Long-term disability trajectories in primary progressive MS patients: A latent class growth analysis.
(2018) Multiple Sclerosis Journal — Vol. 24, n° 5, p. 642-652 (2018)
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- (en) 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.
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Signori, A., Izquierdo, G., Lugaresi, A., Hupperts, R., Grand’Maison, F., Sola, P., Horakova, D., Havrdova, E., Prat, A., Girard, M., Duquette, P., Boz, C., Grammond, P., Terzi, M., Singhal, B., Alroughani, R., Petersen, T., Ramo, C., Oreja-Guevara, C., et al. (2018). Long-term disability trajectories in primary progressive MS patients: A latent class growth analysis. Multiple Sclerosis Journal, 24(5), 642-652. https://doi.org/10.1177/1352458517703800 (Original work published 2018)