Academic Journal
Multiple Sclerosis Progression and Relapse Activity in Children
| Title: | Multiple Sclerosis Progression and Relapse Activity in Children |
|---|---|
| Authors: | Iaffaldano, Pietro, Portaccio, Emilio, Lucisano, Giuseppe, Simone, Marta, Manni, Alessia, Guerra, Tommaso, Paolicelli, Damiano, Betti, Matteo, De Meo, Ermelinda, Pastò, Luisa, Razzolini, Lorenzo, Rocca, Maria A, Ferrè, Laura, Brescia Morra, Vincenzo, Patti, Francesco, Zaffaroni, Mauro, Gasperini, Claudio, De Luca, Giovanna, Ferraro, Diana, Granella, Franco, Pozzilli, Carlo, Romano, Silvia, Gallo, Paolo, Bergamaschi, Roberto, Coniglio, Maria Gabriella, Lus, Giacomo, Vianello, Marika, Banfi, Paola, Lugaresi, Alessandra, Totaro, Rocco, Spitaleri, Daniele, Cocco, Eleonora, Di Palma, Franco, Maimone, Davide, Valentino, Paola, Torri Clerici, Valentina, Protti, Alessandra, Maniscalco, Giorgia Teresa, Salemi, Giuseppe, Pesci, Ilaria, Aguglia, Umberto, Lepore, Vito, Filippi, Massimo, Trojano, Maria, Amato, Maria Pia |
| Contributors: | Iaffaldano, Pietro, Portaccio, Emilio, Lucisano, Giuseppe, Simone, Marta, Manni, Alessia, Guerra, Tommaso, Paolicelli, Damiano, Betti, Matteo, De Meo, Ermelinda, Pastò, Luisa, Razzolini, Lorenzo, Rocca, Maria A, Ferrè, Laura, Brescia Morra, Vincenzo, Patti, Francesco, Zaffaroni, Mauro, Gasperini, Claudio, De Luca, Giovanna, Ferraro, Diana, Granella, Franco, Pozzilli, Carlo, Romano, Silvia, Gallo, Paolo, Bergamaschi, Roberto, Coniglio, Maria Gabriella, Lus, Giacomo, Vianello, Marika, Banfi, Paola, Lugaresi, Alessandra, Totaro, Rocco, Spitaleri, Daniele, Cocco, Eleonora, Di Palma, Franco, Maimone, Davide, Valentino, Paola, Torri Clerici, Valentina, Protti, Alessandra, Maniscalco, Giorgia Teresa, Salemi, Giuseppe, Pesci, Ilaria, Aguglia, Umberto, Lepore, Vito, Filippi, Massimo, Trojano, Maria, Amato, Maria Pia |
| Publisher Information: | AMER MEDICAL ASSOC 330 N WABASH AVE, STE 39300, CHICAGO, IL 60611-5885 USA |
| Publication Year: | 2024 |
| Collection: | Sapienza Università di Roma: CINECA IRIS |
| Subject Terms: | multiple sclerosis, PIRA, POMS |
| Description: | IMPORTANCE Although up to 20% of patients with multiple sclerosis (MS) experience onset before 18 years of age, it has been suggested that people with pediatric-onset MS (POMS) are protected against disability because of greater capacity for repair.OBJECTIVE To assess the incidence of and factors associated with progression independent of relapse activity (PIRA) and relapse-associated worsening (RAW) in POMS compared with typical adult-onset MS (AOMS) and late-onset MS (LOMS).DESIGN, SETTING, AND PARTICIPANTS This cohort study on prospectively acquired data from the Italian MS Register was performed from June 1, 2000, to September 30, 2021. At the time of data extraction, longitudinal data from 73 564 patients from 120 MS centers were available in the register.MAIN OUTCOMES AND MEASURES The main outcomes included age-related cumulative incidence and adjusted hazard ratios (HRs) for PIRA and RAW and associated factors.EXPOSURES Clinical and magnetic resonance imaging features, time receiving disease-modifying therapy (DMT), and time to first DMT.RESULTS After applying the inclusion and exclusion criteria, the study assessed 16130 patients with MS (median [IQR] age at onset, 28.7 [22.8-36.2 years]; 68.3% female). Compared with AOMS and LOMS, patients with POMS had less disability, exhibited more active disease, and were exposed to DMT for a longer period. A first 48-week-confirmed PIRA occurred in 7176 patients (44.5%): 558 patients with POMS (40.4%), 6258 patients with AOMS (44.3%), and 360 patients with LOMS (56.8%) (P < .001). Factors associated with PIRA were older age at onset (AOMS vs POMS HR, 1.42; 95% CI, 1.30-1.55; LOMS vs POMS HR, 2.98; 95% CI, 2.60-3.41; P < .001), longer disease duration (HR, 1.04; 95% CI, 1.04-1.05; P < .001), and shorter DMT exposure (HR, 0.69; 95% CI, 0.64-0.74; P < .001). The incidence of PIRA was 1.3% at 20 years of age, but it rapidly increased approximately 7 times between 21 and 30 years of age (9.0%) and nearly doubled for each age decade from 40 to 70 years (21.6% ... |
| Document Type: | article in journal/newspaper |
| Language: | English |
| Relation: | info:eu-repo/semantics/altIdentifier/pmid/38010712; info:eu-repo/semantics/altIdentifier/wos/WOS:001112185600004; volume:81; issue:1; journal:JAMA NEUROLOGY; https://hdl.handle.net/11573/1706044; info:eu-repo/semantics/altIdentifier/scopus/2-s2.0-85181448113 |
| DOI: | 10.1001/jamaneurol.2023.4455 |
| Availability: | https://doi.org/10.1001/jamaneurol.2023.4455 https://hdl.handle.net/11573/1706044 |
| Accession Number: | edsbas.99E3AD59 |
| Database: | BASE |
| Description not available. |