Early predictors of disability in paediatric multiple sclerosis: evidence from a multi-national registry
- 30 September 2022
- journal article
- research article
- Published by BMJ in Journal of Neurology, Neurosurgery & Psychiatry
- Vol. 93 (12), 1322-1329
- https://doi.org/10.1136/jnnp-2022-329713
Abstract
Background Early recognition of markers of faster disability worsening in paediatric-onset multiple sclerosis (MS) is a key requisite of personalised therapy for children with MS at the earliest possible time. Objective To identify early predictors of rapid disability accrual in patients with paediatric-onset MS. Methods Using the global MSBase registry, we identified patients who were Results 672 patients (70% female) contributing 9357 visits were included. The median age at symptom onset was 16 (quartiles 15–17) years. Older age at symptom onset (exp(β)=1.10 (95% CI 1.04 to 1.17)), higher EDSS score (1.22 (1.12 to 1.34)) and pyramidal (1.31 (1.11 to 1.55)), visual (1.25 (1.10 to 1.44)) or cerebellar (1.18 (1.01 to 1.38)) symptoms in the first year were associated with higher MSSS. MSSS was reduced by 4% for every 24% increase in the proportion of time on higher-efficacy DMTs (0.96 (0.93 to 0.99)). Conclusions A relatively later onset of MS in childhood, higher disability and pyramidal, visual or cerebellar symptoms during the first year predicted significant worsening in disability in patients with paediatric-onset MS. Persistent treatment with higher-efficacy DMTs was associated with a reduced rate of disability worsening.Funding Information
- NHMRC Australia (1129189, 1140766)
This publication has 28 references indexed in Scilit:
- Pediatric-Onset Multiple Sclerosis Disease Progression in Kuwait: A Retrospective AnalysisPediatric Neurology, 2015
- Prognostic indicators of secondary progression in a paediatric-onset multiple sclerosis cohort in KuwaitMultiple Sclerosis Journal, 2015
- Defining reliable disability outcomes in multiple sclerosisBrain, 2015
- Multiple sclerosis in children: an update on clinical diagnosis, therapeutic strategies, and researchThe Lancet Neurology, 2014
- Risk of relapse phenotype recurrence in multiple sclerosisMultiple Sclerosis Journal, 2014
- Elevated relapse rates in pediatric compared to adult MS persist for at least 6 yearsMultiple Sclerosis and Related Disorders, 2014
- Diagnostic criteria for multiple sclerosis: 2010 Revisions to the McDonald criteriaAnnals of Neurology, 2011
- Increased Relapse Rate in Pediatric-Onset Compared With Adult-Onset Multiple SclerosisArchives of Neurology, 2009
- Multiple sclerosis in children: clinical diagnosis, therapeutic strategies, and future directionsThe Lancet Neurology, 2007
- Multiple Sclerosis Severity ScoreNeurology, 2005