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. 2014 Oct;20(11):1511-22.
doi: 10.1177/1352458514528762. Epub 2014 Apr 28.

Risk of relapse phenotype recurrence in multiple sclerosis

Tomas Kalincik  1 , Katherine Buzzard  2 , Vilija Jokubaitis  3 , Maria Trojano  4 , Pierre Duquette  5 , Guillermo Izquierdo  6 , Marc Girard  5 , Alessandra Lugaresi  7 , Pierre Grammond  8 , Francois Grand'Maison  9 , Celia Oreja-Guevara  10 , Cavit Boz  11 , Raymond Hupperts  12 , Thor Petersen  13 , Giorgio Giuliani  14 , Gerardo Iuliano  15 , Jeannette Lechner-Scott  16 , Michael Barnett  17 , Roberto Bergamaschi  17 , Vincent Van Pesch  17 , Maria Pia Amato  17 , Erik van Munster  17 , Ricardo Fernandez-Bolanos  17 , Freek Verheul  17 , Marcela Fiol  17 , Edgardo Cristiano  17 , Mark Slee  17 , Maria Edite Rio  17 , Daniele Spitaleri  18 , Raed Alroughani  17 , Orla Gray  17 , Maria Laura Saladino  17 , Sholmo Flechter  17 , Joseph Herbert  17 , Jose Antonio Cabrera-Gomez  17 , Norbert Vella  17 , Mark Paine  17 , Cameron Shaw  17 , Fraser Moore  17 , Steve Vucic  17 , Aldo Savino  17 , Bhim Singhal  17 , Tatjana Petkovska-Boskova  17 , John Parratt  17 , Carmen-Adella Sirbu  17 , Csilla Rozsa  17 , Danny Liew  17 , Helmut Butzkueven  19 ; MSBase Study Group
Collaborators, Affiliations

Risk of relapse phenotype recurrence in multiple sclerosis

Tomas Kalincik et al. Mult Scler. 2014 Oct.

Abstract

Objectives: The aim was to analyse risk of relapse phenotype recurrence in multiple sclerosis and to characterise the effect of demographic and clinical features on this phenotype.

Methods: Information about relapses was collected using MSBase, an international observational registry. Associations between relapse phenotypes and history of similar relapses or patient characteristics were tested with multivariable logistic regression models. Tendency of relapse phenotypes to recur sequentially was assessed with principal component analysis.

Results: Among 14,969 eligible patients (89,949 patient-years), 49,279 phenotypically characterised relapses were recorded. Visual and brainstem relapses occurred more frequently in early disease and in younger patients. Sensory relapses were more frequent in early or non-progressive disease. Pyramidal, sphincter and cerebellar relapses were more common in older patients and in progressive disease. Women presented more often with sensory or visual symptoms. Men were more prone to pyramidal, brainstem and cerebellar relapses. Importantly, relapse phenotype was predicted by the phenotypes of previous relapses. (OR = 1.8-5, p = 10(-14)). Sensory, visual and brainstem relapses showed better recovery than other relapse phenotypes. Relapse severity increased and the ability to recover decreased with age or more advanced disease.

Conclusion: Relapse phenotype was associated with demographic and clinical characteristics, with phenotypic recurrence significantly more common than expected by chance.

Keywords: MSBase; Multiple sclerosis; phenotype; presentation of neurological diseases; prognosis.

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