Physical impairment is present before perceived MS onset

An analysis of patient-reported outcomes (PROs) over a 10-year period suggests that physical impairment in MS patients with progressive disease is present before the perceived disease onset. This implies that an initial phase of the disease may be generally overlooked.

Online registries offer the opportunity to streamline follow-up through large-scale, long-term, and cost-effective data collection. Registry data can be analysed retrospectively to compare outcomes based on a particular exposure. Additionally, this type of data allows patients to get involved with research and offer a personal perspective on their disease.

Ms Annalaura Lerede (Imperial College London, UK) presented a prospective registry data analysis reflecting 55-year-long disease trajectories, using data from a 10-year period [1]. The aim was to gather new insights into the evolution of physical disability across MS subtypes. Ms Lerede focused on 2 PROs, namely the Multiple Sclerosis Impact Scale (MSIS-29) motor component, and the Multiple Sclerosis Walking Scale (MSWS-12), which measure general motor and walking abilities, respectively. A total of 15,976 MS patients from the UK MS Register provided data for this study. The records were analysed by disease length (5-years bins) and by MS subtype: relapsing-remitting MS (RRMS), primary-progressive MS (PPMS), secondary-progressive MS (SPMS), and so-called ‘benign’ MS.

Results showed that the investigated PROs worsened over time in each disease subtype except benign MS (2% of the total population) and at each disease timepoint (P<0.0001 for both PROs). The average scores of all subtypes differed from each other (P<0.01) and disease duration was associated with PROs for all subtypes (P<0.001). PPMS and SPMS patients had notably higher (e.g. worse) PROs from the first year up to 10 years later. RRMS patients whose disease progressed within the 10-year follow-up also had higher average PROs from onset (P<0.0001 up to 45 years from onset).

Ms Lerede noted that both PROs already reflect physical disability in all categories of patients before perceived MS onset. “These results suggest that patients may be overlooking an initial phase of the disease.” She added that this work supports the value of PROs as alternative outcome measures in MS, and that PROs may be useful to study the MS prodromal phase.

1. Lerede A, et al. From the patient’s perspective: trajectories of physical worsening over 55 years in multiple sclerosis. Abstract O083, ECTRIMS 2022, 26–28 October, Amsterdam, the Netherlands.

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Posted on 19 December 2022