Clinical predictors of early second event in patients with clinically isolated syndrome
This study aimed to determine the predictors of increased risk of a second demyelinating event within the first year of an initial demyelinating event (IDE) suggestive of early multiple sclerosis (MS). Patients with MS or clinically isolated syndrome (CIS) seen at the UCSF MS Center within one year...
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| Veröffentlicht in: | Journal of neurology 2009-07, Vol.256 (7), p.1061-1066 |
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| creator | Mowry, Ellen M. Pesic, Mila Grimes, Barbara Deen, Serina R. Bacchetti, Peter Waubant, Emmanuelle |
| description | This study aimed to determine the predictors of increased risk of a second demyelinating event within the first year of an initial demyelinating event (IDE) suggestive of early multiple sclerosis (MS). Patients with MS or clinically isolated syndrome (CIS) seen at the UCSF MS Center within one year of the IDE were studied. Univariate and multivariate Cox models were used to analyze predictors of having a second event within 1 year of the IDE. Of 330 patients with MS/CIS, 111 had a second event within 1 year. Non-white race/ethnicity (HR = 2.39, 95% CI [1.58, 3.60],
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| doi_str_mv | 10.1007/s00415-009-5063-0 |
| format | Article |
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p
< 0.0001) and younger age (HR for each 10-year decrease in age = 1.51, 95% CI [1.28, 1.80],
p
< 0.0001) were strongly associated with an increased risk of having a second event within one year of onset. Having a lower number of functional systems affected by the IDE was also associated with an increased risk of early second event (HR for every one less FS involved = 1.31, 95% CI [1.06, 1.61],
p
= 0.011). These results were similar after adjusting for treatment of the IDE with steroids and disease-modifying therapy. Non-white race/ethnicity, younger age, and a lower number of FS affected by the IDE are associated with a substantially increased hazard ratio for a second demyelinating event within 1 year. Since early relapse is predictive of worse long-term outcome, identifying and treating such patients after the IDE may be of benefit to them.</description><identifier>ISSN: 0340-5354</identifier><identifier>EISSN: 1432-1459</identifier><identifier>DOI: 10.1007/s00415-009-5063-0</identifier><identifier>PMID: 19252775</identifier><identifier>CODEN: JNRYA9</identifier><language>eng</language><publisher>Heidelberg: D. Steinkopff-Verlag</publisher><subject>Adult ; Age Distribution ; Age Factors ; Biological and medical sciences ; Central Nervous System - immunology ; Central Nervous System - pathology ; Central Nervous System - physiopathology ; Continental Population Groups ; Disease ; Epidemiology ; Ethnicity ; Female ; Humans ; Immunologic Factors - therapeutic use ; Magnetic resonance imaging ; Male ; Medical sciences ; Medicine ; Medicine & Public Health ; Middle Aged ; Multiple sclerosis ; Multiple Sclerosis - epidemiology ; Multiple Sclerosis - pathology ; Multiple Sclerosis - physiopathology ; Multiple sclerosis and variants. Guillain barré syndrome and other inflammatory polyneuropathies. Leukoencephalitis ; Neurology ; Neuroradiology ; Neurosciences ; Original Communication ; Patients ; Prognosis ; Proportional Hazards Models ; Recurrence ; Risk Factors ; Severity of Illness Index ; Steroids - therapeutic use ; Young Adult</subject><ispartof>Journal of neurology, 2009-07, Vol.256 (7), p.1061-1066</ispartof><rights>The Author(s) 2009</rights><rights>2009 INIST-CNRS</rights><rights>Springer-Verlag 2009</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c528t-4526f4f958de968bae2def7131db637ac9989c779f9f102325ac45167a1380713</citedby><cites>FETCH-LOGICAL-c528t-4526f4f958de968bae2def7131db637ac9989c779f9f102325ac45167a1380713</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00415-009-5063-0$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00415-009-5063-0$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,780,784,885,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=21859151$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19252775$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mowry, Ellen M.