PMID- 27885062
OWN - NLM
STAT- MEDLINE
DCOM- 20180516
LR  - 20220408
IS  - 1477-0970 (Electronic)
IS  - 1352-4585 (Linking)
VI  - 23
IP  - 10
DP  - 2017 Sep
TI  - Quantifying risk of early relapse in patients with first demyelinating events: 
      Prediction in clinical practice.
PG  - 1346-1357
LID - 10.1177/1352458516679893 [doi]
AB  - BACKGROUND: Characteristics at clinically isolated syndrome (CIS) examination 
      assist in identification of patient at highest risk of early second attack and 
      could benefit the most from early disease-modifying drugs (DMDs). OBJECTIVE: To 
      examine determinants of second attack and validate a prognostic nomogram for 
      individualised risk assessment of clinical conversion. METHODS: Patients with CIS 
      were prospectively followed up in the MSBase Incident Study. Predictors of 
      clinical conversion were analysed using Cox proportional hazards regression. 
      Prognostic nomograms were derived to calculate conversion probability and 
      validated using concordance indices. RESULTS: A total of 3296 patients from 50 
      clinics in 22 countries were followed up for a median (inter-quartile range 
      (IQR)) of 1.92 years (0.90, 3.71). In all, 1953 (59.3%) patients recorded a 
      second attack. Higher Expanded Disability Status Scale (EDSS) at baseline, first 
      symptom location, oligoclonal bands and various brain and spinal magnetic 
      resonance imaging (MRI) metrics were all predictors of conversion. Conversely, 
      older age and DMD exposure post-CIS were associated with reduced rates. 
      Prognostic nomograms demonstrated high concordance between estimated and observed 
      conversion probabilities. CONCLUSION: This multinational study shows that age at 
      CIS onset, DMD exposure, EDSS, multiple brain and spinal MRI criteria and 
      oligoclonal bands are associated with shorter time to relapse. Nomogram 
      assessment may be useful in clinical practice for estimating future clinical 
      conversion.
FAU - Spelman, Tim
AU  - Spelman T
AD  - Department of Medicine and Melbourne Brain Centre at the Royal Melbourne 
      Hospital, University of Melbourne, Parkville, VIC, Australia.
FAU - Meyniel, Claire
AU  - Meyniel C
AD  - Department of Medicine and Melbourne Brain Centre at the Royal Melbourne 
      Hospital, University of Melbourne, Parkville, VIC, Australia.
AD  - Department of Neurophysiologie, Pitie-Salpetriere Hospital, Paris, France.
FAU - Rojas, Juan Ignacio
AU  - Rojas JI
AD  - Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
FAU - Lugaresi, Alessandra
AU  - Lugaresi A
AD  - MS Center, Department of Neuroscience and Imaging, University 'G. d'Annunzio', 
      Chieti, Italy.
FAU - Izquierdo, Guillermo
AU  - Izquierdo G
AD  - Hospital Universitario Virgen Macarena, Sevilla, Spain.
FAU - Grand'Maison, Francois
AU  - Grand'Maison F
AD  - Neuro Rive-Sud, Hopital Charles LeMoyne, Greenfield Park, QC, Canada.
FAU - Boz, Cavit
AU  - Boz C
AD  - Karadeniz Technical University, Trabzon, Turkey.
FAU - Alroughani, Raed
AU  - Alroughani R
AD  - Amiri Hospital, Kuwait City, Kuwait.
FAU - Havrdova, Eva
AU  - Havrdova E
AD  - Department of Neurology and Center of Clinical Neuroscience, First Faculty of 
      Medicine, General University Hospital and Charles University in Prague, Prague, 
      Czech Republic.
FAU - Horakova, Dana
AU  - Horakova D
AD  - Department of Neurology and Center of Clinical Neuroscience, First Faculty of 
      Medicine, General University Hospital and Charles University in Prague, Prague, 
      Czech Republic.
FAU - Iuliano, Gerardo
AU  - Iuliano G
AD  - Ospedali Riuniti di Salerno, Salerno, Italy.
FAU - Duquette, Pierre
AU  - Duquette P
AD  - Hopital Notre-Dame, Montreal, QC, Canada.
