Abstract
Objective
To analyze time-trends in age at disability milestones among MS patients who were
enrolled into the MSBase International Registry during 1996–2010 period.
Methods
We used linear regression to describe the relationship between mean age at major EDSS
benchmarks and calendar time. We then assessed time-trend in age at initial EDSS rating
with a three level linear growth model specifying that patients were nested within
each of 20 participating countries. The model estimated the average of time-trends
in mean age at initial clinical assessment within each country while controlling for
patients' EDSS and sex in each country. Analyses were repeated in subsamples of patients
diagnosed according to Poser or McDonald criteria.
Results
The MSBase Registry contained data on 11,108 MS patients enrolled between 1996 and
2010 who fulfilled our inclusion criteria. During the 1996–2010 period, enrollment
age for patients with EDSS 4/4.5 increased by 7.9 years, from 43 to 51 years (p<0.001), and for EDSS 6/6.5 — by 4.9 years, from 48 to 53 year (p<0.001). These trends were consistent across 20 investigator countries and were observed
in Poser-diagnosed as well as McDonald-diagnosed patient subsets.
Conclusions
The more recent MSBase enrollees in each of the mild-to-moderate disability strata
were significantly older than earlier enrollees. Possible explanations for this phenomenon
are discussed.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of the Neurological SciencesAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Age-related disability in multiple sclerosis.Ann Neurol. 2002; 51: 475-480
- Age at disability milestones in multiple sclerosis.Brain. 2006; 129: 595-605
- Evidence for a two-stage disability progression in multiple sclerosis.Brain. 2010; 133: 1900-1913
- Progression in multiple sclerosis: further evidence of an age dependent process.J Neurol Sci. 2007; 255: 35-41
- The latent period of multiple sclerosis: a critical review.Epidemiology. 1993; 4: 464-470
- Forward telescoping bias in reported age of onset: an example from cigarette smoking.Int J Methods Psychiatr Res. 2005; 14: 119-129
- Patient delay in cancer studies: a discussion of methods and measures.BMC Health Serv Res. 2009; 9: 189
- (Accessioned 6/30/2011)
- MSBase: an international, online registry and platform for collaborative outcomes research in multiple sclerosis.Mult Scler. 2006; 12: 769-774
- New diagnostic criteria for multiple sclerosis: guidelines for research protocols.Ann Neurol. 1983; 13: 227-231
- Recommended diagnostic criteria for multiple sclerosis: guidelines from the International Panel on the diagnosis of multiple sclerosis.Ann Neurol. 2001; 50: 121-127
- Multiple Sclerosis Severity Score: using disability and disease duration to rate disease severity.Neurology. 2005; 64: 1144-1151
- The natural history of multiple sclerosis: a geographically based study. I. Clinical course and disability.Brain. Feb. 1989; 112: 133-146
- Trend for decreasing Multiple Sclerosis Severity Scores (MSSS) with increasing calendar year of enrollment into the New York State Multiple Sclerosis Consortium.Mult Scler. Jun. 2011; 17: 725-733
- Will Rogers phenomenon in multiple sclerosis.Ann Neurol. 2008; 64: 428-433
- Earlier disability of the patients followed in Multiple Sclerosis centers compared to outpatients.Mult Scler. 2009; 15: 251-257
- Disability progression in multiple sclerosis is slower than previously reported.Neurology. 2006; 66: 172-177
- New perspectives in the natural history of multiple sclerosis.Neurology. 2010; 74: 2004-2015
- Treatment effects of immunomodulatory therapies at different stages of multiple sclerosis in short-term trials.Neurology. 2011; 76: S14-S25
- Impact of multiple sclerosis relapses on progression diminishes with time.Neurology. Nov. 17 2009; 73: 1616-1623
- The natural history of multiple sclerosis: a geographically based study 10: relapses and long-term disability.Brain. Jul. 2010; 133: 1914-1929
- The relation between inflammation and neurodegeneration in multiple sclerosis brains.Brain. May 2009; 132: 1175-1189
- Disease progression among multiple sclerosis patients before and during a disease-modifying drug program: a longitudinal population-based evaluation.Mult Scler. 2009; 15: 1286-1294
- Early immunotherapy in MS reduces the risk of later disability. The secondary progressive course is delayed, according to a study with virtual placebo.Lakartidningen. May 30–Jun 3 2007; 104: 1684-1688
- Disability profile of MS did not change over 10 years in a population-based prevalence cohort.Neurology. Feb. 24 2004; 62: 601-606
- Temporal trends of disability progression in multiple sclerosis: findings from British Columbia, Canada (1975–2009).Mult Scler. Sep. 30 2011; ([Epub ahead of print])
- New natural history of interferon-beta-treated relapsing multiple sclerosis.Ann Neurol. 2007; 61: 300-306
- Analysis of clinical outcomes according to original treatment groups 16 years after the pivotal IFNB-1b trial.J Neurol Neurosurg Psychiatry. Aug. 2010; 81: 907-912
Article info
Publication history
Published online: April 16, 2012
Accepted:
March 22,
2012
Received in revised form:
March 21,
2012
Received:
November 27,
2011
Identification
Copyright
© 2012 Elsevier B.V. Published by Elsevier Inc. All rights reserved.