Treatment Protects Against Disability Accrual in Relapse-Onset MS

HealthDay News — For patients with relapse-onset multiple sclerosis (MS), disease-modifying therapy protects against long-term disability accrual, according to a study published in the Annals of Neurology.

Vilija G. Jokubaitis, PhD, from the University of Melbourne in Australia, and colleagues examined predictors of 10-year expanded disability status scale (EDSS) change after treatment initiation in patients with relapse-onset MS. Patients had remained on injectable therapy for at least 1 day, and were monitored thereafter on any approved disease-modifying therapy or no therapy. Data were included for 2466 patients who reported post-baseline disability scores during follow-up of at least 10 years.

The researchers found that patients were treated 83% of their follow-up time, on average. At 10 years post-baseline, EDSS scores had increased by a median of 1 point. Over 10 years, the annualized relapse rate was predictive of increases in the median EDSS. Greater burden was seen for on-therapy relapses versus off-therapy relapses. There was an independent correlation for cumulative treatment exposure with lower EDSS at 10 years. Over the 10-year observation period, pregnancies were also independently associated with lower EDSS scores.

“We provide evidence of long-term treatment benefit in a large registry cohort, and provide evidence of long-term protective effects of pregnancy against disability accrual,” the authors write. “We demonstrate that high-annualized relapse rate, particularly on-treatment relapse, is an indicator of poor prognosis.”

Several authors disclosed financial ties to the pharmaceutical industry.


Jokubaitis VG, Spelman T, Kalincik T, et al. Predictors of long-term disability accrual in relapse-onset multiple sclerosis. Ann Neurol. 2016; doi:10.1002/ana.24682.