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Long-term disability trajectories in primary progressive MS patients: A latent class growth analysis


Signori, A and Izquierdo, G and Lugaresi, A and Hupperts, R and Grand'Maison, F and Sola, P and Horakova, D and Havrdova, E and Prat, A and Girard, M and Duquette, P and Boz, C and Grammond, P and Terzi, M and Singhal, B and Alroughani, R and Petersen, T and Ramo, C and Oreja-Guevara, C and Spitaleri, D and Shaygannejad, V and Butzkueven, H and Kalincik, T and Jokubaitis, V and Slee, M and Fernandez Bolanos, R and Sanchez-Menoyo, JL and Pucci, E and Granella, F and Lechner-Scott, J and Iuliano, G and Hughes, S and Bergamaschi, R and Taylor, B and Verheul, F and Edite Rio, M and Amato, MP and Sajedi, SA and Majdinasab, N and Van Pesch, V and Sormani, MP and Trojano, M, Long-term disability trajectories in primary progressive MS patients: A latent class growth analysis, Multiple Sclerosis Journal, 24, (5) pp. 642-652. ISSN 1352-4585 (2018) [Refereed Article]

Copyright Statement

Copyright 2017 the authors

DOI: doi:10.1177/1352458517703800


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.

Item Details

Item Type:Refereed Article
Keywords:primary progressive multiple sclerosis, clinical trials, disability, heterogeneity, long-term, trajectories
Research Division:Biomedical and Clinical Sciences
Research Group:Neurosciences
Research Field:Central nervous system
Objective Division:Health
Objective Group:Clinical health
Objective Field:Clinical health not elsewhere classified
UTAS Author:Taylor, B (Professor Bruce Taylor)
ID Code:124237
Year Published:2018 (online first 2017)
Web of Science® Times Cited:24
Deposited By:Menzies Institute for Medical Research
Deposited On:2018-02-14
Last Modified:2022-08-23

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