Multiple sclerosis in older adults: The clinical profile and impact of interferon beta treatment

Afsaneh Shirani, Yinshan Zhao, John Petkau, Paul Gustafson, Mohammad Ehsanul Karim, Charity Evans, Elaine Kingwell, Mia L. Van Der Kop, Joel Oger, Helen Tremlett

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Abstract

Background. We examined (1) patient characteristics and disease-modifying drug (DMD) exposure in late-onset (LOMS, ≥50 years at symptom onset) versus adult-onset (AOMS, 18-<50 years) MS and (2) the association between interferon-beta (IFNβ) and disability progression in older relapsing-onset MS adults (≥50 years). Methods. This retrospective study (1980-2004, British Columbia, Canada) included 358 LOMS and 5627 AOMS patients. IFNβ-treated relapsing-onset MS patients aged ≥50 (regardless of onset age, 90) were compared with 171 contemporary and 106 historical controls. Times to EDSS 6 from onset and from IFNβ eligibility were examined using survival analyses. Results. LOMS patients (6%) were more likely to be male, with motor onset and a primary-progressive course, and exhibit faster progression and were less likely to take DMDs. Nonetheless, 57% were relapsing-onset, of which 31% were prescribed DMDs, most commonly IFNβ. Among older relapsing-onset MS adults, no significant association between IFNβ exposure and disability progression was found when either the contemporary (hazard ratio [HR]: 0.46; 95% CI: 0.18-1.22) or historical controls (HR: 0.54; 95% CI: 0.20-1.42) were considered. Conclusion. LOMS differed clinically from AOMS. One-third of older relapsing-onset MS patients were prescribed a DMD. IFNβ exposure was not significantly associated with reduced disability in older MS patients.

Original languageEnglish (US)
Article number451912
JournalBioMed research international
Volume2015
DOIs
StatePublished - Jan 1 2015

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Interferon-beta
Multiple Sclerosis
Hazards
Therapeutics
Safety Management
British Columbia
Survival Analysis
Age of Onset
Pharmaceutical Preparations
Canada
Retrospective Studies

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Immunology and Microbiology(all)

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Multiple sclerosis in older adults : The clinical profile and impact of interferon beta treatment. / Shirani, Afsaneh; Zhao, Yinshan; Petkau, John; Gustafson, Paul; Karim, Mohammad Ehsanul; Evans, Charity; Kingwell, Elaine; Van Der Kop, Mia L.; Oger, Joel; Tremlett, Helen.

In: BioMed research international, Vol. 2015, 451912, 01.01.2015.

Research output: Contribution to journalArticle

Shirani, A, Zhao, Y, Petkau, J, Gustafson, P, Karim, ME, Evans, C, Kingwell, E, Van Der Kop, ML, Oger, J & Tremlett, H 2015, 'Multiple sclerosis in older adults: The clinical profile and impact of interferon beta treatment', BioMed research international, vol. 2015, 451912. https://doi.org/10.1155/2015/451912
Shirani, Afsaneh ; Zhao, Yinshan ; Petkau, John ; Gustafson, Paul ; Karim, Mohammad Ehsanul ; Evans, Charity ; Kingwell, Elaine ; Van Der Kop, Mia L. ; Oger, Joel ; Tremlett, Helen. / Multiple sclerosis in older adults : The clinical profile and impact of interferon beta treatment. In: BioMed research international. 2015 ; Vol. 2015.
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abstract = "Background. We examined (1) patient characteristics and disease-modifying drug (DMD) exposure in late-onset (LOMS, ≥50 years at symptom onset) versus adult-onset (AOMS, 18-<50 years) MS and (2) the association between interferon-beta (IFNβ) and disability progression in older relapsing-onset MS adults (≥50 years). Methods. This retrospective study (1980-2004, British Columbia, Canada) included 358 LOMS and 5627 AOMS patients. IFNβ-treated relapsing-onset MS patients aged ≥50 (regardless of onset age, 90) were compared with 171 contemporary and 106 historical controls. Times to EDSS 6 from onset and from IFNβ eligibility were examined using survival analyses. Results. LOMS patients (6{\%}) were more likely to be male, with motor onset and a primary-progressive course, and exhibit faster progression and were less likely to take DMDs. Nonetheless, 57{\%} were relapsing-onset, of which 31{\%} were prescribed DMDs, most commonly IFNβ. Among older relapsing-onset MS adults, no significant association between IFNβ exposure and disability progression was found when either the contemporary (hazard ratio [HR]: 0.46; 95{\%} CI: 0.18-1.22) or historical controls (HR: 0.54; 95{\%} CI: 0.20-1.42) were considered. Conclusion. LOMS differed clinically from AOMS. One-third of older relapsing-onset MS patients were prescribed a DMD. IFNβ exposure was not significantly associated with reduced disability in older MS patients.",
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AU - Gustafson, Paul

AU - Karim, Mohammad Ehsanul

AU - Evans, Charity

AU - Kingwell, Elaine

AU - Van Der Kop, Mia L.

AU - Oger, Joel

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N2 - Background. We examined (1) patient characteristics and disease-modifying drug (DMD) exposure in late-onset (LOMS, ≥50 years at symptom onset) versus adult-onset (AOMS, 18-<50 years) MS and (2) the association between interferon-beta (IFNβ) and disability progression in older relapsing-onset MS adults (≥50 years). Methods. This retrospective study (1980-2004, British Columbia, Canada) included 358 LOMS and 5627 AOMS patients. IFNβ-treated relapsing-onset MS patients aged ≥50 (regardless of onset age, 90) were compared with 171 contemporary and 106 historical controls. Times to EDSS 6 from onset and from IFNβ eligibility were examined using survival analyses. Results. LOMS patients (6%) were more likely to be male, with motor onset and a primary-progressive course, and exhibit faster progression and were less likely to take DMDs. Nonetheless, 57% were relapsing-onset, of which 31% were prescribed DMDs, most commonly IFNβ. Among older relapsing-onset MS adults, no significant association between IFNβ exposure and disability progression was found when either the contemporary (hazard ratio [HR]: 0.46; 95% CI: 0.18-1.22) or historical controls (HR: 0.54; 95% CI: 0.20-1.42) were considered. Conclusion. LOMS differed clinically from AOMS. One-third of older relapsing-onset MS patients were prescribed a DMD. IFNβ exposure was not significantly associated with reduced disability in older MS patients.

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