</creatorcontrib><creatorcontrib>Pesic, Mila</creatorcontrib><creatorcontrib>Grimes, Barbara</creatorcontrib><creatorcontrib>Deen, Serina R.</creatorcontrib><creatorcontrib>Bacchetti, Peter</creatorcontrib><creatorcontrib>Waubant, Emmanuelle</creatorcontrib><title>Clinical predictors of early second event in patients with clinically isolated syndrome</title><title>Journal of neurology</title><addtitle>J Neurol</addtitle><addtitle>J Neurol</addtitle><description>This study aimed to determine the predictors of increased risk of a second demyelinating event within the first year of an initial demyelinating event (IDE) suggestive of early multiple sclerosis (MS). Patients with MS or clinically isolated syndrome (CIS) seen at the UCSF MS Center within one year of the IDE were studied. Univariate and multivariate Cox models were used to analyze predictors of having a second event within 1 year of the IDE. Of 330 patients with MS/CIS, 111 had a second event within 1 year. Non-white race/ethnicity (HR = 2.39, 95% CI [1.58, 3.60],
p
< 0.0001) and younger age (HR for each 10-year decrease in age = 1.51, 95% CI [1.28, 1.80],
p
< 0.0001) were strongly associated with an increased risk of having a second event within one year of onset. Having a lower number of functional systems affected by the IDE was also associated with an increased risk of early second event (HR for every one less FS involved = 1.31, 95% CI [1.06, 1.61],
p
= 0.011). These results were similar after adjusting for treatment of the IDE with steroids and disease-modifying therapy. Non-white race/ethnicity, younger age, and a lower number of FS affected by the IDE are associated with a substantially increased hazard ratio for a second demyelinating event within 1 year. Since early relapse is predictive of worse long-term outcome, identifying and treating such patients after the IDE may be of benefit to them.</description><subject>Adult</subject><subject>Age Distribution</subject><subject>Age Factors</subject><subject>Biological and medical sciences</subject><subject>Central Nervous System - immunology</subject><subject>Central Nervous System - pathology</subject><subject>Central Nervous System - physiopathology</subject><subject>Continental Population Groups</subject><subject>Disease</subject><subject>Epidemiology</subject><subject>Ethnicity</subject><subject>Female</subject><subject>Humans</subject><subject>Immunologic Factors - therapeutic use</subject><subject>Magnetic resonance imaging</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Multiple sclerosis</subject><subject>Multiple Sclerosis - epidemiology</subject><subject>Multiple Sclerosis - pathology</subject><subject>Multiple Sclerosis - physiopathology</subject><subject>Multiple sclerosis and variants. Guillain barré syndrome and other inflammatory polyneuropathies. Leukoencephalitis</subject><subject>Neurology</subject><subject>Neuroradiology</subject><subject>Neurosciences</subject><subject>Original Communication</subject><subject>Patients</subject><subject>Prognosis</subject><subject>Proportional Hazards Models</subject><subject>Recurrence</subject><subject>Risk Factors</subject><subject>Severity of Illness Index</subject><subject>Steroids - therapeutic use</subject><subject>Young Adult</subject><issn>0340-5354</issn><issn>1432-1459</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNqFkUuLFDEUhYMoTjv6A9xIEHRXevOqVDbC0PiCATeKy5BOJTMZqpM2t3qk_71puphRQVwlcL577uMQ8pzBGwag3yKAZKoDMJ2CXnTwgKyYFLxjUpmHZAVCQqeEkmfkCeINAAxNeEzOmOGKa61W5Pt6Sjl5N9FdDWPyc6lIS6TB1elAMfiSRxpuQ55pynTn5tS-SH-m-Zr6pbSBCcvk5jBSPOSxlm14Sh5FN2F4trzn5NuH91_Xn7rLLx8_ry8uO6_4MHdS8T7KaNQwBtMPGxf4GKJmgo2bXmjnjRmM19pEExlwwZXzUrFeOyYGaNw5eXfy3e032zD6Nl11k93VtHX1YItL9k8lp2t7VW4t1zAIcTR4vRjU8mMfcLbbhD5Mk8uh7NH2WmoQff9fkAPnkoFs4Mu_wJuyr7ldwXI2MKGMMA1iJ8jXglhDvBuZgT2Ga0_h2hauPYZrodW8-H3X-4olzQa8WgCHLZdYXfYJ77jWXRmmjjvzE4dNyleh3k_47-6_AOjxvME</recordid><startdate>20090701</startdate><enddate>20090701</enddate><creator>Mowry, Ellen M.</creator><creator>Pesic, Mila</creator><creator>Grimes, Barbara</creator><creator>Deen, Serina R.</creator><creator>Bacchetti, Peter</creator><creator>Waubant, Emmanuelle</creator><general>D. 