Toward a Unified Definition of Progression Independent of Relapse Activity in Multiple Sclerosis.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Portaccio Emilio, Betti Matteo, De Meo Ermelinda, Pastò Luisa, Prestipino Elio, Lugaresi Alessandra, Cocco Eleonora, De Luca Giovanna, Patti Francesco, Torri Clerici Valentina Liliana Adriana Maria, Ferraro Diana, Brescia Morra Vincenzo, Salemi Giuseppe, Vianello Marika, Cerqua Raffaella, Inglese Matilde, Pasanisi Maria Barbara, Perini Paola, Romano Silvia, Pozzilli Carlo, Tortorella Carla, Di Sapio Alessia, Annovazzi Pietro, Simone Marta, Iaffaldano Pietro, Rocca Maria A, Filippi Massimo, Trojano Maria, Amato Maria Pia, Italian Multiple Sclerosis and Related Disorders Register
Аннотация
METHODS: Patients with relapsing MS, first visit ≥January 1, 2000, ≥3 visits with Expanded Disability Status Scale (EDSS), and ≥5-year follow-up were extracted from the Italian MS and Related Disorders Register on September 29, 2023. Eighteen PIRA definitions were obtained combining fixed or roving baseline, 24-week, 48-week confirmed or sustained disability accrual, no relapses ≤90 days before/≤30 days after the event (90d), ≤180 days before/≤30 days after the event, or absence of relapses from baseline to confirmation score (ABS). Predictive performance against the reaching of EDSS = 6.0 was calculated.
RESULTS: A total of 30,203 patients were included. After a follow-up of 11.3 ± 4.3 years, PIRA ranged from 38.8% to 74.1%. EDSS = 6.0 was detected in 4,401 (15%) patients. Sensitivity of PIRA definitions against EDSS = 6.0 was higher using the 90d criterion (66.7%-69.4%), while the ABS criterion increased specificity (55.3%-62.2%).
DISCUSSION: The definition of PIRA combining roving baseline, no relapses 90 days before and 30 days after the event and 24-week confirmation achieved the best predictive value and feasibility, supporting its use in routine practice and research.