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Increasing age at disability milestones among MS patients in the MSBase Registry

  • Ilya Kister
    Correspondence
    Corresponding author at: NYU-Multiple Sclerosis Care Center, Department of Neurology, NYU School of Medicine, 301 East 17th Street, New York, NY 10003, USA. Tel.: +1 212 598 6305; fax: +1 212 598 6214.
    Affiliations
    NYU-Multiple Sclerosis Care Center, Department of Neurology, NYU School of Medicine, New York, NY, USA
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  • Eric Chamot
    Affiliations
    Department of Epidemiology, University of Alabama at Birmingham School of Public Health, Birmingham, AL, USA
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  • Gary Cutter
    Affiliations
    Department of Epidemiology, University of Alabama at Birmingham School of Public Health, Birmingham, AL, USA
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  • Tamar E. Bacon
    Affiliations
    NYU-Multiple Sclerosis Care Center, Department of Neurology, NYU School of Medicine, New York, NY, USA
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  • Vilija G. Jokubaitis
    Affiliations
    MS Unit, Department of Neurology, Royal Melbourne Hospital, Victoria, Australia
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  • Stella E. Hughes
    Affiliations
    MS Unit, Department of Neurology, Royal Melbourne Hospital, Victoria, Australia
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  • Orla M. Gray
    Affiliations
    Department of Neurology, Craigavon Area Hospital, Northern Ireland, UK
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  • Maria Trojano
    Affiliations
    University of Bari, Bari, Italy
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  • Guillermo Izquierdo
    Affiliations
    Hospital Universitario, Sevilla, Spain
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  • Francois Grand'Maison
    Affiliations
    Neuro Rive-Sud, Quebec, Canada
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  • Pierre Duquette
    Affiliations
    Hospital Notre Dame, Montreal, Canada
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  • Alessandra Lugaresi
    Affiliations
    MS Center, Dept Neuroscience and Imaging, Univ. “G. d'Annunzio”, Chieti, Italy
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  • Pierre Grammond
    Affiliations
    Hotel_Dieu de Levis, Quebec, Canada
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  • Cavit Boz
    Affiliations
    Karadeniz Technical University, Trabzon, Turkey
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  • Raymond Hupperts
    Affiliations
    Maaslandziekenhuis, Sittard, The Netherlands
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  • Thor Petersen
    Affiliations
    Kommunehospitalet, Arhus C, Denmark
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  • Giorgio Giuliani
    Affiliations
    Ospedale di Macerata, Macerata, Italy
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  • Celia Oreja-Guevara
    Affiliations
    Hospital Universitario La Paz, Madrid, Spain
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  • Gerardo Iuliano
    Affiliations
    Ospedali Riuniti di Salerno, Salerno, Italy
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  • Jeannette Lechner-Scott
    Affiliations
    John Hunter Hospital, New South Wales, Australia
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  • Roberto Bergamaschi
    Affiliations
    Neurological Institute IRCCS Mondino, Pavia, Italy
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  • Maria Edite Rio
    Affiliations
    Hospital S. Joao, Porto, Portugal
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  • Freek Verheul
    Affiliations
    Groen Hart Ziekenhuis, Guoda, The Netherlands
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  • Marcela Fiol
    Affiliations
    FLENI, Buenos Aires, Argentina
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  • Vincent Van Pesch
    Affiliations
    Cliniques Universitaires Saint-Luc, Brussels, Belgium
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  • Mark Slee
    Affiliations
    Flinders University and Medical Centre, South Australia, Australia
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  • Helmut Butzkueven
    Affiliations
    MS Unit, Department of Neurology, Royal Melbourne Hospital, Victoria, Australia
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  • Joseph Herbert
    Affiliations
    NYU-Multiple Sclerosis Care Center, Department of Neurology, NYU School of Medicine, New York, NY, USA
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  • with the MSBase Investigators
    Author Footnotes
