Early non-disabling relapses are important predictors of disability accumulation in people with relapsing-remitting multiple sclerosis

Cyrus Daruwalla; Vahid Shaygannejad; Serkan Ozakbas; Eva Kubala Havrdova; Dana Horakova; Raed Alroughani; Cavit Boz; Francesco Patti; Marco Onofrj; Alessandra Lugaresi; Sara Eichau; Marc Girard; Alexandre Prat; Pierre Duquette; Bassem Yamout; Samia J. Khoury; Seyed Aidin Sajedi; Recai Turkoglu; Ayse Altintas; Olga Skibina; Katherine Buzzard; Pierre Grammond; Rana Karabudak; Anneke van der Walt; Helmut Butzkueven; Davide Maimone; Jeannette Lechner-Scott; Aysun Soysal; Nevin John; Julie Prevost; Daniele Spitaleri; Cristina Ramo-Tello; Oliver Gerlach; Gerardo Iuliano; Matteo Foschi; Radek Ampapa; Vincent van Pesch; Michael Barnett; Nevin Shalaby; Marie D'hooghe; Jens Kuhle; Maria Jose Sa; Marzena Fabis-Pedrini; Allan Kermode; Saloua Mrabet; Riadh Gouider; Suzanne Hodgkinson; Guy Laureys; Liesbeth Van Hijfte; Richard Macdonell; Celia Oreja-Guevara; Edgardo Cristiano; Pamela McCombe; Jose Luis Sanchez-Menoyo; Bhim Singhal; Yolanda Blanco; Stella Hughes; Justin Garber; Claudio Solaro; Chris McGuigan; Bruce Taylor; Koen de Gans; Mario Habek; Abdullah Al-Asmi; Simu Mihaela; Tamara Castillo Trivino; Talal Al-Harbi; Juan Ignacio Rojas; Orla Gray; Dheeraj Khurana; Bart Van Wijmeersch; Nikolaos Grigoriadis; Jihad Inshasi; Jiwon Oh; Eduardo Aguera-Morales; Yara Fragoso; Fraser Moore; Cameron Shaw; Seyed Mohammad Baghbanian; Neil Shuey; Barbara Willekens; Todd A. Hardy; Danny Decoo; Angel Perez Sempere; Deborah Field; Ray Wynford-Thomas; Nick G. Cunniffe; Izanne Roos; Charles B. Malpas; Alasdair J. Coles; Tomas Kalincik; J. William L. Brown; MSBase Study Grp

doi:10.1177/13524585231151951

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Early non-disabling relapses are important predictors of disability accumulation in people with relapsing-remitting multiple sclerosis

Journal article

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Peer reviewed

Early non-disabling relapses are important predictors of disability accumulation in people with relapsing-remitting multiple sclerosis

Cyrus Daruwalla, Vahid Shaygannejad, Serkan Ozakbas, Eva Kubala Havrdova, Dana Horakova, Raed Alroughani, Cavit Boz, Francesco Patti, Marco Onofrj, Alessandra Lugaresi, …

Multiple sclerosis, Vol.29(7), pp.875-883

2023

DOI: https://doi.org/10.1177/13524585231151951

PMID: 36851894

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Abstract

Clinical Neurology

Life Sciences & Biomedicine

Neurosciences

Neurosciences & Neurology

Science & Technology

Background: The prognostic significance of non-disabling relapses in people with relapsing-remitting multiple sclerosis (RRMS) is unclear. Objective: To determine whether early non-disabling relapses predict disability accumulation in RRMS. Methods: We redefined mild relapses in MSBase as 'non-disabling', and moderate or severe relapses as 'disabling'. We used mixed-effects Cox models to compare 90-day confirmed disability accumulation events in people with exclusively non-disabling relapses within 2 years of RRMS diagnosis to those with no early relapses; and any early disabling relapses. Analyses were stratified by disease-modifying therapy (DMT) efficacy during follow-up. Results: People who experienced non-disabling relapses within 2 years of RRMS diagnosis accumulated more disability than those with no early relapses if they were untreated (n = 285 vs 4717; hazard ratio (HR) = 1.29, 95% confidence interval (CI) = 1.00-1.68) or given platform DMTs (n = 1074 vs 7262; HR = 1.33, 95% CI = 1.15-1.54), but not if given high-efficacy DMTs (n = 572 vs 3534; HR = 0.90, 95% CI = 0.71-1.13) during follow-up. Differences in disability accumulation between those with early non-disabling relapses and those with early disabling relapses were not confirmed statistically. Conclusion: This study suggests that early non-disabling relapses are associated with a higher risk of disability accumulation than no early relapses in RRMS. This risk may be mitigated by high-efficacy DMTs. Therefore, non-disabling relapses should be considered when making treatment decisions.

