Universitätsklinikum Hamburg-Eppendorf

Author Of 2 Presentations

Diagnostic Criteria and Differential Diagnosis Poster Presentation

P0263 - Serum neurofilament predicts clinical progression and increases diagnostic accuracy in patients with early multiple sclerosis (ID 1336)

Abstract

Background

Up to date prognostic estimation in newly diagnosed patients is hardly possible while the differentiation between disabling versus more benign courses is of utmost relevance. Reliable blood-based biomarkers that are associated with diagnosis and prognosis of multiple sclerosis (MS) have not been established.

Objectives

Can serum neurofilament light chain measurements serve as a reliable biomarker for diagnostic accuracy and prognosis for multiple sclerosis patients at the time point of diagnosis?

Methods

In a multicenter prospective longitudinal observational cohort, patients with a first diagnosis of multiple sclerosis (MS) or clinically isolated syndrome (CIS) were recruited between August 2010 and November 2015 in 22 centers and assessed yearly with a standardized protocol. Patients were offered standard immunotherapies according to national treatment guidelines. Serum NfL concentrations were measured using an ultrasensitive single-molecule array (Simoa).

Results

A possible association between sNfL levels and clinical diagnosis, relapses, MRI parameters and treatment decisions was tested in 814 patients classified according to current (2017) and older (2010) McDonald criteria at time point of diagnosis and two years after study inclusion sNfL levels correlated with number of T2 and Gd+ lesions and clinical relapses. After reclassification of CIS[2010] patients with existing CSF analysis, according to 2017 criteria, sNfL levels were lower in CIS[2017] than RRMS[2017] patients (9.1 pg/ml, IQR 6.2-13.7 pg/ml, n = 45; 10.8 pg/ml, IQR 7.4-20.1 pg/ml, n = 213; p = 0.036) and increased accuracy of distinction between CIS and RRMS, when including ≥ 90th percentile of sNfL values. Patients receiving disease-modifying treatment (DMT) during the first two years had higher sNfl baseline levels (11.8 pg/ml, 7.5-20.9 pg/ml, n = 727) than patients never receiving DMT (9.5 pg/ml, IQR 6.4-14.1 pg/ml, n = 87, p = 0.002). Longitudinal sNfL levels reflected treatment decisions within the first four years.

Conclusions

sNfL is associated with diagnosis and prognosis of MS patients at the time point of first diagnosis and may be of use for initial treatment stratification.

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Rehabilitation and Comprehensive Care Poster Presentation

P1101 - Information needs about bladder dysfunction in people with multiple sclerosis (ID 1955)

Speakers
Presentation Number
P1101
Presentation Topic
Rehabilitation and Comprehensive Care

Abstract

Background

Eighty percent of all people with multiple sclerosis (pwMS) develop bladder dysfunction (BD) at some point throughout their disease course. The most common types of BD are detrusor hyper- or hypoactivity and sphincter detrusor dyssynergyia (SDD). BD can lead to physical (e.g. urinary tract infections) and psychological complications (social isolation). This the first part of a multi-step-project with the goal to develop an evidence-based patient information (EBPI) about BD.

Objectives

The aim of this survey is to gather information on the information needs of pwMS concerning BD. The ultimate goal of the project is the development of an evidence-based patient information on BD for pwMS.

Methods

A questionnaire was constructed assessing demographic data, urinary function via self-developed questions and the validated instrument Qualiveen (Pallek et al., 2007) as well as communication, knowledge and information needs concerning BD. The questionnaires were sent to n=297 pwMS from the MS dayclinic in Hamburg, Germany. Data was analyzed descriptively using SPSS.

Results

Of n=221 pwMS that participated in the study, 70% were female, mean age was 48.2 years (SD 10.2) and 65 % had chronic MS. Almost 90 % of pwMS had BD; of those, 30 % suffered from detrusor hyperactivity, 21.5% from hypoactivity, 5.5 % from SDD and 36 % didn’t know their type of BD. Participants were affected mildly to moderately by BD. Twenty-five percent had never visited a urologist. In a self-developed knowledge questionnaire 26 % of pwMS answered 80 % of questions correctly. Sixty-four percent of pwMS stated, BD was a taboo topic, 32 % had the desire to talk about BD. Only 48 % had ever received and the majority longed for information about BD, over 40 % were willing to take part in an educational program.

Conclusions

In this cohort with mostly people with chronic MS BD was very common and quality of life was impaired by it, but more than a third did not know what type of BD they had. Basic BD knowledge was decent, but participants still reported a strong desire for information about BD. Currently, no EBPI on BD in MS exists.

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