Relapses count

Lublin et al. Effect of relapses on development of residual deficit in multiple sclerosis. Neurology. 2003 Dec 9;61(11):1528-32. 

OBJECTIVE: To determine the percentage of MSers with residual deficits following MS exacerbations and the magnitude of those deficits using a database of pooled placebo patients from clinical trials.

METHODS: A database of MSers assigned to the placebo group in several randomized clinical trials was queried to determine those patients with Expanded Disability Status Scale (EDSS) and Scripps Neurologic Rating Scale assessments prior to, at the time of, and after an acute exacerbation of MS. The extent of deficit present at these time points was compared to determine the acute effect of exacerbations and the degree of persistent disability.

RESULTS: Forty-two percent of MSers had residual deficit of at least 0.5 and 28% had residual of > or =1.0 EDSS units, at an average of 64 days after an exacerbation. The results were reproduced across subsequent exacerbations and were sustained over time. The subgroup of MSers with measurable change in EDSS during the exacerbation had more extensive residual impairment on the follow-up visits. Similar results were seen when the Scripps score was examined.

CONCLUSION: MS exacerbations produce a measurable and sustained effect on disability.

"This data from trials suggests that relapses do count for MSers with persistent or residual disability after relapses. Would you want to continue having relapses if you could have them stopped with a DMT? In addition, there is increasing evidence  that DMTs have a long-term impact on disease course, the most striking data is the impact on survival at 21-years."
Other posts of interest:

18 Feb 2012
Conclusions: There was a significant survival advantage in this cohort of patients receiving early IFNB-1b treatment versus placebo. The treatment-related increase in survival was unchanged by the inclusion of baseline ...

29 May 2011
There is one caveat to these data; IFNbeta has many actions in the body and the improvement in survival may be due to other mechanisms independent of MS. For example, IFNbeta may improve survival by preventing ...

17 Feb 2012
"This delay in disability progression on DMTs has also translated into an improved survival rate." "With this and other ... Post of interest: Multiple Sclerosis Research: MS and survival - long-term betaferon ... 29 May 2011; ...

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