Karolinska Institutet

Author Of 1 Presentation

Invited Presentations Invited Abstracts

HT03.01 - Presentation 01

Speakers
Authors
Presentation Number
HT03.01
Presentation Topic
Invited Presentations
Lecture Time
09:15 - 09:27

Presenter Of 1 Presentation

Invited Presentations Invited Abstracts

HT03.01 - Presentation 01

Speakers
Authors
Presentation Number
HT03.01
Presentation Topic
Invited Presentations
Lecture Time
09:15 - 09:27

Invited Speaker Of 1 Presentation

Invited Presentations Invited Abstracts

HT03.01 - Presentation 01

Speakers
Authors
Presentation Number
HT03.01
Presentation Topic
Invited Presentations
Lecture Time
09:15 - 09:27

Author Of 1 Presentation

Clinical Outcome Measures Poster Presentation

P0041 - Clinical characteristics and outcome of late onset Multiple Sclerosis (ID 1467)

Speakers
Presentation Number
P0041
Presentation Topic
Clinical Outcome Measures

Abstract

Background

Clinical characteristics and disability progression in late onset MS (LOMS) (> 50 years at symptom onset) compared to adult onset MS (AOMS) (> 18- 50 years at symptom onset) is less well studied.

Objectives

To describe clinical characteristics and risk for disability progression in LOMS and AOMS within the Swedish MS population.

Methods

Data were collected from the nationwide Swedish MS registry (SMSreg). Patients with a diagnosis of MS, symptom onset > 18 years and ≥ 2 expanded disability status scale (EDSS) scores recorded were included. Clinical and demographic factors in LOMS and AOMS were compared. The risk for disease progression was assessed by analyzing time to reach sustained EDSS of 4,0 and 6,0 after disease onset, using Cox proportional hazard regression models adjusted for age, sex, disease course at onset.

Results

A total of 13,040 eligible AOMS were included of which 1,120 (8,6%) had LOMS. Median age (inter quartile range, IQR) at symptom onset was 54.0 (51.0-57.0) years in LOMS and 31.0 (26.0-39.0) yeas in EOMS. Diagnostic delay (time from symptom onset to diagnosis; median (IQR)) in LOMS; 1,21 years (0.41-3.35) and EOMS; 1,38 years (0.36-5.0) and sex distribution (female; 68,0 % vs 70,1%) were comparable in both groups. Close to one third of LOMS patients (29,2%) presented with primary progressive MS (PPMS) compared to 5,9% of AOMS. A relapsing onset was observed in 40.0% of LOMS and 65.4% of AOMS. Exposure to first line treatment was documented in 34.9% of LOMS and 59.6% had been exposed to a second line treatment (defined as fingolimod, natalizumab, rituximab or alemtuzumab). The risks to reach EDSS 4.0 (HR 1.96; 95% CI 1.72-2.24) and 6.0 (HR 2.42; 95% CI 2.13-2.75) were increased in LOMS compared to AOMS.

Conclusions

LOMS is characterized by a significantly higher incidence of PPMS as initial disease course and increased risk of disability progression compared to AOMS even after adjustment for age, sex and course, and even though more than half of the LOMS patients had been treated with a second line DMT.

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