Comparison of the natural history and prognostic features of early onset and adult onset multiple sclerosis in Jordanian population

Abstract

Objectives: To assess the natural history and prognostic features of early onset multiple sclerosis (EOMS) and adult onset multiple sclerosis (AOMS) in Jordanian population.

Patients and methods: A retrospective analysis of 253 multiple sclerosis (MS) patients treated at the three major referral centers for MS in Jordan was performed. Twenty-six patients were excluded due to lack of follow up details. Patients under (or equal to) the age of 18 years were considered as EOMS. Clinical features of the two groups were compared and statistically analyzed. Time to reach expanded disability status score (EDSS) 3 and time to reach secondary progression were used as end points for survival analysis. Log-rank tests were performed and Kaplan-Meier survival curves were presented.

Results: About 44 (19.4%) patients had EOMS. The clinical characteristics of EOMS and AOMS were not significantly different. Most patients (about 88%) had relapsing remitting course. Monosymptomatic presentation was the predominant feature in both groups. Median time to reach EDSS 3 and median time to reach secondary progression were significantly longer in EOMS. Kaplan-Meier survival analysis did not show difference between the two groups. Higher EDSS score at diagnosis, shorter first inter-attack interval, and secondary progressive course were significantly unfavorable prognostic factors for both EOMS and AOMS.

Conclusions: The natural history and prognostic features of EOMS and AOMS are not significantly different in Jordanian population. Therefore, treatment strategies should be the same for the two groups.