    1 MSBase Investigators: From the University of Bari, Italy, Dr. Damiano Paolicelli (MD), Dr. Guglielmo Lucchese (MD) and Dr. Pietro Iaffaldano (MD); From MS-Centrum Nijmegen, Nijmegen, Netherlands, Dr. Cees Zwanikken (MD); From the Royal Melbourne Hospital, Australia, Dr. Mark Marriott (MBBS, PhD), Dr Trevor Kilpatrick (MBBS, PhD), Dr. John King (MBBS) and Dr. Anneke Van der Walt (MBBS); From the Box Hill Hospital, Melbourne, Australia, Dr. Olga Skibina (MD), Ms Jodi Haartsen; From MS Center, Dept Neuroscience and Imaging, Univ. “G. d'Annunzio”, Chieti, Italy, Dr. Giovanna De Luca (MD), Dr. Valeria Di Tommaso (MD), Dr. Daniela Travaglini (MD), Dr. Erika Pietrolongo (PhD), Dr. Maria di Ioia (MD) and Dr. Deborah Farina (MD); From Hopital Notre Dame, Montreal, Canada, Dr. Marc Girard (MD); From Ospedale di Macerata, Macerata, Italy, Dr. Elisabetta Cartechini (MD) and Eugenio Pucci (MD); From John Hunter Hospital, New South Wales, Australia, Dr. David William (MBBS) and Dr. Lisa Dark (MBBS); From FLENI, Buenos Aires, Argentina, Dr. Jorge Correale (MD) and Dr. Celica Ysrraelit (MD); From Hospital Italiano, Buenos Aires, Argentina, Dr. Edgardo Cristiano (MD); Brain Mind Research Institute, New South Wales, Australia, Dr. Michael Barnett (MBBS, PhD); From The Multiple Sclerosis Centre Kamillus-Klinik, Asbach, Germany Dr. Dieter Poehlau (MD); From Ineba, Buenos Aires, Argentina, Dr. Maria Laura Saladino (MD); From Hospital Fernandez, Buenos Aires, Argentina, Dr. Norma Deri (MD), Dr. Gonzalo Jaacks (MD), Dr. Maria Fernanda Páez (MD), Dr. Daniel Muñoz (MD) and Dr. Alfredo Laffue (MD); From Instituto de Neurologia de Curitiba, Curibita, Brazil, Dr. Walter Oleschko Arruda (MD); From Assaf Harofeh Medical Center, Beer-Yaakov, Israel, Dr. Shlomo Felchter (MD); From St Vincent's Hospital, Victoria, Australia, Mark Paine (MBBS); From Centro Internacional de Restauracion Neurologica, Havana, Cuba, Dr. Jose Antonio Cabrera Gomez (MD, PhD); From Consultorio Privado, Buenos Aires, Argentina, Dr. Aldo Savino (MD); From Mater Dei Hospital, Msida, Malta, Dr. Norbert Vella (MD) and Dr. Malcolm Vella (MD); From Geelong Hospital, Victoria, Australia, Cameron Shaw (MBBS, FRACP); From Jewish General Hospital, Montreal, Canada, Dr. Fraser Moore (MD); From Hospital de Especialidades. Centro Medico Nacional Siglo XXI, Mexico, Dr. Eli Skromne (MD); From Al-Zahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran, Dr. Vahid Shaygannejad (MD); From Clinic of Neurology Clinical Center, Skopje, Macedonia, Dr. Tatjana Petkovska-Boskova (MD); From HIGA Gral. San Martin La Plata, Argentina, Dr. Vetere Santiago (MD).
  • Author Footnotes
    1 MSBase Investigators: From the University of Bari, Italy, Dr. Damiano Paolicelli (MD), Dr. Guglielmo Lucchese (MD) and Dr. Pietro Iaffaldano (MD); From MS-Centrum Nijmegen, Nijmegen, Netherlands, Dr. Cees Zwanikken (MD); From the Royal Melbourne Hospital, Australia, Dr. Mark Marriott (MBBS, PhD), Dr Trevor Kilpatrick (MBBS, PhD), Dr. John King (MBBS) and Dr. Anneke Van der Walt (MBBS); From the Box Hill Hospital, Melbourne, Australia, Dr. Olga Skibina (MD), Ms Jodi Haartsen; From MS Center, Dept Neuroscience and Imaging, Univ. “G. d'Annunzio”, Chieti, Italy, Dr. Giovanna De Luca (MD), Dr. Valeria Di Tommaso (MD), Dr. Daniela Travaglini (MD), Dr. Erika Pietrolongo (PhD), Dr. Maria di Ioia (MD) and Dr. Deborah Farina (MD); From Hopital Notre Dame, Montreal, Canada, Dr. Marc Girard (MD); From Ospedale di Macerata, Macerata, Italy, Dr. Elisabetta Cartechini (MD) and Eugenio Pucci (MD); From John Hunter Hospital, New South Wales, Australia, Dr. David William (MBBS) and Dr. Lisa Dark (MBBS); From FLENI, Buenos Aires, Argentina, Dr. Jorge Correale (MD) and Dr. Celica Ysrraelit (MD); From Hospital Italiano, Buenos Aires, Argentina, Dr. Edgardo Cristiano (MD); Brain Mind Research Institute, New South Wales, Australia, Dr. Michael Barnett (MBBS, PhD); From The Multiple Sclerosis Centre Kamillus-Klinik, Asbach, Germany Dr. Dieter Poehlau (MD); From Ineba, Buenos Aires, Argentina, Dr. Maria Laura Saladino (MD); From Hospital Fernandez, Buenos Aires, Argentina, Dr. Norma Deri (MD), Dr. Gonzalo Jaacks (MD), Dr. Maria Fernanda Páez (MD), Dr. Daniel Muñoz (MD) and Dr. Alfredo Laffue (MD); From Instituto de Neurologia de Curitiba, Curibita, Brazil, Dr. Walter Oleschko Arruda (MD); From Assaf Harofeh Medical Center, Beer-Yaakov, Israel, Dr. Shlomo Felchter (MD); From St Vincent's Hospital, Victoria, Australia, Mark Paine (MBBS); From Centro Internacional de Restauracion Neurologica, Havana, Cuba, Dr. Jose Antonio Cabrera Gomez (MD, PhD); From Consultorio Privado, Buenos Aires, Argentina, Dr. Aldo Savino (MD); From Mater Dei Hospital, Msida, Malta, Dr. Norbert Vella (MD) and Dr. Malcolm Vella (MD); From Geelong Hospital, Victoria, Australia, Cameron Shaw (MBBS, FRACP); From Jewish General Hospital, Montreal, Canada, Dr. Fraser Moore (MD); From Hospital de Especialidades. Centro Medico Nacional Siglo XXI, Mexico, Dr. Eli Skromne (MD); From Al-Zahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran, Dr. Vahid Shaygannejad (MD); From Clinic of Neurology Clinical Center, Skopje, Macedonia, Dr. Tatjana Petkovska-Boskova (MD); From HIGA Gral. San Martin La Plata, Argentina, Dr. Vetere Santiago (MD).
Published:April 16, 2012DOI:https://doi.org/10.1016/j.jns.2012.03.017

      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

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