HerMeS: a registry-based evaluation of the HERCULES criteria for identifying nonrelapsing SPMS.
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.
Guerra Tommaso, Lucisano Giuseppe, Rocca Maria A, Cocco Eleonora, Patti Francesco, De Luca Giovanna, Portaccio Emilio, Foschi Matteo, Ferraro Diana, Pozzilli Carlo, Romano Silvia, Annovazzi Pietro, Brescia Morra Vincenzo, Tortorella Carla, Fantozzi Roberta, Perini Paola, Coniglio Maria Gabriella, Salemi Giuseppe, Inglese Matilde, Maniscalco Giorgia Teresa, Torri Clerici Valentina Liliana Adriana Maria, Lugaresi Alessandra, Lus Giacomo, Colombo Elena, Granella Franco, Cavalla Paola, Di Sapio Alessia, Conte Antonella, Cerqua Raffaella, Totaro Rocco, Caputo Francesca, Paolicelli Damiano, Farina Alberto, Mondino Margaret Mary, Todaro Daniele Santo, Olivieri Nunzio, Amato Maria Pia, Filippi Massimo, Trojano Maria, Iaffaldano Pietro, Italian Multiple Sclerosis and Related Disorders Register (RISM)
Аннотация
OBJECTIVES: To characterize a cohort of non-relapsing SPMS (nrSPMS) identified through a data-driven definition adapted from the HERCULES trial criteria, compared with neurologist-defined (ND) SPMS.
METHODS: Relapsing MS patients were retrospectively extracted from the Italian Multiple Sclerosis Register (RISM). ND was defined according to clinical criteria for SPMS and the HERCULES cohort adapting the trial inclusion criteria. Progression independent from relapse activity (PIRA) and relapse-associated worsening (RAW) events were assessed. Diagnostic performances of SPMS definitions were evaluated.
RESULTS: Among 20,306 patients, 866 (4.26%) were classified as SPMS by ND and 1603 (7.89%) by HERCULES criteria. The HERCULES group included older patients, less likely to relapse post-conversion. PIRA occurred in 88.8% of ND and 88.5% of HERCULES-defined cases, with a shorter median time to first PIRA in the latter. The HERCULES definition showed high specificity (93.4%) and low sensitivity (37.6%).
CONCLUSIONS: HERCULES-adapted criteria identified a subgroup of 7.9% nrSPMS patients in the real-world cohort of RISM, characterized by fewer post-conversion relapses and earlier PIRA onset. These findings reinforce the value of applying standardized algorithmic definitions of SPMS in registry-based studies.