Can we predict benign multiple sclerosis? Results of a 20-year long-term follow-up study.
Benign multiple sclerosis (MS) is a discussed clinical entity, with variable reported prevalence (6-64%) requiring at least 5-10 years of clinical observation. Moreover, many benign patients progress with time becoming no longer benign (NLB). The objective of this study is to compare benign MS patients (EDSS ≤3, 10 years from disease onset) who still fulfilled the definition at 20 years to those NLB. In our retrospective study based on Ottawa Hospital MS Clinic database, 175 benign patients fulfilled the inclusion criteria (clinically definite MS, EDSS ≤3 at 10 years, disease onset from 1983 to 1993, and clinical assessments performed at 10 ± 1 and 20 ± 1 years from onset). Out of the identified patients, 66.3% remained benign at 20 years; however, by changing the definition for benign to EDSS ≤2 or ≤1 at 10 years, they increased to 71.9 and 81.6%, respectively. Female sex, EDSS ≤1 at 10 years, and a pure sensory onset were associated with a benign course, while a pure motor onset with an NLB condition. According to multivariate analysis, an EDSS ≤2 at 10 years predicted a long-term benign course. Our study questions the current definition of "benign" MS, suggesting a more stringent EDSS cutoff at 10 years to predict long-term benign prognosis.
['Sartori|Arianna|A|http://orcid.org/0000-0002-4518-518X', 'Abdoli|Mohammad|M|', 'Freedman|Mark S|MS|']
D000328:Adult D017668:Age of Onset D004185:Disability Evaluation D018450:Disease Progression D005260:Female D006801:Humans D007155:Immunologic Factors D008137:Longitudinal Studies D008297:Male D008875:Middle Aged D009103:Multiple Sclerosis D011237:Predictive Value of Tests D012189:Retrospective Studies D018709:Statistics, Nonparametric D013997:Time Factors
Multiple sclerosis Long-term follow-up Benign course Prognosis Disease modifying drugs Natural history