A study of patients with aggressive multiple sclerosis at disease onset.

Publication Type	Academic Article
Authors	Kaunzner U, Kumar G, Askin G, Gauthier S, Nealon N, Vartanian T, Perumal J
Journal	Neuropsychiatr Dis Treat
Volume	12
Pagination	1907-12
Date Published	08/01/2016
ISSN	1176-6328
Abstract	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.
DOI	10.2147/NDT.S111885
PubMed ID	27536112
PubMed Central ID	PMC4975137