Age May Modulate Relapse Frequency and Phenotypic Presentation of MS

senior woman on wheelchair in front of an old building
A team of researchers assessed the Novartis-Oxford Multiple Sclerosis data set to investigate the relationship between age, relapse frequency, and phenotypic presentation of multiple sclerosis.

A novel multiple sclerosis (MS) data set, the Novartis-Oxford MS (NO.MS) data set, was capable of characterizing multiple sclerosis (MS) phenotypes and indicated that age modulates relapse frequency and the phenotypic presentation of MS, according to study results published in Multiple Sclerosis.

The NO.MS cohort integrates deidentified data from 34 Novartis clinical trials on MS conducted between 2003 and 2020. In total, these trials included approximately 35,000 patients with MS, including more than 31,000 patients with relapsing-remitting MS (RRMS). The NO.MS data set also contains over 200,000 brain images in Digital Imaging and Communications in Medicine format from around 10,000 patients with MS with over 10 years of follow up.

Study researchers sought to describe the NO.MS data set and investigate the relationship between age, disease activity, and disease progression between MS phenotypes. They assessed key characteristics of the NO.MS cohort and MS lesion formation, frequency of relapses, change in brain volume, and disability worsening cross-sectionally as a function of baseline age. They utilized phase 3 study data consisting of approximately 8000 patients with MS.

The overall cohort included a total of 34,957 patients with MS, including 32,098 patients with RRMS, 1873 patients with secondary progressive MS, and 986 patients with primary progressive MS.

An analysis of the cohort found that focal disease activity was highest in adolescents with MS but decreases with advancing age. Additionally, the NO.MS data set shows that brain volume change is comparable across phenotype groups among adult patients, and largely independent from age.

Study results indicated that the youngest patients with MS had the lowest likelihood, less than 25%, of worsening disability over a 2-year period, while the risk of disability worsening was higher in patients who were older, disabled, or had progressive MS. Young patients appeared to derive the most benefit from therapy.

Based on their analysis of the NO.MS cohort, the study researchers concluded that the dataset “is a novel comprehensive clinical trial data set across all MS phenotypes” that appears to be “well suited to further [characterize] MS, study individual patient trajectories and identify prognostic markers (or signatures) using advanced analytical methods.”

Disclosure: Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.


Dahlke F, Arnold DL, Aarden P, et al. Characterisation of MS phenotypes across the age span using a novel data set integrating 34 clinical trials (NO.MS cohort): Age is a key contributor to presentation. Mult Scler. Published online January 28, 2021. doi:10.1177/1352458520988637