Impact of Multiple Sclerosis Relapses on Progression Diminishes with time
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Medical Update Memo
November 18, 2009
Summary
Canadian researcher Dr. Helen Tremlett of the University of British Columbia, and colleagues report on the impact of relapses on long-term disability in people with MS. They found that although relapses within the first five years of the disease had an impact on disease progression over the short term, the impact of relapses on long-term disability was minimal, either for early or later relapses. Neurology. 2009 Nov 4. [Epub ahead of print]
Details
The relationship between relapses and long-term disability in multiple sclerosis (MS) remains to be fully elucidated. Current literature is conflicting and focused on early relapses. Authors investigated the effects of relapses at different stages on disability progression. A retrospective review was undertaken examining records of 2,477 patients with definite relapsing-onset MS followed until July 2003 in British Columbia, Canada. Mean follow-up for subjects was 20.6 years; 11,722 post onset relapses were recorded. An early relapse (within 5 years post onset) was associated with an increased risk for disease progression over the short term. The impact of later relapses (>5-10 years post onset) lessened over time. Effects were modulated by age, impact being greatest in younger individuals (<25 years at onset) and least in older (>/=35 years) patients where relapses beyond 5-years post onset typically failed to reach significance. Authors conclude that relapses within the first 5 years of disease impact on disease progression over the short term. The long-term impact was minimal however, either for early or later relapses. Long-term disease progression was least affected by relapses in patients with an extended disease duration (>10 years) or already in the secondary progressive phase.
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Disclaimer
The Multiple Sclerosis Society of Canada is an independent, voluntary health
agency and does not approve, endorse or recommend any specific product or therapy,
but provides information to assist individuals in making their own decisions.
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