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Guillain barré syndrome and other inflammatory polyneuropathies. Leukoencephalitis</topic><topic>Neurology</topic><topic>Neuroradiology</topic><topic>Neurosciences</topic><topic>Original Communication</topic><topic>Patients</topic><topic>Prognosis</topic><topic>Proportional Hazards Models</topic><topic>Recurrence</topic><topic>Risk Factors</topic><topic>Severity of Illness Index</topic><topic>Steroids - therapeutic use</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mowry, Ellen M.</creatorcontrib><creatorcontrib>Pesic, Mila</creatorcontrib><creatorcontrib>Grimes, Barbara</creatorcontrib><creatorcontrib>Deen, Serina R.</creatorcontrib><creatorcontrib>Bacchetti, Peter</creatorcontrib><creatorcontrib>Waubant, Emmanuelle</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Neurosciences Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of neurology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mowry, Ellen M.</au><au>Pesic, Mila</au><au>Grimes, Barbara</au><au>Deen, Serina R.</au><au>Bacchetti, Peter</au><au>Waubant, Emmanuelle</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Clinical predictors of early second event in patients with clinically isolated syndrome</atitle><jtitle>Journal of neurology</jtitle><stitle>J Neurol</stitle><addtitle>J Neurol</addtitle><date>2009-07-01</date><risdate>2009</risdate><volume>256</volume><issue>7</issue><spage>1061</spage><epage>1066</epage><pages>1061-1066</pages><issn>0340-5354</issn><eissn>1432-1459</eissn><coden>JNRYA9</coden><abstract>This study aimed to determine the predictors of increased risk of a second demyelinating event within the first year of an initial demyelinating event (IDE) suggestive of early multiple sclerosis (MS). Patients with MS or clinically isolated syndrome (CIS) seen at the UCSF MS Center within one year of the IDE were studied. Univariate and multivariate Cox models were used to analyze predictors of having a second event within 1 year of the IDE. Of 330 patients with MS/CIS, 111 had a second event within 1 year. Non-white race/ethnicity (HR = 2.39, 95% CI [1.58, 3.60],
p
< 0.0001) and younger age (HR for each 10-year decrease in age = 1.51, 95% CI [1.28, 1.80],
p
< 0.0001) were strongly associated with an increased risk of having a second event within one year of onset. Having a lower number of functional systems affected by the IDE was also associated with an increased risk of early second event (HR for every one less FS involved = 1.31, 95% CI [1.06, 1.61],
p
= 0.011). These results were similar after adjusting for treatment of the IDE with steroids and disease-modifying therapy. Non-white race/ethnicity, younger age, and a lower number of FS affected by the IDE are associated with a substantially increased hazard ratio for a second demyelinating event within 1 year. Since early relapse is predictive of worse long-term outcome, identifying and treating such patients after the IDE may be of benefit to them.</abstract><cop>Heidelberg</cop><pub>D. Steinkopff-Verlag</pub><pmid>19252775</pmid><doi>10.1007/s00415-009-5063-0</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Journal of neurology, 2009-07, Vol.256 (7), p.1061-1066 |
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| subjects | Adult Age Distribution Age Factors Biological and medical sciences Central Nervous System - immunology Central Nervous System - pathology Central Nervous System - physiopathology Continental Population Groups Disease Epidemiology Ethnicity Female Humans Immunologic Factors - therapeutic use Magnetic resonance imaging Male Medical sciences Medicine Medicine & Public Health Middle Aged Multiple sclerosis Multiple Sclerosis - epidemiology Multiple Sclerosis - pathology Multiple Sclerosis - physiopathology Multiple sclerosis and variants. Guillain barré syndrome and other inflammatory polyneuropathies. Leukoencephalitis Neurology Neuroradiology Neurosciences Original Communication Patients Prognosis Proportional Hazards Models Recurrence Risk Factors Severity of Illness Index Steroids - therapeutic use Young Adult |
| title | Clinical predictors of early second event in patients with clinically isolated syndrome |
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