“RoAD” Score Predicts Prognosis in Relapsing-Remitting Multiple Sclerosis

Relapsing-remitting Multiple sclerosis diagnosis in form.
To determine the effectiveness of the Risk of Ambulatory Disability (RoAD) score, study researchers evaluated the prognosis of patients with relapsing-remitting MS.

The Risk of Ambulatory Disability (RoAD) score, a risk assessment test that includes variables such as disease duration, previous relapses, and treatment response, was effective for predicting the prognosis of patients with relapsing-remitting multiple sclerosis (RRMS), according to a study in the European Journal of Neurology.

This retrospective, longitudinal cohort study used real-world data from 2 datasets of patients with RRMS from Italy and Spain. All patients in these datasets had an Expanded Disability Status Scale (EDSS) score less than 4.0 at the start of interferon beta (INFB) or glatiramer acetate (GA) therapy. Study researchers followed patients for at least 10 years.

The training dataset (n=1225) served as a framework for the creation of the RoAD score, while the second dataset (n=296) served to validate the score in independent patients.

Variables in the RoAD score included demographic (age and sex) as well as clinical variables (disease duration, number of relapses in prior year, and presence/absence of gadolinium [GD]-enhancing lesions) recorded at the start of the first treatment. Additionally, the 1-year variable of treatment response included EDSS-confirmed disability worsening, number of relapses, number of GD-enhancing lesions, as well as the number of new T2 lesions.

Study researchers measured the time it took for patients to reach ambulatory disability, confirmed by an EDSS score of at least 6.0. The most optimal cut-off RoAD score for the discrimination of patients at increased risk of reaching the EDSS-defined disability milestone was at least 4 (area under the curve [AUC], 0.86; 95% CI, 0.84-0.88; P <.001). After applying to the validation set, the study researchers found that patients with a RoAD score of at least 4 had a 4-fold increased risk for reaching the EDSS-defined disability milestone (hazard ratio, 4.2; 95% CI, 2.3-7.5; P <.001).

The primary limitations of the study included those due to its retrospective and observational nature. Additionally, the findings from this study may not be generalizable to patients who are not treated with GA and IFNB.

Despite these limitations, the study researchers wrote they hope that “the proposed RoAD score, derived by the [aforementioned] combination of demographic, clinical and MRI data, can help neurologists in optimizing the treatment decision-making process.”

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


Gasperini C, Prosperini L, Rovira A, et al. Scoring the 10-year risk of ambulatory disability in multiple sclerosis: the RoAD score. Eur J Neurol. Published online March 31, 2021. doi:10.1111/ene.14845