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Trajectories of pro...
Trajectories of processing speed, disability, and their connections, over the years following disease modulatory treatment initiation among relapsing-remitting multiple sclerosis patients
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- Longinetti, E. (author)
- Karolinska Institutet, Clinical Neuroscience, Stockholm, Swede
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- Englund, S. (author)
- Karolinska Institutet, Clinical Neuroscience, Stockholm, Swede
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- Burman, J. (author)
- Uppsala University Hospital, Neuroscience, Uppsala, Sweden
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- Fogdell-Hahn, A. (author)
- Karolinska Institutet, Clinical Neuroscience, Stockholm, Swede
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- Gunnarsson, Martin, 1973- (author)
- Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län
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- Hillert, J. (author)
- Karolinska Institutet, Clinical Neuroscience, Stockholm, Swede
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- Langer-Gould, A. (author)
- Southern California Permanente Medical Group, Kaiser Permanente, Pasadena, United States
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- Lycke, J. (author)
- Gothenburg University, Institution of Neuroscience and Physiology, Gothenburg, Sweden
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- Nilsson, P. (author)
- Lund University, Neurology, Lund, Sweden
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- Salzer, J. (author)
- Umeå University, Clinical Science, Neurosciences, Umeå, Sweden
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- Svenningsson, A. (author)
- Danderyd Hospital, Clinical Sciences, Stockholm, Sweden
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- Vrethem, M. (author)
- weden, 8Danderyd HospiLinköping University, Biomedical and Clinical Sciences, Linköping, Sweden
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- Olsson, T. (author)
- Karolinska Institutet, Clinical Neuroscience, Stockholm, Swede
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- Piehl, F. (author)
- Karolinska Institutet, Clinical Neuroscience, Stockholm, Swede
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- Frisell, T. (author)
- Karolinska Institutet, Clinical Neuroscience, Stockholm, Swede
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(creator_code:org_t)
- Sage Publications, 2021
- 2021
- English.
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In: Multiple Sclerosis Journal. - : Sage Publications. - 1352-4585 .- 1477-0970. ; 27:Suppl. 2, s. 677-678
- Related links:
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https://urn.kb.se/re...
Abstract
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- Introduction: Data on how processing speed of relapsing-remitting multiple sclerosis patients (RRMS) evolve over time and its association with disability progression is scarce. We analysed the COMparison Between All immunoTherapies for Multiple Sclerosis (CombatMS; NCT03193866), a nationwide observational drug trial in RRMS.Objectives: Identify trajectories of processing speed and disability and their connections after disease modulatory treatment (DMT) start within the RRMS population.Describe patient characteristics associated with trajectory groups.Aim: Model trajectories of processing speed and disability.Methods: We assessed trajectories of oral Symbol Digit Modalities Test (SDMT) and expanded disability status scale (EDSS) from first DMT start using a group-based modeling approach among 1,800 RRMS patients followed 2010-2021. We investigated predictors of trajectories using group membership assignments as a multinomial outcome and calculated conditional probabilities linking membership across the trajectories.Results: We identified four trajectories of processing speed: low SDMT score (mean starting values; MSV=36.7, standard deviation; SD=8.4)-stable (13%), medium score (MSV =50.8, SD=6.7)-minor decrease (52%), medium/high score (MSV=62.9, SD=8.6)-minor decrease (32%), and high score (MSV= 75.2, SD=9.7)-moderate decrease (3%), and four trajectories of disability: no disability-stable (23%), minimal signs-minor increase (45%), minimal disability-moderate increase (27%), and relatively severe disability-moderate increase (5%). Patients with natalizumab as first DMT were less likely to belong to the medium and high processing speed trajectories, relative to the low SDMT score-stable one. Sex, age at DMT start, and geographical region of treatment were associated with medium and high processing speed and with minimal signs and minimal dis-ability trajectories.There was 0% probability of belonging to the relatively severe disability-moderate increase EDSS trajectory if belonging to the high score-moderate decrease SDMT trajectory, and 8% probability of belonging to the no disability-stable EDSS trajectory if belonging to the low score-stable SDMT trajectory.Conclusions: Patients with lower SDMT scores at DMT start did not decline over the years, whereas those with minimal or relatively severe disability moderately lost function. Our results also suggest an inverse link between processing speed and disability trajectories after DMT start.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Neurologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Neurology (hsv//eng)
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- vet (subject category)
- art (subject category)
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- By the author/editor
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Longinetti, E.
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Englund, S.
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Burman, J.
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Fogdell-Hahn, A.
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Gunnarsson, Mart ...
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Hillert, J.
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show more...
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Langer-Gould, A.
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Lycke, J.
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Nilsson, P.
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Salzer, J.
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Svenningsson, A.
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Vrethem, M.
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Olsson, T.
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Piehl, F.
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Frisell, T.
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Neurology
- Articles in the publication
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Multiple Scleros ...
- By the university
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Örebro University