Time until treatment and prognosis of multiple sclerosis beyond physical disability

Address for correspondence: Mateus Boaventura de Oliveira (email: [e-mail]).

Abstract

Background: Multiple sclerosis (MS) is the most common non-traumatic debilitating condition affecting young adults, with a global incidence on the rise. This trend contributes to its significant socioeconomic impact, which is related to physical disability and cognitive dysfunction. Investing in early diagnosis and treatment may reduce the daily limitations faced by the affected individuals.

Objective: To statistically elucidate the true long-term impact that the time gap between the initial onset of symptoms and treatment has on prognosis.

Methods: The present is a multicenter study, in which MS patients from three outpatient clinics were ambispectively analyzed. The time gap from disease onset to the first disease-modifying treatment (TFDT) and the time between disease onset and the first high-efficacy therapy (TFET) were calculated. Sociodemographic and clinical data were collected through the local database, and the course of the disease was evaluated through classic physical/cognitive disability scales and burden symptoms questionnaire (SymtoMScreen).

Results: A total of 184 MS patients were included in the baseline analysis (77.7% of female subjects; mean age at analysis of 39.1(±10.8) years; mean at disease onset of 29.8(±9.4) years; mean disease duration of 9.3(±7.6) years; and median baseline EDSS score of 2.0). Significant correlations were observed between: TFDT and EDSS (r = 0.374; p < 0.001); TFET and EDSS (r = 0.442; p < 0.001); TFDT and processing speed (r = -0.207; p = 0.042); TFDT and visual memory (r = -0.271; p = 0.008); and TFET and SypmtoMScreen (r = 0.203; p = 0.049). No significant correlations were observed between both time intervals and the Modified Fatigue Impact Scale (MFIS) or the Multiple Sclerosis Impact Scale (MSIS-29).

Conclusion: A longer time to start treatment is associated with worse physical disability, cognitive dysfunction, and symptom severity. These findings may support decisions regarding the need for early MS therapy in the Brazilian setting, beyond just the classic physical outcomes.

 

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Publikationsverlauf

Artikel online veröffentlicht:
02. Oktober 2024