Umberto Aguglia (Italy)

Magna Graecia University of Catanzaro, Regional Epilepsy Unit Medical and Surgical Sciences
Full Professor of Neurology and Director of the Neurology School, Magna Graecia University, Catanzaro (Italy), Head of the Regional Centre for Assistance, Diagnosis, Study and Research of Epilepsies, Great Metropolitan Hospital of Reggio Cal. Coordinator of the curriculum “New Technologies in Bioinformatics applied to Neurosciences” in the doctorate “Biomarkers in Chronic and Complex Diseases”, Magna Graecia University, Catanzaro. Founder of the Neurologic Unit, Great Metropolitan Hospital, Reggio Cal, in 1999. Author of more than 400 papers published on peer reviewed journals especially in the epileptic field. Author of different chapters of international scientific or educational books. Principal investigator in more than 30 Clinical Trials (Phase II-III-IV) during the last 10 years.

Author Of 1 Presentation

Free Communication

PROGRESSION INDEPENDENT OF RELAPSE ACTIVITY IN EARLY MULTIPLE SCLEROSIS PATIENTS

Session Type
Free Communication
Date
05.10.2021, Tuesday
Session Time
11:30 - 13:00
Room
Free Communication C
Lecture Time
11:50 - 12:00
Presenter
  • Emilio Portaccio (Italy)

Abstract

Background and Aims:

Disability accrual in multiple sclerosis (MS) may occur as relapse-associated worsening (RAW) or progression independent of relapse activity (PIRA). We investigated the contribution of RAW and PIRA to confirmed disability accumulation (CDA) in patients with clinically isolated syndrome (CIS) and early relapsing-remitting (RR) MS.

Methods:

Relapsing-onset MS patients assessed within one year from onset and with follow-up >/= 5 years (n=5,340) were extracted from the Italian MS Registry. CDA was defined by an increase in Expanded Disability Status Scale (EDSS) score confirmed at 6 months, and classified per temporal association with relapses. Predictors of PIRA and RAW were assessed using multivariable Cox regression models.

Results:

PIRA occurred in 1472 (27.6%) and RAW in 240 (17.6%) patients. Predictors of PIRA were older age (HR=1.02;95%CI 1.02-1.03,p<0.001), RR course (HR=1.46;95%CI 1.30-1.64,p<0.001), longer disease duration (HR=1.49;95%CI 1.22-1.82,p<0.001), lower EDSS (HR=0.89;95%CI 0.85-0.93,p<0.001), lower number of relapses before the event (HR=0.93;95%CI 0.91-0.95,p<0.001). RAW was associated with younger age (HR=0.99;95%CI 0.98-0.99,p<0.001), RR course (HR=1.56; 95%CI 1.35-1.80,p<0.001), lower EDSS (HR=0.92;95%CI 0.87-0.97,p=0.002), higher number of relapses before the event (HR=1.07;95%CI 1.05-1.09,p<0.001). Longer exposure to disease modifying drugs (DMD) reduced the risk of both PIRA and RAW (p<0.001).

Conclusions:

in this early relapsing-onset MS cohort, PIRA was an important contributor to CDA. Our findings indicate that insidious progression appears even in the earliest phases of the disease, suggesting that inflammation and neurodegeneration can represent a single disease continuum. The analysis on progression independent of relapse and radiological activity is ongoing.

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Moderator of 1 Session

Free Communication
Session Time
09:30 - 11:00
Room
Free Communication A
Chair(s)
  • Umberto Aguglia (Italy)