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Long-term disability trajectories in primary progressive MS patients: A latent class growth analysis

Signori, A, Izquierdo, G, Lugaresi, A, Hupperts, R, Grand'Maison, F, Sola, P, Horakova, D, Havrdova, E, Prat, A, Girard, M, Duquette, P, Boz, C, Grammond, P, Terzi, M, Singhal, B, Alroughani, R, Petersen, T, Ramo, C, Oreja-Guevara, C, Spitaleri, D, Shaygannejad, V, Butzkueven, H, Kalincik, T, Jokubaitis, V, Slee, M, Fernandez Bolanos, R, Sanchez-Menoyo, JL, Pucci, E, Granella, F, Lechner-Scott, J, Iuliano, G, Hughes, S, Bergamaschi, R, Taylor, B, Verheul, F, Edite Rio, M, Amato, MP, Sajedi, SA, Majdinasab, N, Van Pesch, V, Sormani, MP and Trojano, M 2017 , 'Long-term disability trajectories in primary progressive MS patients: A latent class growth analysis' , Multiple Sclerosis Journal , pp. 1-11 , doi: 10.1177/1352458517703800.

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Background: Several natural history studies on primary progressive multiple sclerosis (PPMS) patients detected a consistent heterogeneity in the rate of disability accumulation.Objectives: To identify subgroups of PPMS patients with similar longitudinal trajectories of Expanded Disability Status Scale (EDSS) over time.Methods: All PPMS patients collected within the MSBase registry, who had their first EDSS assessment within 5 years from onset, were included in the analysis. Longitudinal EDSS scores were modeled by a latent class mixed model (LCMM), using a nonlinear function of time from onset. LCMM is an advanced statistical approach that models heterogeneity between patients by classifying them into unobserved groups showing similar characteristics.Results: A total of 853 PPMS (51.7% females) from 24 countries with a mean age at onset of 42.4 years (standard deviation (SD): 10.8 years), a median baseline EDSS of 4 (interquartile range (IQR): 2.5-5.5), and 2.4 years of disease duration (SD: 1.5 years) were included. LCMM detected three different subgroups of patients with a mild (n = 143; 16.8%), moderate (n = 378; 44.3%), or severe (n = 332; 38.9%) disability trajectory. The probability of reaching EDSS 6 at 10 years was 0%, 46.4%, and 81.9% respectively.Conclusion: Applying an LCMM modeling approach to long-term EDSS data, it is possible to identify groups of PPMS patients with different prognosis.

Item Type: Article
Authors/Creators:Signori, A and Izquierdo, G and Lugaresi, A and Hupperts, R and Grand'Maison, F and Sola, P and Horakova, D and Havrdova, E and Prat, A and Girard, M and Duquette, P and Boz, C and Grammond, P and Terzi, M and Singhal, B and Alroughani, R and Petersen, T and Ramo, C and Oreja-Guevara, C and Spitaleri, D and Shaygannejad, V and Butzkueven, H and Kalincik, T and Jokubaitis, V and Slee, M and Fernandez Bolanos, R and Sanchez-Menoyo, JL and Pucci, E and Granella, F and Lechner-Scott, J and Iuliano, G and Hughes, S and Bergamaschi, R and Taylor, B and Verheul, F and Edite Rio, M and Amato, MP and Sajedi, SA and Majdinasab, N and Van Pesch, V and Sormani, MP and Trojano, M
Keywords: primary progressive multiple sclerosis, clinical trials, disability, heterogeneity, long-term, trajectories
Journal or Publication Title: Multiple Sclerosis Journal
Publisher: Arnold
ISSN: 1352-4585
DOI / ID Number: 10.1177/1352458517703800
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Copyright 2017 the authors

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