Recent studies have confirmed that CLs are predictive of the development of progressive MS and worsening disability in MS patients2,3. The objective of this study was to assess the prognostic value of CLs after 20 years, when CLs were determined at an early stage of the disease. For this purpose, 220 patients with MS (relapsing-remitting n=162, clinically isolated syndrome n=45, primary progressive n=12) were followed for 20 years.
At diagnosis and within 4 years since clinical onset of the disease, they underwent a 1.5 Tesla brain MRI and a spinal cord MRI scan. The number of CLs, the number of white matter lesions, and the presence of spinal cord lesions were evaluated. Primary endpoints were the correlation of early MRI features with conversions to secondary progressive MS types and Expanded Disability Status Scale (EDSS) scores at the end of follow-up. Dr Gian Marco Schiavi (University of Verona, Italy) shared the results.
After 20 years of follow-up, 152 patients were relapsing-remitting, 44 had conversed to secondary progressive disease, and 12 had clinically isolated syndromes still. The number of CLs at diagnosis was higher in patients who conversed to secondary progressive disease (mean 6.28) than in non-secondary progressive disease MS patients (mean 1.16, P<0.001). Moreover, higher EDSS scores were associated with higher numbers of CLs at baseline (P<0.001). Corresponding mean EDSS scores ranged from 1.5, in patients without CLs, to 6.0 in patients with > 3CLs at baseline.