Young, Carolyn A 
ORCID: 0000-0001-6971-8203, Rog, David J, Sharrack, Basil, Tanasescu, Radu, Kalra, Seema, Harrower, Timothy, Tennant, Alan, Mills, Roger J ORCID: 0000-0001-6341-6220 and Trajectories of Outcome in Neurological Conditions-MS Study Grou,
(2024)
Correlates and trajectories of relapses in relapsing-remitting multiple sclerosis.
Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, 45 (5).
pp. 2181-2189.
Abstract
<h4>Background and aims</h4>In people with relapsing-remitting multiple sclerosis (pwRRMS), data from studies on non-pharmacological factors which may influence relapse risk, other than age, are inconsistent. There is a reduced risk of relapses with increasing age, but little is known about other trajectories in real-world MS care.<h4>Methods</h4>We studied longitudinal questionnaire data from 3885 pwRRMS, covering smoking, comorbidities, disease-modifying therapy (DMT), and patient-reported outcome measures, as well as relapses during the past year. We undertook Rasch analysis, group-based trajectory modelling, and multilevel negative binomial regression.<h4>Results</h4>The regression cohort of 6285 data sets from pwRRMS over time showed that being a current smoker was associated with 43.9% greater relapse risk; having 3 or more comorbidities increased risk and increasing age reduced risk. Those diagnosed within the last 2 years showed two distinct trajectories, both reducing in relapse frequency but 25.8% started with a higher rate and took 4 years to reduce to the rate of the second group. In the cohort with at least three data points completed, there were three groups: 73.7% followed a low stable relapse rate, 21.6% started from a higher rate and decreased, and 4.7% had an increasing then decreasing pattern. These different trajectory groups showed significant differences in fatigue, neuropathic pain, disability, health status, quality of life, self-efficacy, and DMT use.<h4>Conclusions</h4>These results provide additional evidence for supporting pwRRMS to stop smoking and underline the importance of timely DMT decisions and treatment initiation soon after diagnosis with RRMS.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | Trajectories of Outcome in Neurological Conditions-MS Study Group, Humans, Multiple Sclerosis, Multiple Sclerosis, Relapsing-Remitting, Recurrence, Health Status, Quality of Life |
| Divisions: | Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Systems, Molecular and Integrative Biology |
| Depositing User: | Symplectic Admin |
| Date Deposited: | 22 Nov 2023 16:09 |
| Last Modified: | 26 Apr 2024 15:35 |
| DOI: | 10.1007/s10072-023-07155-3 |
| Open Access URL: | https://doi.org/10.1007/s10072-023-07155-3 |
| Related URLs: | |
| URI: | https://livrepository.liverpool.ac.uk/id/eprint/3176970 |
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