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A study of patients with aggressive multiple sclerosis at disease onset.

TitleA study of patients with aggressive multiple sclerosis at disease onset.
Publication TypeJournal Article
Year of Publication2016
AuthorsKaunzner UW, Kumar G, Askin G, Gauthier SA, Nealon NN, Vartanian T, Perumal JS
JournalNeuropsychiatr Dis Treat
Volume12
Pagination1907-12
Date Published2016
ISSN1176-6328
Abstract

OBJECTIVE: Identify aggressive onset multiple sclerosis (AOMS) and describe its clinical course.

METHODS: AOMS patients were identified from a multiple sclerosis (MS) database based on a set of criteria. The subsequent clinical course of AOMS patients was then reviewed with the goal of potentially identifying the best approaches to manage these patients.

RESULTS: Fifty-eight of 783 (7.4%) patients in the MS database met the criteria for AOMS, and 43 patients who had complete data for the duration of their follow-up were included in the subsequent analysis. The mean duration of the follow-up was 54 months. Thirty-five patients (81%) were started on a conventional first-line agent (injectable therapies for MS). Only two of these 35 patients (5.7%) had no evidence of disease activity. Twenty-two of 35 patients suffering from refractory disease were switched to a more aggressive treatment (natalizumab, rituximab, alemtuzumab, cyclophosphamide). Eight patients were started on aggressive treatment as their initial therapy, and seven of these eight (87.5%) patients showed no evidence of disease activity.

CONCLUSION: With recognition of the crucial significance of early optimal treatment during the potential window of opportunity for best long-term outcomes, we describe AOMS within 1 year of disease onset and discuss possible treatment considerations for these patients.

DOI10.2147/NDT.S111885
Alternate JournalNeuropsychiatr Dis Treat
PubMed ID27536112
PubMed Central IDPMC4975137