Characterising aggressive multiple sclerosis

Suresh Menon, Afsaneh Shirani, Yinshan Zhao, Joel Oger, Anthony Traboulsee, Mark S. Freedman, Helen Tremlett

Research output: Contribution to journalArticle

35 Citations (Scopus)

Abstract

Objective: To explore the occurrence and characteristics of aggressive multiple sclerosis (AMS) in adult-onset multiple sclerosis (MS) patients. Methods: Prospectively collected data (1980-2009) from British Columbia, Canada, were retrospectively analysed. AMS was defined in three different ways (AMS1, 2 and 3): 'AMS1'-confirmed Expanded Disability Status Scale (EDSS) ≥6 within 5 years of MS onset; 'AMS2'-confirmed EDSS ≥6 by age 40; and 'AMS3'-secondary progressive MS within 3 years of a relapsing-onset course. Three respective 'non-aggressive' MS comparison cohorts were selected. Patients' characteristics were compared between aggressive and non-aggressive cohorts using multivariable logistic regression, with findings expressed as adjusted OR (AOR) and 95% CI. Results: Application of the three definitions to the source population of 5891 patients resulted in 235/4285 (5.5%) patients fulfilling criteria for AMS1 (59.6% were female; 74.5% had relapsing-onset MS), 388/2762 (14.0%) for AMS2 (65.2% were female; 92.8% had relapsing-onset MS) and 195/4918 (4.0%) patients for AMS3 (61.0% were female). Compared to the respective control cohorts, those with AMS were more likely to be male (AOR=1.5, 95% CI 1.1 to 2.0 (AMS1); 1.6, 95% CI 1.3 to 2.1 (AMS2); 1.8, 95% CI 1.3 to 2.4 (AMS3)), older at MS symptom onset (AOR=1.1; 95% CI 1.1 to 1.1 (AMS1 and AMS3)) and have primary progressive MS (AOR=2.3, 95% CI 1.6 to 3.3 (AMS1); 2.7, 95% CI 1.7 to 4.4 (AMS2)). Conclusions: AMS was identified in 4-14% of patients, depending on the definition used. Although there was a relative preponderance of men and primary progressive MS presenting with AMS, the majority of patients were still women and those with relapsing-onset MS.

Original languageEnglish (US)
Pages (from-to)1192-1198
Number of pages7
JournalJournal of Neurology, Neurosurgery and Psychiatry
Volume84
Issue number11
DOIs
StatePublished - Nov 2013

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Multiple Sclerosis
Chronic Progressive Multiple Sclerosis
British Columbia
Canada
Logistic Models

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology
  • Psychiatry and Mental health

Cite this

Menon, S., Shirani, A., Zhao, Y., Oger, J., Traboulsee, A., Freedman, M. S., & Tremlett, H. (2013). Characterising aggressive multiple sclerosis. Journal of Neurology, Neurosurgery and Psychiatry, 84(11), 1192-1198. https://doi.org/10.1136/jnnp-2013-304951

Characterising aggressive multiple sclerosis. / Menon, Suresh; Shirani, Afsaneh; Zhao, Yinshan; Oger, Joel; Traboulsee, Anthony; Freedman, Mark S.; Tremlett, Helen.

In: Journal of Neurology, Neurosurgery and Psychiatry, Vol. 84, No. 11, 11.2013, p. 1192-1198.

Research output: Contribution to journalArticle

Menon, S, Shirani, A, Zhao, Y, Oger, J, Traboulsee, A, Freedman, MS & Tremlett, H 2013, 'Characterising aggressive multiple sclerosis', Journal of Neurology, Neurosurgery and Psychiatry, vol. 84, no. 11, pp. 1192-1198. https://doi.org/10.1136/jnnp-2013-304951
Menon, Suresh ; Shirani, Afsaneh ; Zhao, Yinshan ; Oger, Joel ; Traboulsee, Anthony ; Freedman, Mark S. ; Tremlett, Helen. / Characterising aggressive multiple sclerosis. In: Journal of Neurology, Neurosurgery and Psychiatry. 2013 ; Vol. 84, No. 11. pp. 1192-1198.
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title = "Characterising aggressive multiple sclerosis",
abstract = "Objective: To explore the occurrence and characteristics of aggressive multiple sclerosis (AMS) in adult-onset multiple sclerosis (MS) patients. Methods: Prospectively collected data (1980-2009) from British Columbia, Canada, were retrospectively analysed. AMS was defined in three different ways (AMS1, 2 and 3): 'AMS1'-confirmed Expanded Disability Status Scale (EDSS) ≥6 within 5 years of MS onset; 'AMS2'-confirmed EDSS ≥6 by age 40; and 'AMS3'-secondary progressive MS within 3 years of a relapsing-onset course. Three respective 'non-aggressive' MS comparison cohorts were selected. Patients' characteristics were compared between aggressive and non-aggressive cohorts using multivariable logistic regression, with findings expressed as adjusted OR (AOR) and 95{\%} CI. Results: Application of the three definitions to the source population of 5891 patients resulted in 235/4285 (5.5{\%}) patients fulfilling criteria for AMS1 (59.6{\%} were female; 74.5{\%} had relapsing-onset MS), 388/2762 (14.0{\%}) for AMS2 (65.2{\%} were female; 92.8{\%} had relapsing-onset MS) and 195/4918 (4.0{\%}) patients for AMS3 (61.0{\%} were female). Compared to the respective control cohorts, those with AMS were more likely to be male (AOR=1.5, 95{\%} CI 1.1 to 2.0 (AMS1); 1.6, 95{\%} CI 1.3 to 2.1 (AMS2); 1.8, 95{\%} CI 1.3 to 2.4 (AMS3)), older at MS symptom onset (AOR=1.1; 95{\%} CI 1.1 to 1.1 (AMS1 and AMS3)) and have primary progressive MS (AOR=2.3, 95{\%} CI 1.6 to 3.3 (AMS1); 2.7, 95{\%} CI 1.7 to 4.4 (AMS2)). Conclusions: AMS was identified in 4-14{\%} of patients, depending on the definition used. Although there was a relative preponderance of men and primary progressive MS presenting with AMS, the majority of patients were still women and those with relapsing-onset MS.",
author = "Suresh Menon and Afsaneh Shirani and Yinshan Zhao and Joel Oger and Anthony Traboulsee and Freedman, {Mark S.} and Helen Tremlett",
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AU - Menon, Suresh

