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Importance of early treatment initiation in the clinical course of multiple sclerosis
KTH, School of Engineering Sciences (SCI), Mathematics (Dept.), Mathematics (Div.).
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2017 (English)In: Multiple Sclerosis, ISSN 1352-4585, E-ISSN 1477-0970, Vol. 23, no 9, p. 1233-1240Article in journal (Refereed) Published
Abstract [en]

Objectives: The aim of this study was to identify factors influencing the long-term clinical progression of multiple sclerosis (MS). A special objective was to investigate whether early treatment decisions influence outcome. Methods: We included 639 patients diagnosed with MS from 2001 to 2007. The median follow-up time was 99 months (8.25 years). Cox regression models were applied to identify factors correlating with the outcome variable defined as time from treatment start to irreversible score 4 of the Expanded Disability Status Scale (EDSS). Results: Patients initiated on treatment later had a greater risk of reaching EDSS 4 (hazard ratio of 1.074 (95% confidence interval (CI), 1.048-1.101)), increased by 7.4% for every year of delay in treatment start after MS onset. Patients who started treatment after 3 years from MS onset reached the outcome sooner with hazard ratio of 2.64 (95% CI, 1.71-4.08) compared with the patients who started treatment within 1 year from MS onset. Baseline EDSS and age at onset were found to be predictive factors of disability progression. Conclusion: Early treatment initiation was associated with a better clinical outcome. In addition, we confirmed the well-established prognostic factors of late age at onset and early disability.

Place, publisher, year, edition, pages
SAGE PUBLICATIONS LTD , 2017. Vol. 23, no 9, p. 1233-1240
Keyword [en]
Multiple sclerosis, drug therapy, treatment outcome, disease progression, disability evaluation, cohort studies, survival analysis
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Neurology
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URN: urn:nbn:se:kth:diva-212338DOI: 10.1177/1352458516675039ISI: 000406386600011Scopus ID: 2-s2.0-85026672961OAI: oai:DiVA.org:kth-212338DiVA, id: diva2:1135502
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QC 20170823

Available from: 2017-08-23 Created: 2017-08-23 Last updated: 2017-08-23Bibliographically approved

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