Factors associated with benign multiple sclerosis in the New York State MS Consortium (NYSMSC)

Abstract

Background: This retrospective analysis explored prognostic factors associated with a benign multiple sclerosis (BMS) disease course at baseline and over the 4-year follow-up.

Methods: Patients from the centralized New York State Multiple Sclerosis Consortium registry were classified as having BMS according to 3 different criteria centered on disease duration and disability. Additional analyses explored prognostic factors associated with BMS using the most conservative disability criteria (Expanded Disability Status Scale ≤2 and disease duration ≥10 years).

Results: Among 6258 patients who fulfilled eligibility criteria, 19.8 % to 33.3 % were characterized as having BMS, at baseline depending on classification criteria used. Positive prognostic factors for BMS at baseline included female sex (p < 0.0001) and younger age at onset (p < 0.0001); negative prognostic factors included progressive-onset type of MS and African-American race. Of the 1237 BMS patients (per most conservative criteria), 742 were followed for a median of 4 years to explore effect of disease-modifying treatment (DMT) on benign status. DMT (p = 0.009) and longer disease duration (p = 0.007) were the only significant positive predictors of maintaining BMS at follow-up. The protective effect was stronger for patients taking DMT at both enrollment and follow-up (OR = 0.71; p = 0.006).

Conclusions: There is a need for development of more reliable prognostic indicators of BMS. Use of DMT was significantly associated with maintaining a benign disease state.

Keywords: Benign multiple sclerosis; DMT; Disease course; Disease-modifying treatment; Multiple sclerosis.

Fig. 1

Cox regression survival curves. Probability of remaining benign for n = 742 Criterion I benign MS patients for (a) 2-category definition of DMT use: Ever (n = 633) vs Never (n = 109; p = 0.009) and (b) 4-category definition of DMT use: Never Used (n = 109, comparison group); at enrollment only (n = 83, not significant); at follow-up only (n = 258, p = 0.038); at both enrollment and follow-up (n = 292, p = 0.006). Abbreviations: DMT, disease-modifying therapy. Data from New York State Multiple Sclerosis Consortium