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Modelling disease progression of Multiple Sclerosis in a South Wales cohort

Uzochukwu, Emeka C., Harding, Katherine E., Hrastelj, James ORCID:, Kreft, Karim L., Holmans, Peter ORCID:, Robertson, Neil P. ORCID:, Tallantyre, Emma C. ORCID: and Lawton, Michael 2024. Modelling disease progression of Multiple Sclerosis in a South Wales cohort. Neuroepidemiology 58 (3) , pp. 218-226. 10.1159/000536427

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Objectives: To model multiple sclerosis (MS) disease progression and compare disease trajectories by sex, age of onset, and year of diagnosis. Study Design and settings: Longitudinal EDSS scores (20,854 observations) were collected for 1787 relapse-onset MS patients at MS clinics in South Wales and modelled using a multilevel model (MLM). The MLM adjusted for baseline covariates (sex, age of onset, year of diagnosis, and disease modifying treatments (DMTs)), and included interactions between baseline covariates and time variables. Results: The optimal model was truncated at 30 years after disease onset and excluded EDSS recorded within 3 months of relapse. As expected, older age of onset was associated with faster disease progression at 15 years (effect size (ES): 0.75; CI: 0.63, 0.86; P: <0.001) and female-sex progressed more slowly at 15 years (ES: -0.43; CI: -0.68, -0.18; P: <0.001). Patients diagnosed more recently (defined as 2007-2011 and >2011) progressed more slowly than those diagnosed historically (<2006); (ES: -0.46; CI: -0.75, -0.16; P: 0.006) and (ES: -0.95; CI: -1.20, -0.70; P: <0.001), respectively. Conclusion: We present a novel model of MS outcomes, accounting for the nonlinear trajectory of MS and effects of baseline covariates, validating well-known risk factors (sex and age of onset) associated with disease progression. Also, patients diagnosed more recently progressed more slowly than those diagnosed historically.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
MRC Centre for Neuropsychiatric Genetics and Genomics (CNGG)
Publisher: Karger Publishers
ISSN: 0251-5350
Date of First Compliant Deposit: 30 January 2024
Date of Acceptance: 27 December 2023
Last Modified: 04 Jun 2024 14:37

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