Diagnostic Criteria and Differential Diagnosis Poster Presentation

P0255 - Improvement during the last decades in the time of diagnosis but not in the time of starting DMD in MS patients in Argentina (ID 1297)

Speakers
  • J. Rojas
Authors
  • L. Patrucco
  • A. Papolla
  • J. Rojas
  • E. Cristiano
Presentation Number
P0255
Presentation Topic
Diagnostic Criteria and Differential Diagnosis

Abstract

Background

There has been a significant shortening of time from multiple sclerosis (MS) onset to diagnosis in parallel with the adoption of new diagnostic criteria. However, it is not clear whether that time has been accompanied by a shortening in the time since diagnosis to the initiation of disease modifying treatment (DMD).

Objectives

The objective of the study was described and compare the interval from first symptom of MS to the date of diagnosis and the interval between date of diagnosis and DMD initiation regarding the introduction of upgraded MS diagnosis criteria.

Methods

retrospective cohort study that included relapsing remitting MS patients between January 2005 and January 2018. To be included, date of disease onset (first relapse), date of diagnosis (confirmed disease) and date of DMD initiation must be available. Kaplan-Meier estimator and plots were applied. Survival probabilities were evaluated for the 2 diagnosis epoch groups according to the diagnostic criteria advised at the time: group 1, for diagnosis performed between 2005-2009 (2005 revised McDonald criteria) and group 2, for diagnosis performed between 2010-2017 (2010 revised McDonald criteria). Survival curves were compared by log-rank method. P-value less than 0.05 was considered statistically significant

Results

654 patients were revised, 586 included (278 in group 1 and 308 in group 2) and 68 excluded due to missing data. Most of patients in group 1 were treated with beta interferons (82%), while in group 2, 32% were on beta interferons, 45% on oral treatments (fingolimod, teriflunomide and dymethil-fumarate), 15% on natalizumab and 8 % on alemtuzumab. There were no differences in mean age at disease onset between group 1 and 2 (33 ± 5 and 31 ± 6 years, p=0.45). The mean time since disease onset to diagnosis in group 1 was 1.35 ± 0.32 vs. 1.11 ± 0.22 years (p 0.001). Mean time since disease diagnosis to first DMD was 4.6 ± 2.1 months in group 1 vs. 5.8 ± 1.5 months in group 2 (p=0.07).

Conclusions

despite a shorten in time of diagnosis was described a trend to increase the time to initiate a DMD was noted in group 2. An improvement in access to treatments must follow the improvement in diagnosis if it is intended to treat patients earlier to prevent disease progression.

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