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Detection of disability worsening in relapsing‐remitting multiple sclerosis patients: a real‐world roving Expanded Disability Status Scale reference analysis from the Italian Multiple Sclerosis Register
Author(s) -
Lepore V.,
Bosetti C.,
Santucci C.,
Iaffaldano P.,
Trojano M.,
Mosconi P.
Publication year - 2021
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1111/ene.14589
Subject(s) - expanded disability status scale , medicine , multiple sclerosis , cohort , relapsing remitting , physical therapy , pediatrics , psychiatry
Background and purpose In relapsing‐remitting multiple sclerosis patients (RRMS) disability progressively accumulates over time. To compare the cumulative probability of 6‐month confirmed disability‐worsening events using a fixed baseline or a roving Expanded Disability Status Scale (EDSS) reference, in a real‐world setting. Methods A cohort of 7964 RRMS patients followed for 2 or more years, with EDSS scores recorded every 6 months, was selected from the Italian Multiple Sclerosis Register. The overall probability of confirmed disability‐worsening events and of confirmed disability‐worsening events unrelated to relapse was evaluated using as reference a fixed baseline EDSS score or a roving EDSS score in which the increase had to be separated from the last EDSS assessment by at least 6 or 12 months. Results Using a fixed baseline EDSS reference, the cumulative probability of 6‐year overall confirmed disability‐worsening events was 33.2%, and that of events unrelated to relapse was 10.9% (33% of overall confirmed disability‐worsening events). Using a roving EDSS, the proportions were respectively 35.2% and 21.3% (61% of overall confirmed disability‐worsening events). Conclusions In a real‐world setting, roving EDSS reference scores appear to be more sensitive for detecting confirmed disability‐worsening events unrelated to relapse in RRMS patients.