Early predictors of conversion to secondary progressive multiple sclerosis

Barzegar, Mahdi; Najdaghi, Soroush; Afshari-Safavi, Alireza; Nehzat, Nasim; Mirmosayyeb, Omid; Shaygannejad, Vahid

doi:10.1016/j.msard.2021.103115

Cited by 28 publications

(12 citation statements)

References 72 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…57 Several other potential viral contributors to MS risk, including human herpes virus 6, cytomegalovirus, herpes simplex virus, and human endogenous retroviruses, have been explored, but thus far have less well-established associations with MS pathogenesis than EBV. 49 Smoking Smoking has been associated with increased risk of MS, 58 as well as conversion from CIS to clinically definite MS 33 and conversion of relapsing to secondary progressive MS. 59,60 Smoking may also reduce efficacy of at least some DMTs including interferon and natalizumab. 61,62 Passive smoke exposure has also been associated with increased MS risk.…”

Section: Geneticsmentioning

confidence: 99%

See 1 more Smart Citation

Epidemiology and Pathophysiology of Multiple Sclerosis

Ward¹,

Goldman²

2022

CONTINUUM: Lifelong Learning in Neurology

View full text Add to dashboard Cite

PURPOSE OF REVIEW: This article provides an overview of genetic, environmental, and lifestyle risk factors affecting the disease course of multiple sclerosis (MS) and reviews the pathophysiologic characteristics of both relapsing and progressive MS.RECENT FINDINGS: The prevalence of MS has increased in recent decades, and costs of care for patients with MS have risen dramatically. Black, Asian, and Hispanic individuals may be at risk for more severe MS-related disability. Multiple genetic MS risk factors have been identified. Factors such as low vitamin D levels and a history of Epstein-Barr virus, smoking, and obesity, especially during childhood, also influence MS risk. Traditionally thought to be a T-cell-mediated disease, recent research has highlighted the additional roles of B cells and microglia in both relapsing and progressive MS. SUMMARY: Complex interactions between genetic, environmental, and lifestyle factors affect the risk for MS as well as the disease course. People of color have historically been underrepresented in both MS clinical trials and literature, but current research is attempting to better clarify unique considerations in these groups. MS pathology consists of the focal inflammatory lesions that have been well characterized in relapsing MS, as well as a more widespread neurodegenerative component that is posited to drive progressive disease. Recent advances in characterization of both the inflammatory and neurodegenerative aspects of MS pathophysiology have yielded potential targets for future therapeutic options.

show abstract

Section: Geneticsmentioning

confidence: 99%

“…Smoking has been associated with increased risk of MS, 58 as well as conversion from CIS to clinically definite MS 33 and conversion of relapsing to secondary progressive MS 59,60 . Smoking may also reduce efficacy of at least some DMTs including interferon and natalizumab 61,62 .…”

Section: Risk Factorsmentioning

confidence: 99%

Epidemiology and Pathophysiology of Multiple Sclerosis

Ward¹,

Goldman²

2022

CONTINUUM: Lifelong Learning in Neurology

View full text Add to dashboard Cite

show abstract

“…The study of Amato et al showed that cerebellar manifestations at the onset of MS were associated with a high disability rate and rapid progression to secondary disease (36). Meanwhile, a prospective study of 1,903 patients showed that brainstem dysfunction was one of the important prognostic factors for RRMS conversion to SPMS (20), and brainstem dysfunction at onset was one of the predictors of treatment failure in the second year (21). However, other studies have shown that brainstem symptoms during the onset of MS have no statistical significance in the rate of conversion to SPMS and disability prognosis (22).…”

Section: Clinically Definite Msmentioning

confidence: 99%

Cerebellar and/or Brainstem Lesions Indicate Poor Prognosis in Multiple Sclerosis: A Systematic Review

Yang

Wang

et al. 2022

Front. Neurol.

View full text Add to dashboard Cite

Multiple sclerosis is a serious neurological disease that affects millions of people worldwide. Cerebellar and brainstem symptoms are common in the course of multiple sclerosis, but their prognostic value is unclear. This systematic review aimed to determine the relationship between the location of lesions in the cerebellum and/or brainstem and the prognosis in multiple sclerosis. In this systematic review, we searched and comprehensively read articles related to this research topic in Chinese and English electronic databases (PubMed, Embase, Cochrane Library, CNKI, and CBM) using search terms “multiple sclerosis,” “cerebellum,” “brainstem,” “prognosis,” and others. Cerebellar and brainstem clinically isolated syndromes and clinically definite multiple sclerosis were important predictors of transformation (hazard ratio, 2.58; 95% confidence interval, 1.58–4.22). Cerebellar and/or brainstem lesions indicate a poor overall prognosis in multiple sclerosis, but because of inconsistency, more clinical data are needed.

show abstract

“…The majority of MS patients (∼ 85%) are diagnosed with RRMS, and approximately 50–60% of them transition to SPMS between 5 and 30 years [ 13 , 14 ], highlighting the heterogeneity of the time between disease onset and transition to SPMS due to the high interindividual variability in the disease course. According to the revised Lublin criteria, SPMS is diagnosed retrospectively based on a course of confirmed progression over the last 3–12 months with or without acute exacerbations during the progressive course after an initial relapsing disease course [ 1 ].…”

Section: Defining the Transition Phase To Secondary Progressive Ms (S...mentioning

confidence: 99%

Treatment of Patients with Multiple Sclerosis Transitioning Between Relapsing and Progressive Disease

et al. 2023

View full text Add to dashboard Cite

Multiple sclerosis (MS) is a chronic autoimmune demyelinating and neurodegenerative disease of the central nervous system with a wide variety of clinical phenotypes. In spite of the phenotypic classification of MS patients, current data provide evidence that diffuse neuroinflammation and neurodegeneration coexist in all MS forms, the latter gaining increasing clinical relevance in progressive phases. Given that the transition phase of relapsing-remitting MS (RRMS) to secondary progressive MS (SPMS) is not well defined, and widely accepted criteria for SPMS are lacking, randomised controlled trials (RCTs) specifically designed for the transition phase have not been conducted. This review summarizes primary and secondary analyses and reports derived from phase III prospective clinical RCTs listed in PubMed of compounds authorised through the European Medicines Agency (EMA) and the US Food and Drug Administration (FDA) for the treatment of MS. The best data are available for interferon beta-1a (IFNb-1a) subcutaneous (s.c.), IFNb-1b s.c., mitoxantrone and siponimod, the latter being the most modern compound with likely the best risk-to-effect ratio. Moreover, there is a labels discrepancy for many disease-modifying treatments (DMTs) between the FDA and EMA, which have to be taken into consideration when opting for a specific DMT.

show abstract

Early predictors of conversion to secondary progressive multiple sclerosis

Cited by 28 publications

References 72 publications

Epidemiology and Pathophysiology of Multiple Sclerosis

Epidemiology and Pathophysiology of Multiple Sclerosis

Cerebellar and/or Brainstem Lesions Indicate Poor Prognosis in Multiple Sclerosis: A Systematic Review

Treatment of Patients with Multiple Sclerosis Transitioning Between Relapsing and Progressive Disease

Contact Info

Product

Resources

About