TY - JOUR
T1 - Correlates and trajectories of relapses in relapsing–remitting multiple sclerosis
AU - Young, Carolyn A.
AU - Rog, David J.
AU - Sharrack, Basil
AU - Tanasescu, Radu
AU - Kalra, Seema
AU - Harrower, Timothy
AU - Tennant, Alan
AU - Mills, Roger J.
AU - Hanemann, Oliver
N1 - Publisher Copyright:
© 2023, The Author(s).
PY - 2023/11/17
Y1 - 2023/11/17
N2 - Background and aims: In people with relapsing–remitting multiple sclerosis (pwRRMS), data from studies on non-pharmacological factors which may influence relapse risk, other than age, are inconsistent. There is a reduced risk of relapses with increasing age, but little is known about other trajectories in real-world MS care. Methods: We studied longitudinal questionnaire data from 3885 pwRRMS, covering smoking, comorbidities, disease-modifying therapy (DMT), and patient-reported outcome measures, as well as relapses during the past year. We undertook Rasch analysis, group-based trajectory modelling, and multilevel negative binomial regression. Results: The regression cohort of 6285 data sets from pwRRMS over time showed that being a current smoker was associated with 43.9% greater relapse risk; having 3 or more comorbidities increased risk and increasing age reduced risk. Those diagnosed within the last 2 years showed two distinct trajectories, both reducing in relapse frequency but 25.8% started with a higher rate and took 4 years to reduce to the rate of the second group. In the cohort with at least three data points completed, there were three groups: 73.7% followed a low stable relapse rate, 21.6% started from a higher rate and decreased, and 4.7% had an increasing then decreasing pattern. These different trajectory groups showed significant differences in fatigue, neuropathic pain, disability, health status, quality of life, self-efficacy, and DMT use. Conclusions: These results provide additional evidence for supporting pwRRMS to stop smoking and underline the importance of timely DMT decisions and treatment initiation soon after diagnosis with RRMS.
AB - Background and aims: In people with relapsing–remitting multiple sclerosis (pwRRMS), data from studies on non-pharmacological factors which may influence relapse risk, other than age, are inconsistent. There is a reduced risk of relapses with increasing age, but little is known about other trajectories in real-world MS care. Methods: We studied longitudinal questionnaire data from 3885 pwRRMS, covering smoking, comorbidities, disease-modifying therapy (DMT), and patient-reported outcome measures, as well as relapses during the past year. We undertook Rasch analysis, group-based trajectory modelling, and multilevel negative binomial regression. Results: The regression cohort of 6285 data sets from pwRRMS over time showed that being a current smoker was associated with 43.9% greater relapse risk; having 3 or more comorbidities increased risk and increasing age reduced risk. Those diagnosed within the last 2 years showed two distinct trajectories, both reducing in relapse frequency but 25.8% started with a higher rate and took 4 years to reduce to the rate of the second group. In the cohort with at least three data points completed, there were three groups: 73.7% followed a low stable relapse rate, 21.6% started from a higher rate and decreased, and 4.7% had an increasing then decreasing pattern. These different trajectory groups showed significant differences in fatigue, neuropathic pain, disability, health status, quality of life, self-efficacy, and DMT use. Conclusions: These results provide additional evidence for supporting pwRRMS to stop smoking and underline the importance of timely DMT decisions and treatment initiation soon after diagnosis with RRMS.
KW - Multiple sclerosis
KW - Patient-reported outcome measure
KW - Rasch
KW - Relapse
KW - Trajectories of Outcome in Neurological Conditions-MS
UR - http://www.scopus.com/inward/record.url?scp=85176798040&partnerID=8YFLogxK
UR - https://pearl.plymouth.ac.uk/context/pms-research/article/2103/viewcontent/s10072_023_07155_3.pdf
U2 - 10.1007/s10072-023-07155-3
DO - 10.1007/s10072-023-07155-3
M3 - Article
C2 - 37976012
AN - SCOPUS:85176798040
SN - 1590-1874
JO - Neurological Sciences
JF - Neurological Sciences
ER -