AU - Shirani, Afsaneh

AU - Zhao, Yinshan

AU - Oger, Joel

AU - Traboulsee, Anthony

AU - Freedman, Mark S.

AU - Tremlett, Helen

PY - 2013/11

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N2 - Objective: To explore the occurrence and characteristics of aggressive multiple sclerosis (AMS) in adult-onset multiple sclerosis (MS) patients. Methods: Prospectively collected data (1980-2009) from British Columbia, Canada, were retrospectively analysed. AMS was defined in three different ways (AMS1, 2 and 3): 'AMS1'-confirmed Expanded Disability Status Scale (EDSS) ≥6 within 5 years of MS onset; 'AMS2'-confirmed EDSS ≥6 by age 40; and 'AMS3'-secondary progressive MS within 3 years of a relapsing-onset course. Three respective 'non-aggressive' MS comparison cohorts were selected. Patients' characteristics were compared between aggressive and non-aggressive cohorts using multivariable logistic regression, with findings expressed as adjusted OR (AOR) and 95% CI. Results: Application of the three definitions to the source population of 5891 patients resulted in 235/4285 (5.5%) patients fulfilling criteria for AMS1 (59.6% were female; 74.5% had relapsing-onset MS), 388/2762 (14.0%) for AMS2 (65.2% were female; 92.8% had relapsing-onset MS) and 195/4918 (4.0%) patients for AMS3 (61.0% were female). Compared to the respective control cohorts, those with AMS were more likely to be male (AOR=1.5, 95% CI 1.1 to 2.0 (AMS1); 1.6, 95% CI 1.3 to 2.1 (AMS2); 1.8, 95% CI 1.3 to 2.4 (AMS3)), older at MS symptom onset (AOR=1.1; 95% CI 1.1 to 1.1 (AMS1 and AMS3)) and have primary progressive MS (AOR=2.3, 95% CI 1.6 to 3.3 (AMS1); 2.7, 95% CI 1.7 to 4.4 (AMS2)). Conclusions: AMS was identified in 4-14% of patients, depending on the definition used. Although there was a relative preponderance of men and primary progressive MS presenting with AMS, the majority of patients were still women and those with relapsing-onset MS.

AB - Objective: To explore the occurrence and characteristics of aggressive multiple sclerosis (AMS) in adult-onset multiple sclerosis (MS) patients. Methods: Prospectively collected data (1980-2009) from British Columbia, Canada, were retrospectively analysed. AMS was defined in three different ways (AMS1, 2 and 3): 'AMS1'-confirmed Expanded Disability Status Scale (EDSS) ≥6 within 5 years of MS onset; 'AMS2'-confirmed EDSS ≥6 by age 40; and 'AMS3'-secondary progressive MS within 3 years of a relapsing-onset course. Three respective 'non-aggressive' MS comparison cohorts were selected. Patients' characteristics were compared between aggressive and non-aggressive cohorts using multivariable logistic regression, with findings expressed as adjusted OR (AOR) and 95% CI. Results: Application of the three definitions to the source population of 5891 patients resulted in 235/4285 (5.5%) patients fulfilling criteria for AMS1 (59.6% were female; 74.5% had relapsing-onset MS), 388/2762 (14.0%) for AMS2 (65.2% were female; 92.8% had relapsing-onset MS) and 195/4918 (4.0%) patients for AMS3 (61.0% were female). Compared to the respective control cohorts, those with AMS were more likely to be male (AOR=1.5, 95% CI 1.1 to 2.0 (AMS1); 1.6, 95% CI 1.3 to 2.1 (AMS2); 1.8, 95% CI 1.3 to 2.4 (AMS3)), older at MS symptom onset (AOR=1.1; 95% CI 1.1 to 1.1 (AMS1 and AMS3)) and have primary progressive MS (AOR=2.3, 95% CI 1.6 to 3.3 (AMS1); 2.7, 95% CI 1.7 to 4.4 (AMS2)). Conclusions: AMS was identified in 4-14% of patients, depending on the definition used. Although there was a relative preponderance of men and primary progressive MS presenting with AMS, the majority of patients were still women and those with relapsing-onset MS.

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