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Multiple sclerosis relapses: a multivariable analysis of residual disability determinants
Author(s) -
Vercellino M.,
Romagnolo A.,
Mattioda A.,
Masera S.,
Piacentino C.,
Merola A.,
Chiò A.,
Mutani R.,
Cavalla P.
Publication year - 2009
Publication title -
acta neurologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.967
H-Index - 95
eISSN - 1600-0404
pISSN - 0001-6314
DOI - 10.1111/j.1600-0404.2008.01076.x
Subject(s) - medicine , persistence (discontinuity) , multiple sclerosis , severity of illness , expanded disability status scale , population , proportional hazards model , disease , pediatrics , immunology , geotechnical engineering , environmental health , engineering
Background – Recovery from multiple sclerosis (MS) relapses is variable. The factors influencing persistence of residual disability (RD) after a relapse are still to be thoroughly elucidated. Aims of study – To assess RD after MS relapses and to define the factors associated with persistence of RD. Methods – Data were retrospectively collected for all relapses in a population of relapsing–remitting MS patients during 3 years. Relapse severity and RD after 1 year were calculated on Expanded Disability Status Scale basis. A multivariable analysis for factors influencing RD and relapse severity was performed (variables: age, gender, disease duration, oligoclonal bands, relapse severity, monosymptomatic/polysymptomatic relapse, immunomodulating treatment, incomplete recovery at 1 month). Results – A total of 174 relapses were assessed. RD after 1 year was observed in 54.5% of the relapses. Higher risk of RD was associated with occurrence of a severe relapse ( P = 0.024). Incomplete recovery at 1 month was highly predictive of RD at 1 year ( P < 0.0001). Risk of a severe relapse was associated with age ≤ 30 years ( P = 0.025) and inversely associated with the use of immunomodulating treatment ( P = 0.006). Conclusions – Incomplete recovery at 1 month is a predictor of long‐term persistence of RD. Higher relapse severity is associated with higher risk of RD. Risk of severe relapses is lower in patients treated with immunomodulating drugs.