ADVERTISEMENT
Disease-Modifying Treatments for Primary Progressive MS May Lower Risk of Wheelchair Dependence
Disease-modifying treatments in patients with primary progressive multiple sclerosis (MS) and persistent inflammatory activity may lower the risk of becoming wheelchair dependent, according to study findings published online in JAMA Neurology.
“Results of this comparative effectiveness research study suggest that inflammation also occurs in patients with primary progressive MS, may contribute to long-term disability, and may be associated with a reduced risk of becoming wheelchair dependent by current licensed disease-modifying treatments,” wrote lead study author Emilio Portaccio, MD, University of Florence, Italy, and coauthors.
The observational comparative effectiveness study included 409 matched patients with primary progressive MS from the Italian multiple sclerosis register. Among them, 288 received disease-modifying treatments.
Quiz: How does following a keto diet affect depression and fatigue in MS patients?
During a mean follow-up of 10.6 years, 37% of patients reached an Expanded Disability Status Scale (EDSS) score of 7.0, which signaled the need to use a wheelchair, according to the study.
The risk of a 7.0 EDSS score was higher among patients with a higher EDSS score at baseline (researchers reported a 1.32 adjusted hazard ratio), superimposed relapses (2.37 adjusted hazard ratio), and exposure to disease-modifying treatments (1.75 adjusted hazard ratio).
However, the interaction interval between disease-modifying treatments and superimposed relapses was associated with a reduced risk of EDSS score of 7.0; researchers reported an adjusted hazard ratio of 0.33.
The results were confirmed in a subgroup of patients with magnetic resonance imaging data.
“Inflammatory activity may be a modifiable component of long-term disability outcomes in patients with primary progressive MS,” researchers advised.
Reference
