- Title
- Long-term disability trajectories in primary progressive MS patients: a latent class growth analysis
- Creator
- Signori, Alessio; Izquierdo, Guillermo; Duquette, Pierre; Boz, Cavit; Grammond, Pierre; Terzi, Murat; Singhal, Bhim; Alroughani, Raed; Petersen, Thor; Ramo, Cristina; Oreja-Guevara, Celia; Spitaleri, Daniele; Lugaresi, Alessandra; Lechner-Scott, Jeanette; Hupperts, Raymond; Grand'Maison, Francois; Sola, Patrizia; Horakova, Dana; Havrdova, Eva; Prat, Alexandre; Girard, Marc
- Relation
- Multiple Sclerosis Journal Vol. 24, Issue 5, p. 642-652
- Publisher Link
- http://dx.doi.org/10.1177/1352458517703800
- Publisher
- Sage
- Resource Type
- journal article
- Date
- 2018
- Description
- Background: Several natural history studies on primary progressive multiple sclerosis (PPMS) patients detected a consistent heterogeneity in the rate of disability accumulation. Objectives: To identify subgroups of PPMS patients with similar longitudinal trajectories of Expanded Disability Status Scale (EDSS) over time. Methods: All PPMS patients collected within the MSBase registry, who had their first EDSS assessment within 5 years from onset, were included in the analysis. Longitudinal EDSS scores were modeled by a latent class mixed model (LCMM), using a nonlinear function of time from onset. LCMM is an advanced statistical approach that models heterogeneity between patients by classifying them into unobserved groups showing similar characteristics. Results: A total of 853 PPMS (51.7% females) from 24 countries with a mean age at onset of 42.4 years (standard deviation (SD): 10.8 years), a median baseline EDSS of 4 (interquartile range (IQR): 2.5-5.5), and 2.4 years of disease duration (SD: 1.5 years) were included. LCMM detected three different subgroups of patients with a mild ( n = 143; 16.8%), moderate ( n = 378; 44.3%), or severe ( n = 332; 38.9%) disability trajectory. The probability of reaching EDSS 6 at 10 years was 0%, 46.4%, and 81.9% respectively. Conclusion: Applying an LCMM modeling approach to long-term EDSS data, it is possible to identify groups of PPMS patients with different prognosis.
- Subject
- primary progressive multiple sclerosis; disability; long-term; trajectories; clinical trials; heterogeneity
- Identifier
- http://hdl.handle.net/1959.13/1409519
- Identifier
- uon:36042
- Identifier
- ISSN:1352-4585
- Language
- eng
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