A Comprehensive Assessment of Progression Independent of Relapse Activity in a Cohort of Patients with Secondary Progressive Multiple Sclerosis (P8-6.010)

Abstract

Objective: To analyze characteristics of patients with secondary progressive Multiple Sclerosis (SPMS) exhibiting Progression Independent of Relapse Activity (PIRA) and to identify factors contributing to earlier progression Background: Emerging evidence suggests that PIRA is not restricted to progressive MS forms, starting early in the disease and contributing to disability accrual in MS. However, how PIRA starts and the factors accelerating its onset remain uncertain. Design/Methods: A retrospective analysis of clinical and demographic characteristics of SPMS patients was conducted. Parametric and non-parametric tests and multivariate regression analysis were applied according to objectives. Demographics were expressed as median (IQR1–3) Results: 178 SPMS patients were included out of which 108 were females. The median follow-up duration was 11.83 years (4.83–18.58), 139 patients were classified as active. Median time since the first evidence of PIRA was 7.58 years (5–35), and in 43 patients this occurred within 5 years (early PIRA, EP). Patients with EP were older compared to late PIRA (LP) (EP 38, 32–46.5 vs. LP 32, 25–42.75, p=0.02) with female predominance (62% vs. LP 32%, 25–42.7, p=0.02). No increased risk of EP was observed at age 60 or older. Myelitis was the first clinical symptom presented in EP more frequently (70% vs. 36%, p<0.005). EP patients transitioned to SPMS faster (74 vs 162 months, p<0.01). Frequency of EP decreased with age; those initiating treatment between 30–39 years presented OR=6.2 (95% CI=1.8–21.4, p=0.004), at 40–49 years OR=6.1 (95% CI=1.6–23, p=0.007), and at 50–59 years OR=5.77 (95% CI=1.1–28, p=0.03). Conclusions: Early PIRA occurrence is influenced by age, initial symptoms, and treatment onset, highlighting the complexity of MS progression. Disclosure: Miss Zarate has nothing to disclose. Dr. Marrodan has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck. Dr. Marrodan has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Merck, Astra Zeneca, Gador, Biogen, Roche and Novartis. Mrs. Piedrabuena has nothing to disclose. Marcela Fiol has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for merck. The institution of Marcela Fiol has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for biogen. Marcela Fiol has received personal compensation in the range of $0-$499 for serving on a Speakers Bureau for Merck. Marcela Fiol has received personal compensation in the range of $0-$499 for serving on a Speakers Bureau for Biogen. Marcela Fiol has received personal compensation in the range of $0-$499 for serving on a Speakers Bureau for Novartis. Marcela Fiol has received personal compensation in the range of $0-$499 for serving on a Speakers Bureau for Teva. Marcela Fiol has received personal compensation in the range of $0-$499 for serving on a Speakers Bureau for Roche. Celica Ysrraelit has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck. Celica Ysrraelit has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Celica Ysrraelit has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Biogen. Celica Ysrraelit has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Merck. Celica Ysrraelit has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Genzyme. Celica Ysrraelit has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Roche. Celica Ysrraelit has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Merck, . Celica Ysrraelit has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Biogen. Celica Ysrraelit has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Bayer. Celica Ysrraelit has received research support from Novartis. The institution of Celica Ysrraelit has received research support from ROCHE. The institution of Celica Ysrraelit has received research support from Roche. Dr. Correale has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Roche. Dr. Correale has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Merck. Dr. Correale has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen. Dr. Correale has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Dr. Correale has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Sanofi-Genzyme. Dr. Correale has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for ROche. Dr. Correale has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck. Dr. Correale has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Correale has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Correale has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi-Genzyme. The institution of Dr. Correale has received research support from Merck. The institution of Dr. Correale has received research support from Biogen. The institution of Dr. Correale has received research support from Novartis.