Long-term disability trajectories in primary progressive MS patients: A latent class growth analysis
Por:
Signori, A, Izquierdo, G, Lugaresi, A, Hupperts, R, Grand'Maison, F, Sola, P, Horakova, D, Havrdova, E, Prat, A, Girard, M, Duquette, P, Boz, C, Grammond, P, Terzi, M, Singhal, B, Alroughani, R, Petersen, T, Ramo, C, Oreja-Guevara, C, Spitaleri, D, Shaygannejad, V, Butzkueven, H, Kalincik, T, Jokubaitis, V, Slee, M, Bolanos, RF, Sanchez-Menoyo, JL, Pucci, E, Granella, F, Lechner-Scott, J, Iuliano, G, Hughes, S, Bergamaschi, R, Taylor, B, Verheul, F, Rio, ME, Amato, MP, Sajedi, SA, Majdinasab, N, Van Pesch, V, Sormani, MP and Trojano, M
Publicada:
1 abr 2018
Resumen:
Background: Several natural history studies on primary progressive multiple sclerosis (PPMS) patients detected a consistent heterogeneity in the rate of disability accumulation.
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.
Filiaciones:
Signori, A:
Univ Genoa, Sect Biostat, Dept Hlth Sci DISSAL, Via A Pastore 1, I-16132 Genoa, Italy
Izquierdo, G:
Hosp Univ Virgen Macarena, Seville, Spain
Lugaresi, A:
Univ Bologna, Dept Biomed & Neuromotor Sci DIBINEM, Alma Mater Studiorum, Bologna, Italy
IRCCS Ist Sci Neurol Bologna, Bologna, Italy
Hupperts, R:
Zuyderland Ziekenhuis, Sittard, Netherlands
Grand'Maison, F:
Clin Neuro Rive Sud, Greenfield Pk, PQ, Canada
Sola, P:
Nuovo Osped Civile S Agostino Estense, Modena, Italy
Horakova, D:
Charles Univ Prague, Fac Med 1, Dept Neurol, Prague, Czech Republic
Charles Univ Prague, Fac Med 1, Ctr Clin Neurosci, Prague, Czech Republic
Gen Univ Hosp Prague, Prague, Czech Republic
Havrdova, E:
Charles Univ Prague, Fac Med 1, Dept Neurol, Prague, Czech Republic
Charles Univ Prague, Fac Med 1, Ctr Clin Neurosci, Prague, Czech Republic
Gen Univ Hosp Prague, Prague, Czech Republic
Prat, A:
Hop Notre Dame De Bon Secours, Montreal, PQ, Canada
Girard, M:
Hop Notre Dame De Bon Secours, Montreal, PQ, Canada
Duquette, P:
Hop Notre Dame De Bon Secours, Montreal, PQ, Canada
Boz, C:
Farabi Hosp, KTU Med Fac, Trabzon, Turkey
Grammond, P:
Ctr Readaptat Deficience Phys Chaudiere Appalache, Levis, PQ, Canada
Terzi, M:
Ondokuz Mayis Univ, Fac Med, Samsun, Turkey
Singhal, B:
BHIMS, Bombay, Maharashtra, India
Alroughani, R:
Amiri Hosp, Kuwait, Kuwait
Petersen, T:
Kommunehospitalet, Aarhus, Denmark
:
Hosp Badalona Germans Trias & Pujol, Badalona, Spain
Oreja-Guevara, C:
Hosp Clin San Carlos, Madrid, Spain
Spitaleri, D:
Azienda Osped Rilievo Nazl, Avellino, Italy
Shaygannejad, V:
Isfahan Univ Med Sci, Esfahan, Iran
Butzkueven, H:
Box Hill Hosp, Melbourne, Vic, Australia
Univ Melbourne, Dept Med, Melbourne, Vic, Australia
Kalincik, T:
Univ Melbourne, Dept Med, Melbourne, Vic, Australia
Jokubaitis, V:
Univ Melbourne, Dept Med, Melbourne, Vic, Australia
Slee, M:
Flinders Univ & Med Ctr, Adelaide, SA, Australia
Bolanos, RF:
Hosp Univ Virgen de Valme, Seville, Spain
Sanchez-Menoyo, JL:
Hosp Galdakao Usansolo, Galdakao, Spain
Pucci, E:
Azienda Sanit Unica Reg Marche, UOC Neurol, Macerata, Italy
Granella, F:
Univ Parma, Parma, Italy
Lechner-Scott, J:
Univ Newcastle, Hunter Med Res Inst, Newcastle, NSW, Australia
Iuliano, G:
Osped Riuniti Salerno, Salerno, Italy
Hughes, S:
Craigavon Area Hosp, Craigavon, North Ireland
Bergamaschi, R:
C Mondino Natl Neurol Inst, Pavia, Italy
Taylor, B:
Royal Hobart Hosp, Hobart, Tas, Australia
Verheul, F:
Groene Hart Ziekenhuis, Gouda, Netherlands
Rio, ME:
Hosp Sao Joao, Porto, Portugal
Amato, MP:
Univ Florence, Sect Neurosci, Dept NEUROFARBA, Florence, Italy
Sajedi, SA:
Golestan Univ Med Sci, Dept Neurol, Gorgan, Iran
Ahvaz Jundishapur Univ Med Sci, Golestan Hosp, Ahvaz, Iran
Majdinasab, N:
Ahvaz Jundishapur Univ Med Sci, Golestan Hosp, Ahvaz, Iran
Van Pesch, V:
Clin Univ St Luc, Brussels, Belgium
Sormani, MP:
Univ Genoa, Sect Biostat, Dept Hlth Sci DISSAL, Via A Pastore 1, I-16132 Genoa, Italy
Trojano, M:
Univ Bari, Dept Basic Med Sci Neurosci & Sense Organs, Bari, Italy
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