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Correlates and trajectories of relapses in relapsing-remitting multiple sclerosis
Tanasescu, Radu Constantinescu, Cris S.
Tanasescu, Radu
Constantinescu, Cris S.
Abstract
Background and aims: In people with relapsing-remitting multiple sclerosis (pwRRMS), data from studies on non-pharmacological factors which may influence relapse risk, other than age, are inconsistent. There is a reduced risk of relapses with increasing age, but little is known about other trajectories in real-world MS care. Method(s): We studied longitudinal questionnaire data from 3885 pwRRMS, covering smoking, comorbidities, disease-modifying therapy (DMT), and patient-reported outcome measures, as well as relapses during the past year. We undertook Rasch analysis, group-based trajectory modelling, and multilevel negative binomial regression. Result(s): The regression cohort of 6285 data sets from pwRRMS over time showed that being a current smoker was associated with 43.9% greater relapse risk; having 3 or more comorbidities increased risk and increasing age reduced risk. Those diagnosed within the last 2 years showed two distinct trajectories, both reducing in relapse frequency but 25.8% started with a higher rate and took 4 years to reduce to the rate of the second group. In the cohort with at least three data points completed, there were three groups: 73.7% followed a low stable relapse rate, 21.6% started from a higher rate and decreased, and 4.7% had an increasing then decreasing pattern. These different trajectory groups showed significant differences in fatigue, neuropathic pain, disability, health status, quality of life, self-efficacy, and DMT use. Conclusion(s): These results provide additional evidence for supporting pwRRMS to stop smoking and underline the importance of timely DMT decisions and treatment initiation soon after diagnosis with RRMS.Copyright © The Author(s) 2023.
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Date
2024
Type
Article
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Citation
Young, C.A., Rog, D.J., Sharrack, B., Tanasescu, R., Kalra, S., Harrower, T., Tennant, A., Mills, R.J. and Trajectories of Outcome in Neurological Conditions-MS Study Group (2024) 'Correlates and trajectories of relapses in relapsing-remitting multiple sclerosis', Neurological Sciences, 45(5), pp. 2181–2189. doi: 10.1007/s10072-023-07155-3 https://doi.org/10.1007/s10072-023-07155-3.