targu Mures, Romania.
J Clin Med. 2024 Mar 21;13(6):1813. doi: 10.3390/jcm13061813.
Multiple sclerosis (MS) is a prevalent chronic inflammatory and neurodegenerative disease of the central nervous system. The main evolving forms, relapsing-remitting MS (RRMS) and secondary progressive MS (SPMS), lack clear delineation. We conducted an observational study on 523 Caucasian RRMS patients receiving first-line disease-modifying therapies (DMTs), analyzing demographic, clinical, and geographical data. RRMS patients experienced a statistically significant reduction in relapse rates post-DMT initiation. Significant differences in time to reach an Expanded Disability Status Score (EDSS) of 3.0 and 6.0 were observed based on demographics and onset topography. Kaplan-Meier analysis revealed that the onset with optic or supratentorial symptoms is linked to a longer time until EDSS = 3.0 is reached. Urban origin correlated with a prolonged time until EDSS = 3.0. Gender and environment showed no significant associations with the hazard of reaching an EDSS = 6.0. Cox regression analysis revealed no significant impact of relapses on the time to reach EDSS scores of 3.0 and 6.0 in our study cohort. Multivariate analysis identified several predictive factors for disability progression, including environment, age at onset, and disability level at DMT initiation.
多发性硬化症(MS)是一种常见的中枢神经系统慢性炎症性和神经退行性疾病。其主要的演变形式,复发缓解型多发性硬化症(RRMS)和继发进展型多发性硬化症(SPMS),缺乏明确的界定。我们对523名接受一线疾病修正治疗(DMTs)的白种人RRMS患者进行了一项观察性研究,分析了人口统计学、临床和地理数据。RRMS患者在开始DMT治疗后复发率有统计学意义的降低。基于人口统计学和发病部位,观察到达到扩展残疾状态评分(EDSS)为3.0和6.0的时间存在显著差异。Kaplan-Meier分析显示,伴有视神经或幕上症状的发病与达到EDSS = 3.0的时间较长有关。城市出身与达到EDSS = 3.0的时间延长相关。性别和环境与达到EDSS = 6.0的风险无显著关联。Cox回归分析显示,在我们的研究队列中,复发对达到EDSS评分3.0和6.0的时间没有显著影响。多变量分析确定了残疾进展的几个预测因素,包括环境、发病年龄和开始DMT治疗时的残疾水平。