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Sunday, February 21, 2016

Disability Accumulation Varies in Moderately Advanced MS

Caroline Helwick
February 19, 2016



NEW ORLEANS — Disability accumulation for patients with moderately advanced multiple sclerosis (MS) appears to be independent of prior disease progression, but the disease trajectory is still highly variable, an analysis of the international database MSBase has shown.
Australian investigators determined that greater relapse rates during the course of moderately advanced MS increased the probability of progression, but stronger immunomodulatory therapies appeared to mitigate the accrual of disability, said Nathaniel Lizak, a fourth-year medical student at Monash University in Clayton, Australia.
"We dispute the practice of treatment cessation on the basis of disability milestone attainment," Lizak said. "Patients should continue being treated at greater EDSS [Expanded Disability Status Scale] scores."
The investigators presented their findings at Americas Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS) Forum 2016, the first meeting by ACTRIMS focused on progressive forms of MS. The study's senior investigator was Tomas Kalincik, MD, from the University of Melbourne in Australia.
Disease Trajectory After EDSS 3 Not Clear
Three large cohort studies have previously examined factors influencing disability accumulation in moderately advanced MS but reached contradictory conclusions. Their general implication has been that disease trajectories after the attainment of EDSS 3 are not modifiable, he said.



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