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Title: Early non-disabling relapses are important predictors of disability accumulation in people with relapsing-remitting multiple sclerosis
Authors/Creators: Cyrus Daruwalla - University of Cambridge
Vahid Shaygannejad - Isfahan University of Medical Sciences
Serkan Ozakbas - Dokuz Eylül University
Eva Kubala Havrdova - Charles University
Dana Horakova - Charles University
Raed Alroughani - Amiri Hospital
Cavit Boz - Farabi Hastanesi
Francesco Patti - University of Catania
Marco Onofrj - University of Chieti-Pescara
Alessandra Lugaresi - Istituto delle Scienze Neurologiche di Bologna
Sara Eichau - Hospital Universitario Virgen Macarena
Marc Girard - Université de Montréal
Alexandre Prat - Université de Montréal
Pierre Duquette - Université de Montréal
Bassem Yamout - American University of Beirut Medical Center
Samia J. Khoury - American University of Beirut Medical Center
Seyed Aidin Sajedi - Golestan University
Recai Turkoglu - Haydarpaşa Numune Eğitim ve Araştırma Hastanesi
Ayse Altintas - Koç University
Olga Skibina - Box Hill Hospital
Katherine Buzzard - The Royal Melbourne Hospital
Pierre Grammond - Centre Intégré de Santé et Services Sociaux de Chaudière-Appalache
Rana Karabudak - Hacettepe University
Anneke van der Walt - Monash University
Helmut Butzkueven - Monash University
Davide Maimone
Jeannette Lechner-Scott - John Hunter Hospital
Aysun Soysal - Bakırköy Psychiatric Hospital
Nevin John - Monash Medical Centre
Julie Prevost - Cegep de Saint Jerome
Daniele Spitaleri - Azienda Ospedaliera S.Giuseppe Moscati
Cristina Ramo-Tello - Hospital Universitari Germans Trias i Pujol
Oliver Gerlach - Zuyderland Medisch Centrum
Gerardo Iuliano - Ospedali Riuniti San Giovanni di Dio e Ruggi d'Aragona
Matteo Foschi - Ospedale "Santa Maria delle Croci" di Ravenna
Radek Ampapa - Hospital Jihlava
Vincent van Pesch - Cliniques Universitaires Saint-Luc
Michael Barnett - Mind Australia
Nevin Shalaby
Marie D'hooghe - National MS Center Melsbroek
Jens Kuhle - University of Basel
Maria Jose Sa - Fernando Pessoa University
Marzena Fabis-Pedrini - Perron Institute for Neurological and Translational Science
Allan Kermode - Murdoch University, Institute for Immunology and Infectious Diseases
Saloua Mrabet - Tunis El Manar University
Riadh Gouider - Hôpital Razi de La Manouba
Suzanne Hodgkinson - Ingham Institute
Guy Laureys - Ghent University Hospital
Liesbeth Van Hijfte - Ghent University Hospital
Richard Macdonell - Austin Health
Celia Oreja-Guevara - Hospital Clínico San Carlos
Edgardo Cristiano - Ctr Esclerosis Multiple Buenos Aires CEMBA, Buenos Aires, Argentina
Pamela McCombe - Royal Brisbane and Women's Hospital
Jose Luis Sanchez-Menoyo - Hospital de Galdakao
Bhim Singhal - Bombay Hospital
Yolanda Blanco - Hospital Clínic de Barcelona
Stella Hughes - Royal Victoria Hospital
Justin Garber - Westmead Hospital
Claudio Solaro - Genoa (Brazil)
Chris McGuigan - St. Vincent's University Hospital
Bruce Taylor - Royal Hobart Hospital
Koen de Gans - Groene Hart Ziekenhuis
Mario Habek - University of Zagreb
Abdullah Al-Asmi - Sultan Qaboos University Hospital
Simu Mihaela - Victor Babeș University of Medicine and Pharmacy Timișoara
Tamara Castillo Trivino - Hosp Univ Donostia, San Sebastian, Spain
Talal Al-Harbi - King Fahad Specialist Hospital
Juan Ignacio Rojas - Hospital Universitario Austral
Orla Gray - South Eastern Health and Social Care Trust
Dheeraj Khurana - Post Graduate Institute of Medical Education and Research
Bart Van Wijmeersch - Hasselt University
Nikolaos Grigoriadis - AHEPA University Hospital
Jihad Inshasi - Rashid Hospital
Jiwon Oh - St. Michael's Hospital
Eduardo Aguera-Morales - Hospital Universitario Reina Sofía
Yara Fragoso - Universidade Metropolitana de Santos
Fraser Moore - Jewish General Hospital
Cameron Shaw - Geelong Hospital
Seyed Mohammad Baghbanian - Mazandaran University of Medical Sciences
Neil Shuey - St Vincent's Hospital Melbourne
Barbara Willekens - Antwerp University Hospital
Todd A. Hardy - Concord Repatriation General Hospital
Danny Decoo - Alma
Angel Perez Sempere - Hospital General Universitario de Alicante Doctor Balmis
Deborah Field - Lyell McEwin Hospital
Ray Wynford-Thomas - University Hospital of Wales
Nick G. Cunniffe - University of Cambridge
Izanne Roos - The Royal Melbourne Hospital
Charles B. Malpas - The Royal Melbourne Hospital
Alasdair J. Coles - University of Cambridge
Tomas Kalincik - The Royal Melbourne Hospital
J. William L. Brown - University of Cambridge
MSBase Study Grp
Publication Details: Multiple sclerosis, Vol.29(7), pp.875-883
Publisher: SAGE Publications
Number of pages: 9
Grant note: 1140766; 1080518; 1129189; 1083539 / National Health and Medical Research Council of Australia; National Health and Medical Research Council (NHMRC) of Australia University of Melbourne EAN/ACA-006/7488627/C / Academic Clinical Fellowship 301728 / National Institute for Health and Care Research (UK) Advanced Fellowship
Identifiers: 991005590370007891
Murdoch Affiliation: Institute for Immunology and Infectious Diseases
Language: English
Resource Type: Journal article

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Collaboration types: Domestic collaboration; International collaboration
Citation topics: 1 Clinical & Life Sciences; 1.203 Neuromuscular Disorders; 1.203.147 Multiple Sclerosis
Web Of Science research areas: Clinical Neurology; Neurosciences
ESI research areas: Neuroscience & Behavior