Long-term outcomes in patients presenting with optic neuritis: Analyses of the MSBase registry,Journal of the Neurological Sciences

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Long-term outcomes in patients presenting with optic neuritis: Analyses of the MSBase registry
Journal of the Neurological Sciences ( IF 3.6 ) Pub Date : 2021-09-03 , DOI: 10.1016/j.jns.2021.118067
Rachel Kenney ₁ , Mengling Liu ₂ , Sachi Patil ₃ , Raed Alroughani ₄ , Radek Ampapa ₅ , Roberto Bergamaschi ₆ , Cavit Boz ₇ , Helmut Butzkueven ₈ , Jose Cabrera Gomez ₉ , Elisabetta Cartechini ₁₀ , Sara Eichau Madueño ₁₁ , Diana Ferraro ₁₂ , Francois Grand-Maison ₁₃ , Franco Granella ₁₄ , Dana Horakova ₁₅ , Guillermo Izquierdo Ayuso ₁₁ , Tomas Kalincik ₁₆ , Jana Lizrova Preiningerova ₁₇ , Alessandra Lugaresi ₁₈ , Marco Onofrj ₁₉ , Serkan Ozakbas ₂₀ , Francesco Patti ₂₁ , Patrizia Sola ₂₂ , Aysun Soysal ₂₃ , Daniele Litterio A Spitaleri ₂₄ , Murat Terzi ₂₅ , Recai Turkoglu ₂₆ , Vincent van Pesch ₂₇ , Shiv Saidha ₂₈ , Lorna E Thorpe ₂ , Steven L Galetta ₂₉ , Laura J Balcer ₃₀ , Ilya Kister ₃ , Tim Spelman ₃₁ ,

Affiliation

Department of Neurology, New York University Grossman School of Medicine, New York, NY, USA; Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA.
Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA.
Department of Neurology, New York University Grossman School of Medicine, New York, NY, USA.
Amiri Hospital, Kuwait City, Kuwait.
Neurologicka Klinika Jihlava, Jihlava, Czech Republic.
IRCCS Mondino Foundation, Pavia, Italy.
KTU Medical Faculty Farabi Hospital, Trabzon, Turkey.
Monash University, Melbourne, Victoria, Australia.
Centro Internacional de Restauracion Neurologica, La Habana, Cuba.
Azienda Sanitaria Unica Regionale Marche, Ancona, Province of Ancona, Italy.
Hospital Universitario Virgen Macarena, Seville, Spain.
University of Modena and Reggio Emilia, Modena, Province of Modena, Italy.
Neuro Rive-Sud, Quebec, Canada.
Department of Medicine and Surgery, University of Parma, Italy.
Charles University in Prague and General University Hospital, Prague, Czech Republic.
MS Centre, Royal Melbourne Hospital, CORe, Department of Medicine, University of Melbourne, Melbourne, AU.
Neurologicka Klinika 1 LF UK, Prague, Czech Republic.
IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy; Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna, Bologna, Italy.
University G. d'Annunzio, Chieti-Pescara, Italy.
Dokuz eylul uni. faculty of medicine, Izmir, Turkey.
Department of Medical and Surgical Sciences and Advanced Technologies, University of Catania, Catania, Italy.
Nuovo Ospedale Civile S. Agostino-Estense, Baggiovara, MO, Italy.
Bakirkoy Hospital Of Mental Disorders And Neuro, Bakirkoy/Istanbul, Turkey.
A.O. "S. Giuseppe Moscati", Avellino, Italy.
Ondokuz Mayis Universitesi, Samsun, Turkey.
Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey.
Cliniques Universitaires Saint-Luc, UCLouvain, Brussels, Belgium.
Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Department of Neurology, New York University Grossman School of Medicine, New York, NY, USA; Department of Ophthalmology, New York University Grossman School of Medicine, New York, NY, USA.
Department of Neurology, New York University Grossman School of Medicine, New York, NY, USA; Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA; Department of Ophthalmology, New York University Grossman School of Medicine, New York, NY, USA.
MSBase Foundation, Alfred Centre, Melbourne, Australia; Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden.

Background

Short-term outcomes of optic neuritis (ON) have been well characterized. Limited data exists on longer-term visual outcomes in patients who present with ON. The large MSBase registry allows for characterization of long-term visual outcomes after ON.

Methods

Via the MSBase Registry, data on patients from 41 centers was collected during routine clinical and research visits. Physical and visual disability were measured using the expanded disability status scale (EDSS) and the visual function score (VFS). Inclusion criteria for this analysis included age ≥ 18 years, clinically isolated syndrome (CIS), ON-onset, baseline visit within 6 months of onset, and at least one follow-up visit. Survival analysis was used to evaluate the association of disease-modifying treatment with time to conversion to clinically definite MS or sustained EDSS/VFS progression.

Results

Data from 60,933 patients were obtained from the MSBase registry in July 2019. Of these, 1317 patients met inclusion criteria; 935 were treated at some point in disease course, while 382 were never treated. At baseline, mean age was 32.3 ± 8.8 years, 74% were female, median EDSS was 2 (IQR 1–2), and median VFS was 1 (IQR 0–2). Median follow-up time was 5.2 years (IQR 2.4–9.3). Treatment was associated with reduced risk and delayed conversion to clinically definite MS (HR = 0.70, p < 0.001), sustained EDSS progression (HR = 0.46, p < 0.0001) and sustained VFS (HR = 0.41, p < 0.001) progression.

Conclusions

In the MSBase cohort, treatment after ON was associated with better visual and neurological outcomes compared to no treatment. These results support early treatment for patients presenting with ON as the first manifestation of MS.

中文翻译：

视神经炎患者的长期结果：MSBase 注册分析

背景

视神经炎 (ON) 的短期结果已得到很好的表征。关于 ON 患者的长期视力结果的数据有限。大型 MSBase 注册表允许表征 ON 后的长期视觉结果。

方法

通过 MSBase Registry，在常规临床和研究访问期间收集了来自 41 个中心的患者数据。使用扩展残疾状态量表 (EDSS) 和视觉功能评分 (VFS) 测量身体和视觉残疾。该分析的纳入标准包括年龄 ≥ 18 岁、临床孤立综合征 (CIS)、发病、发病后 6 个月内的基线访视以及至少一次随访。生存分析用于评估疾病改善治疗与转化为临床确诊 MS 或持续 EDSS/VFS 进展的时间之间的关联。

结果

2019 年 7 月从 MSBase 登记处获得了 60,933 名患者的数据。其中，1317 名患者符合纳入标准；935 人在病程的某个时间点接受了治疗，而 382 人从未接受过治疗。基线时，平均年龄为 32.3 ± 8.8 岁，74% 为女性，EDSS 中位数为 2（IQR 1-2），VFS 中位数为 1（IQR 0-2）。中位随访时间为 5.2 年（IQR 2.4-9.3）。治疗与降低风险和延迟转化为临床明确的 MS（HR = 0.70，p < 0.001）、持续的 EDSS 进展（HR = 0.46，p < 0.0001）和持续的 VFS（HR = 0.41，p < 0.001）进展相关。