Abstract:
BACKGROUND:In multiple sclerosis (MS) the quantitative role of relapses in Expanded Disability Status Scale (EDSS) worsening beyond the recovery phase is not well known. Most studies have examined the predictive role of early relapses in more distant endpoints. Relapses and worsening may be associated because they could be independent effects of the same underlying disease characteristics without causal relationship. With the design of the present study we aim to estimate the direct effect on disability of relapses. METHODS:We used data from the obligatory bi-annually registration in the Danish Multiple Sclerosis Registry of relapses and EDSS for all patients treated with disease modifying drugs for relapsing/remitting MS from 1996 to 2015 with exclusion of patients in whom no relapses had ever been recorded during treatment. We paired two consecutive control periods into study intervals which were the actual study units. Study intervals were qualified and included if they were at length 12-24 months, with EDSS ≤ 5.5 at start, and if a preceding relapse had been no closer than nine months to the EDSS assessment at the start or end of the study interval to eliminate relapse-related temporary EDSS worsening. We compared EDSS worsening in study intervals with and without relapses. The same patients could contribute with study intervals with and without relapses. For statistical analyses we used Generalized Estimating Equations to account for intra-patient correlations. RESULTS:We analysed 5187 study intervals from 2015 MS patients. The mean of EDSS increase was 0.205 units in qualifying study intervals with relapses and 0.065 without relapses when adjusted for length of study interval, sex, and EDSS at start of interval; p < 0.0001. However, the effect of relapses on EDSS was absent in male patients (p = 0.521), and when EDSS was ≥ 4.0 at start of the study interval (p = 0.726). CONCLUSION:Relapses play an independent and significant role for worsening of MS in patients under disease-modifying therapy (DMT) and eliminating relapses would not only free the patients from the temporary perils of relapses but would also reduce the worsening of the disease.
journal_name
Mult Scler Relat Disordjournal_title
Multiple sclerosis and related disordersauthors
Koch-Henriksen N,Thygesen LC,Sørensen PS,Magyari Mdoi
10.1016/j.msard.2019.04.017subject
Has Abstractpub_date
2019-07-01 00:00:00pages
1-8eissn
2211-0348issn
2211-0356pii
S2211-0348(19)30177-4journal_volume
32pub_type
杂志文章abstract:BACKGROUND:Cognitive dysfunctions are very frequent in people living with multiple sclerosis (MS). Several studies have previously indicated grey matter (GM) atrophy as useful predictor of patients' cognitive impairment. However, considerable uncertainty exists about the possible impact of deep grey matter volumes on c...
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journal_title:Multiple sclerosis and related disorders
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doi:10.1016/j.msard.2020.102120
更新日期:2020-07-01 00:00:00
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journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章,多中心研究
doi:10.1016/j.msard.2017.07.019
更新日期:2017-10-01 00:00:00
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journal_title:Multiple sclerosis and related disorders
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doi:10.1016/j.msard.2020.102397
更新日期:2020-10-01 00:00:00
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journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章,多中心研究
doi:10.1016/j.msard.2015.01.003
更新日期:2015-03-01 00:00:00
abstract:BACKGROUND:Several studies have reported the characteristics of acute multiple sclerosis (MS) lesions on diffusion-weighted magnetic resonance imaging (DWI MRI). Current publications reported a transient reduction of the apparent diffusion coefficient (ADC) delineating an early phase of lesion evolution, before increas...
journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章
doi:10.1016/j.msard.2019.01.027
更新日期:2019-04-01 00:00:00
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journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章,评审
doi:10.1016/j.msard.2018.03.014
更新日期:2018-05-01 00:00:00
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journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章
doi:10.1016/j.msard.2015.04.005
更新日期:2015-07-01 00:00:00
abstract:BACKGROUND:The 2015 criteria for diagnosing neuromyelitis optica spectrum disorder (NMOSD) have encouraged several groups across the world to report on their patients using these criteria. The disease typically manifests with severe relapses of optic neuritis, longitudinally extensive myelitis and/or brainstem syndrome...
journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章
doi:10.1016/j.msard.2018.11.031
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abstract:BACKGROUND:Multiple Sclerosis (MS) specialists routinely evaluate misdiagnosed patients, or patients incorrectly assigned a diagnosis of MS. Misdiagnosis has significant implications for patient morbidity and healthcare costs, yet its contemporary incidence is unknown. We examined the incidence of MS misdiagnosis in ne...
journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章
doi:10.1016/j.msard.2019.01.048
更新日期:2019-05-01 00:00:00
abstract:BACKGROUND:High salt intake may be associated with pro-inflammatory changes in the immune response, and increased clinical and MRI activity in adults with relapsing-remitting multiple sclerosis. OBJECTIVE:We sought to determine if dietary salt intake is associated with pediatric-onset MS risk in a multicenter, case-co...
journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章,多中心研究
doi:10.1016/j.msard.2016.02.011
更新日期:2016-03-01 00:00:00
abstract:BACKGROUND:As vaccines for the coronavirus become available, it will be important to know the rate of COVID-19 vaccine acceptability in adults with multiple sclerosis (MS), given that vaccination will be a key strategy for preventing SARS-CoV-2 infections. Using a national sample of adults with MS in the United States ...
journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章
doi:10.1016/j.msard.2021.102788
更新日期:2021-01-22 00:00:00
abstract:BACKGROUND:Neuromyelitis optica spectrum disorder (NMOSD) is a chronic autoimmune disorder which is associated with sleep disturbances and a lower quality of life. The aims of the study were: (1) Comparing sleep characteristics, quality of life, and symptoms of depression and anxiety between patients with NMOSD and hea...
journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章
doi:10.1016/j.msard.2019.04.008
更新日期:2019-07-01 00:00:00
abstract:BACKGROUND:Growing evidence supports the efficacy of restorative cognitive training in people with multiple sclerosis (PwMS), but the effects vary across individuals. Differences in treatment efficacy may be related to baseline individual differences. We investigated clinical characteristics and MRI variables to predic...
journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章
doi:10.1016/j.msard.2019.06.026
更新日期:2019-09-01 00:00:00
abstract::Neoplasms and reactivation of latent viruses have been observed in individuals taking fingolimod. Merkel cell carcinoma (MCC), a rare neuroendocrine skin cancer, is associated with immunosuppression and can be triggered by the oncogenic Merkel cell polyoma virus (MCPyV). We report a case of a 61-year-old man with mult...
journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章
doi:10.1016/j.msard.2017.06.004
更新日期:2017-10-01 00:00:00
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journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章
doi:10.1016/j.msard.2018.08.007
更新日期:2018-10-01 00:00:00
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journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章
doi:10.1016/j.msard.2020.102041
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journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章
doi:10.1016/j.msard.2014.09.211
更新日期:2015-01-01 00:00:00
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journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章
doi:10.1016/j.msard.2015.10.006
更新日期:2016-01-01 00:00:00
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journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章,评审
doi:10.1016/j.msard.2020.102189
更新日期:2020-09-01 00:00:00
abstract::Acute relapses continue to be a significant aspect of multiple sclerosis (MS) on both the epidemiologic level and the individual patient level. Past work demonstrates residual disability from relapses as well as high patient-reported rates of ineffective relapse treatment. To better characterize the impact of MS relap...
journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章
doi:10.1016/j.msard.2015.03.005
更新日期:2015-05-01 00:00:00
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journal_title:Multiple sclerosis and related disorders
pub_type: 信件
doi:10.1016/j.msard.2020.102568
更新日期:2020-11-01 00:00:00
abstract:BACKGROUND:Alemtuzumab significantly improved clinical and MRI outcomes vs. subcutaneous interferon beta-1a (SC IFNB-1a) in the CARE-MS trials (NCT00530348, NCT00548405), with sustained efficacy in 2 consecutive extensions (NCT00930553, NCT02255656 [TOPAZ]). METHODS:Post hoc analysis of 8-year alemtuzumab efficacy and...
journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章
doi:10.1016/j.msard.2020.102717
更新日期:2020-12-24 00:00:00
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journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章
doi:10.1016/j.msard.2020.102319
更新日期:2020-09-01 00:00:00
abstract:BACKGROUND:Pain can interfere with the daily functioning of persons with multiple sclerosis (PwMS). Furthermore, beliefs about pain and activity engagement are reliably associated with persons' experience of chronic pain. This study aimed to explore the extent to which different aspects of PwMS' activity engagement is ...
journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章
doi:10.1016/j.msard.2019.101882
更新日期:2020-02-01 00:00:00
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journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章
doi:10.1016/j.msard.2018.09.039
更新日期:2019-01-01 00:00:00
abstract:BACKGROUND:Relapsing-Remitting MS (RRMS) Deep Grey Matter (DGM) 5 year changes were examined using MRI measures of volume, transverse relaxation rate (R2*) and quantitative magnetic susceptibility (QS). By applying Discriminative Analysis of Regional Evolution (DARE), R2* and QS changes from iron and non-iron sources w...
journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章
doi:10.1016/j.msard.2019.05.028
更新日期:2019-08-01 00:00:00
abstract::Multiple sclerosis (MS) is a complex chronic immune disease in the central nervous system, causing neurological disability among young and middle-aged adults. Impaired cognition is now emerging as a major clinical symptom being present in more than 50% of MS patients. Recent data support that neuroinflammation mediate...
journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章,评审
doi:10.1016/j.msard.2020.102622
更新日期:2020-11-14 00:00:00