Women with multiple sclerosis (MS), and people who stay in a relapsing stage or use disease-modifying therapies (DMTs) for longer periods are less likely to transition to secondary progressive multiple sclerosis (SPMS) than others, according to a study based on the Italian MS registry.
But patients whose disease starts after age 40, have a multifocal onset (multiple lesions and symptoms), greater disability at MS onset, and repeat relapses are more likely to progress to SPMS.
DMT exposure was the only significant “protective factor” in this transition found in two models of SPMS conversion used in this study.
These findings were detailed by Pietro Iaffaldano, a neurologist and researcher at the University of Bari Aldo Moro, in Italy, at the 35th Congress of the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) running through Friday in Stockholm.
SPMS is a second MS stage, one that follows relapsing-remitting MS (RRMS). In people transitioning to SPMS, the disease gradually changes from the inflammatory process seen in RRMS to a more steadily worsening phase characterized by nerve damage or loss, and the accumulation of disability over time.
Before DMTs became available, studies indicated that nearly all (about 90%) of those with RRMS would transition to SPMS within 25 years.
According to Iaffaldano, however, while these medicines have brought unprecedented benefits, it is too early to say how much they have altered or delayed disease course.
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