A study of patients with aggressive multiple sclerosis at disease onset
Ulrike W Kaunzner,1 Gaurav Kumar,2 Gulce Askin,3 Susan A Gauthier,1 Nancy N Nealon,1 Timothy Vartanian,1 Jai S Perumal1 1Judit Jaffe Multiple Sclerosis Center, Weill-Cornell Medical College, New York City, NY, 2Department of Cell Biology and Neuroscience, Rutgers University, New Brunswick, NJ, 3Ins...
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Dove Medical Press
2016
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oai:doaj.org-article:40b89627044949a795a4d190d375434f2021-12-02T04:57:12ZA study of patients with aggressive multiple sclerosis at disease onset1178-2021https://doaj.org/article/40b89627044949a795a4d190d375434f2016-08-01T00:00:00Zhttps://www.dovepress.com/a-study-of-patients-with-aggressive-multiple-sclerosis-at-disease-onse-peer-reviewed-article-NDThttps://doaj.org/toc/1178-2021Ulrike W Kaunzner,1 Gaurav Kumar,2 Gulce Askin,3 Susan A Gauthier,1 Nancy N Nealon,1 Timothy Vartanian,1 Jai S Perumal1 1Judit Jaffe Multiple Sclerosis Center, Weill-Cornell Medical College, New York City, NY, 2Department of Cell Biology and Neuroscience, Rutgers University, New Brunswick, NJ, 3Institute for Biostatistics and Epidemiology, Weill-Cornell Medical College, New York City, NY, USA Objective: Identify aggressive onset multiple sclerosis (AOMS) and describe its clinical course.Methods: AOMS patients were identified from a multiple sclerosis (MS) database based on a set of criteria. The subsequent clinical course of AOMS patients was then reviewed with the goal of potentially identifying the best approaches to manage these patients.Results: Fifty-eight of 783 (7.4%) patients in the MS database met the criteria for AOMS, and 43 patients who had complete data for the duration of their follow-up were included in the subsequent analysis. The mean duration of the follow-up was 54 months. Thirty-five patients (81%) were started on a conventional first-line agent (injectable therapies for MS). Only two of these 35 patients (5.7%) had no evidence of disease activity. Twenty-two of 35 patients suffering from refractory disease were switched to a more aggressive treatment (natalizumab, rituximab, alemtuzumab, cyclophosphamide). Eight patients were started on aggressive treatment as their initial therapy, and seven of these eight (87.5%) patients showed no evidence of disease activity.Conclusion: With recognition of the crucial significance of early optimal treatment during the potential window of opportunity for best long-term outcomes, we describe AOMS within 1 year of disease onset and discuss possible treatment considerations for these patients. Keywords: aggressive multiple sclerosis, algorithm, treatment course, database, retrospective analysisKaunzner UWKumar GAskin GGauthier SANealon NNVartanian TPerumal JSDove Medical PressarticleAggressive Multiple SclerosisAlgorithmTreatment courseDatabaseRetrospective AnalysisNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571Neurology. Diseases of the nervous systemRC346-429ENNeuropsychiatric Disease and Treatment, Vol 2016, Iss Issue 1, Pp 1907-1912 (2016) |
| institution |
DOAJ |
| collection |
DOAJ |
| language |
EN |
| topic |
Aggressive Multiple Sclerosis Algorithm Treatment course Database Retrospective Analysis Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429 |
| spellingShingle |
Aggressive Multiple Sclerosis Algorithm Treatment course Database Retrospective Analysis Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429 Kaunzner UW Kumar G Askin G Gauthier SA Nealon NN Vartanian T Perumal JS A study of patients with aggressive multiple sclerosis at disease onset |
| description |
Ulrike W Kaunzner,1 Gaurav Kumar,2 Gulce Askin,3 Susan A Gauthier,1 Nancy N Nealon,1 Timothy Vartanian,1 Jai S Perumal1 1Judit Jaffe Multiple Sclerosis Center, Weill-Cornell Medical College, New York City, NY, 2Department of Cell Biology and Neuroscience, Rutgers University, New Brunswick, NJ, 3Institute for Biostatistics and Epidemiology, Weill-Cornell Medical College, New York City, NY, USA Objective: Identify aggressive onset multiple sclerosis (AOMS) and describe its clinical course.Methods: AOMS patients were identified from a multiple sclerosis (MS) database based on a set of criteria. The subsequent clinical course of AOMS patients was then reviewed with the goal of potentially identifying the best approaches to manage these patients.Results: Fifty-eight of 783 (7.4%) patients in the MS database met the criteria for AOMS, and 43 patients who had complete data for the duration of their follow-up were included in the subsequent analysis. The mean duration of the follow-up was 54 months. Thirty-five patients (81%) were started on a conventional first-line agent (injectable therapies for MS). Only two of these 35 patients (5.7%) had no evidence of disease activity. Twenty-two of 35 patients suffering from refractory disease were switched to a more aggressive treatment (natalizumab, rituximab, alemtuzumab, cyclophosphamide). Eight patients were started on aggressive treatment as their initial therapy, and seven of these eight (87.5%) patients showed no evidence of disease activity.Conclusion: With recognition of the crucial significance of early optimal treatment during the potential window of opportunity for best long-term outcomes, we describe AOMS within 1 year of disease onset and discuss possible treatment considerations for these patients. Keywords: aggressive multiple sclerosis, algorithm, treatment course, database, retrospective analysis |
| format |
article |
| author |
Kaunzner UW Kumar G Askin G Gauthier SA Nealon NN Vartanian T Perumal JS |
| author_facet |
Kaunzner UW Kumar G Askin G Gauthier SA Nealon NN Vartanian T Perumal JS |
| author_sort |
Kaunzner UW |
| title |
A study of patients with aggressive multiple sclerosis at disease onset |
| title_short |
A study of patients with aggressive multiple sclerosis at disease onset |
| title_full |
A study of patients with aggressive multiple sclerosis at disease onset |
| title_fullStr |
A study of patients with aggressive multiple sclerosis at disease onset |
| title_full_unstemmed |
A study of patients with aggressive multiple sclerosis at disease onset |
| title_sort |
study of patients with aggressive multiple sclerosis at disease onset |
| publisher |
Dove Medical Press |
| publishDate |
2016 |
| url |
https://doaj.org/article/40b89627044949a795a4d190d375434f |
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