Abstract
Background
Daily practice is still faced with uncertainty in predicting the long-term disability
of multiple sclerosis (MS). Most information comes from northern hemisphere cohorts,
but in South America this information is scarce, and race, genetic and environmental
factors could play an important role in the heterogeneity observed in disease outcomes.
Methods
We evaluated 197 patients attending our MS Center gathering clinical and demographic
information. Outcome measures analyzed were time from first clinical symptom to EDSS
of 6, 7 and 8. For survival analysis we employed Cox regression models and the Kaplan–Meier
method.
Results
Time to EDSS 6 was 25.83 years (95% CI 15.36–36.31), and 36.25 years (95% CI 20.72–51.78) for EDSS 7. Male sex was associated with a 4.63 and 4.69
fold increased risk to EDSS 6 and 7, respectively (p<0.001 and p=0.006). Motor and brainstem symptoms at onset were also associated with an 8.1 and
13.1 fold increased risk to EDSS 6, respectively (p=0.04 and p=0.01). The number of relapses in five and ten years of disease onset was associated
with a slightly increased risk to EDSS 8 (1.28 and 1.19, respectively; p=0.032 and p=0.015).
Conclusions
Male patients presenting with frequent relapses, especially those with motor and brainstem
involvement, deserve close observation and should be cautiously monitored to early
signs of treatment failure.
Keywords
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Article info
Publication history
Published online: October 16, 2012
Accepted:
September 17,
2012
Received in revised form:
August 28,
2012
Received:
June 19,
2012
Identification
Copyright
© 2012 Elsevier B.V. Published by Elsevier Inc. All rights reserved.
