The average progression to heightened disability levels in patients diagnosed with multiple sclerosis (MS) takes place at a much slower rate than previously thought, according to a study published recently in the International Journal of MS Care.
Conducted by researchers from the Allegheny Health Network (AHN) Neuroscience Institute at Allegheny General Hospital (AGH) in Pittsburgh, the study points to advancing clinical therapies and education as a primary reason for improved prognosis and outcomes compared to natural history studies and previously reported data.
“The improvement is in part due to our ability to incorporate new therapies that improve a person’s quality of life and slow progression rates,” says Thomas Scott, MD, AHN neurologist and chief researcher in the study, in a media release from Allegheny Health Network.
The study followed patients with MS up to 15 years from the onset of early symptoms. One hundred and eighty four newly diagnosed patients followed at AGH MS Treatment Center met criteria for the study, among all MS patients seen there from 1989 through 2006. Most of the patients were examined at least yearly from the point of initial diagnosis and were followed on average for 13 years.
In the study, measurement of outcomes was based on the expanded disability status scale (EDSS) ranging from 0.0 of “no disability” through 6.0, which indicates “the use of a walking aid such as a cane or crutch to walk roughly 100 meters.” It took about 10 years for 25% of the patient population to reach 3.0 of “moderate disability,” and it took roughly 17 years for 25% of patients to reach an EDSS of 6.0, the release explains.
“For patients who were observed throughout the duration of the study, we looked at them until they reached about 50 years old. At that time, just under 20 percent had become cane dependent, needing support to walk more than one or two blocks. From a bird’s-eye view, it looks like general progression of the disease has slowed, and far few patients are ever disabled, thanks to advances in clinical therapies, education and resources,” Scott states.
These findings come on the heels of a related study published earlier this year by Dr. Scott’s group. Titled, “Multiple Sclerosis Relapses Contribute to Long-Term Disability,” the work outlines the connection between a reduction of MS relapses through immunotherapy and a resulting positive impact on the disease’s progression.
Further, it claims that prior studies may have overemphasized the role of slow progressive degenerative changes compared to autoimmune flares. Incomplete recovery from these flares or “relapses” was the predominant type of worsening seen in the earliest years, and although it eventually declined, it remained an important cause of disability throughout the first 15 years from initial diagnosis.
“Together, our studies share an important voice in the ongoing conversation classifying MS as a predominantly autoimmune condition instead of a degenerative one. Through these findings, we begin to open a larger window of opportunities for clinicians to better understand and treat patients.
“For patients and their loved ones, I think we’re also shedding more light on the disease, which in turn can lend to a healthier peace of mind and hope for a promising future,” he concludes.
[Source(s): Allegheny Health Network]