Corticosteroid treatment of multiple sclerosis relapses is associated with lower disability worsening over 5 years.
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.
Roberts Jodie I, Sharmin Sifat, Horakova Dana, Kubala Havrdova Eva, Ozakbas Serkan, Lugaresi Alessandra, Tomassini Valentina, Alroughani Raed, Buzzard Katherine, Skibina Olga, Boz Cavit, Turkoglu Recai, Maimone Davide, Yamout Bassem, Khoury Samia Joseph, Spitaleri Daniele, Lechner-Scott Jeannette, Girard Marc, Duquette Pierre, Al-Asmi Abdullah, Ampapa Radek, Foschi Matteo, Surcinelli Andrea, Patti Francesco, Van Pesch Vincent, Ramo-Tello Cristina, Sánchez-Menoyo José Luis, Altintas Ayse, Grammond Pierre, Cartechini Elisabetta, Csepany Tunde, Laureys Guy, Willekens Barbara, Roos Izanne, Kalincik Tomas, Study Group MSBase
Аннотация
METHODS: Individuals with clinically definite MS and ≥3 Expanded Disability Status Scale (EDSS) measurements over ≥12 months were identified within the international neuroimmunology registry MSBase. Individuals were required to have ≥1 relapse, with complete information on relapse treatment, phenotype and severity for all documented relapses. The primary outcome was disability worsening confirmed over 12 months. The association of the cumulative number of steroid-treated and untreated relapses (as a time-varying exposure) with disability worsening was evaluated with Cox proportional hazards.
RESULTS: In total, 3673 individuals met the inclusion criteria (71% female, mean age 38 years, mean disability EDSS step 2); 5809 relapses (4671 treated/1138 untreated) were captured (annualised relapse rate 0.19). Over the study period (total 30 175 person-years), 32.7% reached the outcome of confirmed disability worsening (median survival time 5.2 years). Non-treated relapses were associated with a higher risk of disability worsening (HR 1.72, 95% CI 1.57 to 1.88) than steroid-treated relapses (HR 1.50, 95% CI 1.43 to 1.57). This association was modified by the efficacy of disease-modifying therapy at the time of relapse.
CONCLUSIONS: Our results suggest that a lack of steroid treatment of MS relapses is associated with a higher risk of future disability worsening. Hence, corticosteroid treatment of MS relapses may impact not only the speed of recovery but also the severity of residual structural damage.