Highlights
- •New data on the predictors of progression for PPMS are needed for prognostification.
- •We verified the effect of onset age on disease progression rate.
- •Onset with spinal motor symptoms was identified as a negative prognostic factor.
- •Onset with supratentorial signs was associated with a longer time to EDSS6.
- •Presence of gadolinium enhancing lesions was not associated with outcome.
Abstract
Background
Studies on the predictors of progression for primary progressive multiple sclerosis
(PPMS) are limited and there is no information in the literature for populations outside
Europe and North America. In this study, we aimed to identify predictors of progression
in a large Turkish PPMS cohort.
Methods
We analyzed a cohort of 157 PPMS patients to investigate the effect of age of onset,
gender, onset symptoms, presence or absence of relapses, and baseline gadolinium-enhancing
lesions on the rate of progression to EDSS6 by using Kaplan-Meier analysis and multivariate
Cox regression.
Results
Older age of onset and presence of spinal motor symptoms at onset were associated
with a shorter time to EDSS6 and presence of supratentorial signs at onset was associated
with a longer time to EDSS6 according to Kaplan-Meier analysis. These factors remained
significant after multivariate Cox-regression analysis. Clinical relapses were present
in 22.3% and gadolinium-enhancing lesions on baseline MRI were present in 28% of patients,
but these factors were not predictive of time to EDSS6.
Conclusion
We identified age of onset and symptom at onset as predictors of progression in Turkish
PPMS patients. Presence of clinical relapses or baseline gadolinium-enhancing lesions
did not affect PPMS progression rate.
Keywords
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Article info
Publication history
Published online: November 12, 2019
Accepted:
November 10,
2019
Received in revised form:
November 7,
2019
Received:
May 25,
2019
Identification
Copyright
© 2019 Elsevier B.V. All rights reserved.
