Long-term disability trajectories in primary progressive MS patients: A latent class growth analysis.
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Signori Alessio, Izquierdo Guillermo, Lugaresi Alessandra, Hupperts Raymond, Grand'Maison Francois, Sola Patrizia, Horakova Dana, Havrdova Eva, Prat Alexandre, Girard Marc, Duquette Pierre, Boz Cavit, Grammond Pierre, Terzi Murat, Singhal Bhim, Alroughani Raed, Petersen Thor, Ramo Cristina, Oreja-Guevara Celia, Spitaleri Daniele, Shaygannejad Vahid, Butzkueven Helmut, Kalincik Tomas, Jokubaitis Vilija, Slee Mark, Fernandez Bolaños Ricardo, Sanchez-Menoyo Jose Luis, Pucci Eugenio, Granella Franco, Lechner-Scott Jeannette, Iuliano Gerardo, Hughes Stella, Bergamaschi Roberto, Taylor Bruce, Verheul Freek, Edite Rio Maria, Amato Maria Pia, Sajedi Seyed Aidin, Majdinasab Nastaran, Van Pesch Vincent, Sormani Maria Pia, Trojano Maria
Аннотация
OBJECTIVES: To identify subgroups of PPMS patients with similar longitudinal trajectories of Expanded Disability Status Scale (EDSS) over time.
METHODS: All PPMS patients collected within the MSBase registry, who had their first EDSS assessment within 5 years from onset, were included in the analysis. Longitudinal EDSS scores were modeled by a latent class mixed model (LCMM), using a nonlinear function of time from onset. LCMM is an advanced statistical approach that models heterogeneity between patients by classifying them into unobserved groups showing similar characteristics.
RESULTS: A total of 853 PPMS (51.7% females) from 24 countries with a mean age at onset of 42.4 years (standard deviation (SD): 10.8 years), a median baseline EDSS of 4 (interquartile range (IQR): 2.5-5.5), and 2.4 years of disease duration (SD: 1.5 years) were included. LCMM detected three different subgroups of patients with a mild ( n = 143; 16.8%), moderate ( n = 378; 44.3%), or severe ( n = 332; 38.9%) disability trajectory. The probability of reaching EDSS 6 at 10 years was 0%, 46.4%, and 81.9% respectively.
CONCLUSION: Applying an LCMM modeling approach to long-term EDSS data, it is possible to identify groups of PPMS patients with different prognosis.