Author Of 1 Presentation
P0836 - Aggressive multiple sclerosis in Argentina: data from the nationwide registry RelevarEM (ID 1632)
- M. Kohler
- E. Kohler
- C. Vrech
- A. Pappolla
- J. Miguez
- L. Patrucco
- J. Correale
- M. Marrodan
- M. Gaitán
- M. Fiol
- L. Negrotto
- M. Ysrraelit
- E. Cristiano
- A. Carra
- A. Chertcoff
- J. Steinberg
- A. Martinez
- C. Curbelo
- L. Cohen
- R. Alonso
- O. Garcea
- C. Pita
- B. Silva
- G. Luetic
- N. Deri
- M. Balbuena
- V. Tkachuk
- E. Carnero Contentti
- P. Lopez
- J. Pettinicchi
- A. Caride
- M. Burgos
- F. Leguizamon
- E. Knorre
- R. Piedrabuena
- A. Barboza
- S. Liwacki
- P. Nofal
- G. Volman
- A. Alves Pinheiro
- J. Hryb
- D. Tavolini
- P. Blaya
- L. Recchia
- C. Mainella
- E. Silva
- J. Blanche
- S. Tizio
- M. Saladino
- F. Caceres
- N. Fernandez Liguori
- L. Lazaro
- G. Zanga
- M. Parada Marcilla
- M. Fracaro
- F. Pagani Cassará
- G. Vazquez
- V. Sinay
- G. Sgrilli
- P. Divi
- M. Jacobo
- E. Reich
- L. Cabrera
- M. Menichini
- M. Coppola
- I. Martos
- J. Viglione
- G. Jose
- S. Bestoso
- R. Manzi
- D. Giunta
- M. Doldan
- M. Alonso Serena
- J. Rojas
Abstract
Background
Aggressive MS (AMS) describes a form of the disease with a rapid progressive course leading to significant disability in multiple neurologic systems or even death in a relatively short time after onset. Despite there being no consensus on the exact definition of AMS, several studies performed during the last years have tried to better identify and understand the frequency and distribution as well as the progression and treatment response in order to determine more accurately which patients with AMS would most benefit from higher-efficacy, higher-risk treatments
Objectives
The objectives of the present study were to describe the frequency of aggressive multiple sclerosis (AMS) as well as to compare clinical and radiological characteristics in AMS and non-AMS patients included in the Argentinean MS and NMOSD registry (RelevarEM, NCT 03375177).
Methods
The eligible study population and cohort selection included adult-onset patients (≥18 years) with definite MS. AMS were defined as those reaching confirmed EDSS ≥6 within 5 years from symptom onset. Confirmation was achieved when a subsequent EDSS ≥6 was recorded at least six months later but within 5 years of the first clinical presentation. AMS and non-AMS were compared using the χ2 test for categorical and the Mann-Whitney for continuous variables at MS onset and multivariable analysis was performed using forward stepwise logistic regression with baseline characteristics at disease onset.
Results
A total of 2158 patients with MS were included: 74 AMS and 2084 non-AMS. The prevalence of AMS in our cohort was 3.4% (95%CI 2.7-4.2). AMS were more likely to be male (p=0.003), older at MS onset (p<0.001), have primary progressive MS (PPMS) phenotype (p=0.03), multifocal presentation (p<0.001), and spinal cord as well as infratentorial lesions at MRI during disease onset (p=0.004 and p=0.002, respectively).
Conclusions
3.4% of our patient population could be considered AMS. Men, patients older at symptom onset, multifocal presentation, PPMS phenotype, and spinal cord as well as brainstem lesion on MRI at clinical presentation all had higher odds of having AMS.