Predictors of Long-term Disability in Multiple Sclerosis: Real World Data from a Cohort of Egyptian Patients

Abstract

Background: Specification of prognostic factors in multiple sclerosis (MS) is crucial for clinicians to guide therapeutic protocols. This study aimed to identify demographic, clinical, and radiological factors associated with disability on a long-term basis in relapsing-remitting MS (RRMS) and secondary progressive MS (SPMS). Methods: This was a retrospective study conducted on patients with RRMS and SPMS with a disease duration of at least 10 years. Demographic, clinical, and radiological parameters were collected from the medical records. Results: During the study period, 217 patients were recruited with a mean disease duration of 14.9±4.6 (range: 10-35) years. Regression analysis revealed that age (B=0.071, CI: 0.00-0.132, P=0.025), male sex (B=–0.825, CI: –1.444 to –0.206, P=0.009), duration between first 2 attacks (B=-0.007, CI: -0.015-0.000, P=0.037), and involvement of pyramidal (B=0.754, CI: 0.051-1.457, P=0.036) or cerebellar domains (B=1.355, CI: 0.542-2.168, P=0.001) at disease onset were the only parameters that had an independent effect on EDSS. Conclusion: Predictors of long-term disability in our cohort were closely similar, but not typically identical to predictors reported in the literature. Age, male sex, short duration between first 2 relapses pyramidal and cerebellar affection were the strongest predictors of disability in patients with RRMS and SPMS.

Keywords

• edss
• early predictor
• long-term prognosis
• multiple sclerosis