Do relapses count?

This figures shows a clear difference in relation to the prognosis based on early relapses. MSers with zero or 1 attack in the first 2 years needed a walking stick on average 14 years later (year 20) compared to MSers with 5 or more relapses in the same period (year 6). 

From: Weinshenker et al. The natural history of multiple sclerosis: a geographically based study. 2. Predictive value of the early clinical course. Brain. 1989 Dec;112 ( Pt 6):1419-28. 

"The question that has been posed by some of you is whether or not this can be altered by the use of DMTs. The data is now very clear that suppressing relapses in early MS delays disease progression. In addition,  MSers with highly-active disease going onto one of the more active DMTs may actually see an improvement in their disability." 

"Suppressing relapses in early RRMS is an important treatment aim; anybody arguing the contrary needs to reassess the data or challenge their dogma!"

"This delay in disability progression on DMTs has also translated into an improved survival rate."

"With this and other emerging data it would be a brave person with active MS to turn down the option of going onto a licensed DMT. It will also be a brave neurologist to advise against suppressing relapses."

Post of interest: Multiple Sclerosis Research: MS and survival - long-term betaferon ...
29 May 2011; 
MS and survival - long-term betaferon treatment improves survival. I had to give a talk yesterday, at the European Neurological Society (ENS) Meeting in Lisbon, on how to handle the complexity that the emergence of new ...

CoI: Multiple

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