FAU - Terzi, Murat
AU  - Terzi M
AD  - Ondokuz Mayis University, Samsun, Turkey.
FAU - Grammond, Pierre
AU  - Grammond P
AD  - Centre de readaptation en deficience physique Chaudiere-Appalaches, Levis, QC, 
      Canada.
FAU - Hupperts, Raymond
AU  - Hupperts R
AD  - Maaslandziekenhuis, Sittard, The Netherlands.
FAU - Lechner-Scott, Jeannette
AU  - Lechner-Scott J
AD  - John Hunter Hospital, Newcastle, NSW, Australia.
FAU - Oreja-Guevara, Celia
AU  - Oreja-Guevara C
AD  - Hospital Clinico San Carlos, Madrid, Spain.
FAU - Pucci, Eugenio
AU  - Pucci E
AD  - Neurology Unit, ASUR Marche - AV3, Macerata, Italy.
FAU - Verheul, Freek
AU  - Verheul F
AD  - Groene Hart Ziekenhuis, Gouda, The Netherlands.
FAU - Fiol, Marcela
AU  - Fiol M
AD  - Fundacion para la Lucha contra las Enfermedades Neurologicas de la Infancia, 
      Buenos Aires, Argentina.
FAU - Van Pesch, Vincent
AU  - Van Pesch V
AD  - Cliniques Universitaires Saint-Luc, Brussels, Belgium.
FAU - Cristiano, Edgardo
AU  - Cristiano E
AD  - Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
FAU - Petersen, Thor
AU  - Petersen T
AD  - Kommunehospitalet, Aarhus, Denmark.
FAU - Moore, Fraser
AU  - Moore F
AD  - Jewish General Hospital, Montreal, QC, Canada.
FAU - Kalincik, Tomas
AU  - Kalincik T
AD  - Department of Medicine and Melbourne Brain Centre at the Royal Melbourne 
      Hospital, University of Melbourne, Parkville, VIC, Australia.
FAU - Jokubaitis, Vilija
AU  - Jokubaitis V
AD  - Department of Medicine and Melbourne Brain Centre at the Royal Melbourne 
      Hospital, University of Melbourne, Parkville, VIC, Australia.
FAU - Trojano, Maria
AU  - Trojano M
AD  - Department of Basic Medical Sciences, Neuroscience and Sense Organs, University 
      of Bari, Bari, Italy.
FAU - Butzkueven, Helmut
AU  - Butzkueven H
AD  - Department of Neurology, Box Hill hospital, Monash University, Box Hill, VIC, 
      Australia.
CN  - MSBasis (an MSBase Substudy) Investigators
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
DEP - 20161125
PL  - England
TA  - Mult Scler
JT  - Multiple sclerosis (Houndmills, Basingstoke, England)
JID - 9509185
RN  - 0 (Immunosuppressive Agents)
SB  - IM
MH  - Adult
MH  - Age of Onset
MH  - Demyelinating Diseases/drug therapy/*pathology
MH  - Disease Progression
MH  - Female
MH  - Humans
MH  - Immunosuppressive Agents/therapeutic use
MH  - Male
MH  - Middle Aged
MH  - Multiple Sclerosis/pathology
MH  - *Nomograms
MH  - Prognosis
MH  - Proportional Hazards Models
MH  - Recurrence
MH  - Risk Factors
OTO - NOTNLM
OT  - CIS
OT  - CSF
OT  - MRI
OT  - MS
OT  - Nomogram
OT  - clinically definite multiple sclerosis
OT  - clinically isolated syndrome
OT  - disease-modifying drugs
OT  - second attack
EDAT- 2016/11/26 06:00
MHDA- 2018/05/17 06:00
CRDT- 2016/11/26 06:00
PHST- 2016/11/26 06:00 [pubmed]
PHST- 2018/05/17 06:00 [medline]
PHST- 2016/11/26 06:00 [entrez]
AID - 1352458516679893 [pii]
AID - 10.1177/1352458516679893 [doi]
PST - ppublish
SO  - Mult Scler. 2017 Sep;23(10):1346-1357. doi: 10.1177/1352458516679893. Epub 2016 
      Nov 25.