Prognostic indicators in pediatric clinically isolated syndrome

Giuseppe Salemi; Vahid Shaygannejad; Liliana Patrucco; Vincent Van Pesch; Thor Petersen; Maria Di Ioia; Daniela Travaglini; Murat Terzi; Roberto Balgera; Seyed Aidin Sajedi; Bonaventura Ardito; Pietro Iaffaldano; Tim Spelman; Antonio Bosco; Giovanna De Luca; Giuseppe Lucisano; Marcela Fiol; Valeria Di Tommaso; Pierre Grammond; Erika Pietrolongo; Roberto Bergamaschi; Marta Simone; Maria Teresa Ferrò; Gerardo Iuliano; Aldo Savino; Jose Antonio Cabrera-Gomez; Raymond Hupperts; Lucia Margari; Luca Mancinelli; Roberta Grasso; Marika Vianello; Marika Vianello; Bhim Singhal; Helmut Butzkueven; Paolo Gallo; Patrizia Sola; Carlo Pozzilli; Michael Barnett; Enrico Granieri; Pamela Mccombefrom; Raed Alroughani; Elio Scarpini; Elio Scarpini; Maria Edite Rio; Francesco Corea; Raed Alroughani; Marika Vianello; Paolo Bellantonio; Ricardo Fernández Bolaños; Francois Grand'Maison; Alessandra Protti; Cees Zwanikken; Damiano Paolicelli; Daniele Spitaleri; Carlo Avolio; Giacomo Lus; Francesca De Robertis; Jeannette Lechner-Scott; Monica Rezzonico; Francesco Corea; Maria Rosa Rottoli; Paola Cavalla; Vincenzo Brescia Morra; Davide Maimone; Cavit Boz; Giovanni Bosco Zimatore; Franco Granella; Eleonora Cocco; Claudio Solaro; Enrico Millefiorini; Alessandra Lugaresi; Deboah Farina; Pierre Duquette; Maria Trojano; Guillermo Izquierdo; Angelo Ghezzi; Eugenio Pucci; Gianfranco Costantino; Mark Paine; Carlo Pozzilli; Giancarlo Di Battista; Carla Tortorella; Antonio Bertolotto; Enrico Montanari; Francesco Patti; Luca Durelli; Gioacchino Tedeschi; Maria Pia Amato; Giancarlo Comi; Michael Barnett; Gabriella Coniglio; Mark Slee

Prognostic indicators in pediatric clinically isolated syndrome

Giuseppe Salemi, Vahid Shaygannejad, Liliana Patrucco, Vincent Van Pesch, Thor Petersen, Maria Di Ioia, Daniela Travaglini, Murat Terzi, Roberto Balgera, Seyed Aidin Sajedi, Bonaventura Ardito, Pietro Iaffaldano, Tim Spelman, Antonio Bosco, Giovanna De Luca, Giuseppe Lucisano, Marcela Fiol, Valeria Di Tommaso, Pierre Grammond, Erika PietrolongoRoberto Bergamaschi, Marta Simone, Maria Teresa Ferrò, Gerardo Iuliano, Aldo Savino, Jose Antonio Cabrera-Gomez, Raymond Hupperts, Lucia Margari, Luca Mancinelli, Roberta Grasso, Marika Vianello, Marika Vianello, Bhim Singhal, Helmut Butzkueven, Paolo Gallo, Patrizia Sola, Carlo Pozzilli, Michael Barnett, Enrico Granieri, Pamela Mccombefrom, Raed Alroughani, Elio Scarpini, Elio Scarpini, Maria Edite Rio, Francesco Corea, Raed Alroughani, Marika Vianello, Paolo Bellantonio, Ricardo Fernández Bolaños, Francois Grand'Maison, Alessandra Protti, Cees Zwanikken, Damiano Paolicelli, Daniele Spitaleri, Carlo Avolio, Giacomo Lus, Francesca De Robertis, Jeannette Lechner-Scott, Monica Rezzonico, Francesco Corea, Maria Rosa Rottoli, Paola Cavalla, Vincenzo Brescia Morra, Davide Maimone, Cavit Boz, Giovanni Bosco Zimatore, Franco Granella, Eleonora Cocco, Claudio Solaro, Enrico Millefiorini, Alessandra Lugaresi, Deboah Farina, Pierre Duquette, Maria Trojano, Guillermo Izquierdo, Angelo Ghezzi, Eugenio Pucci, Gianfranco Costantino, Mark Paine, Carlo Pozzilli, Giancarlo Di Battista, Carla Tortorella, Antonio Bertolotto, Enrico Montanari, Francesco Patti, Luca Durelli, Gioacchino Tedeschi, Maria Pia Amato, Giancarlo Comi, Michael Barnett, Gabriella Coniglio, Mark Slee

Biomedicina, Neuroscienze e Diagnostica avanzata

Risultato della ricerca: Article › peer review

26 Citazioni (Scopus)

Abstract

OBJECTIVE:To assess prognostic factors for a second clinical attack and a first disability-worsening event in pediatric clinically isolated syndrome (pCIS) suggestive of multiple sclerosis (MS) patients.METHODS:A cohort of 770 pCIS patients was followed up for at least 10 years. Cox proportional hazard models and Recursive Partitioning and Amalgamation (RECPAM) tree-regression were used to analyze data.RESULTS:In pCIS, female sex and a multifocal onset were risk factors for a second clinical attack (hazard ratio [HR], 95% confidence interval [CI] = 1.28, 1.06-1.55; 1.42, 1.10-1.84, respectively), whereas disease-modifying drug (DMD) exposure reduced this risk (HR, 95% CI = 0.75, 0.60-0.95). After pediatric onset MS (POMS) diagnosis, age at onset younger than 15 years and DMD exposure decreased the risk of a first Expanded Disability Status Scale (EDSS)-worsening event (HR, 95% CI = 0.59, 0.42-0.83; 0.75, 0.71-0.80, respectively), whereas the occurrence of relapse increased this risk (HR, 95% CI = 5.08, 3.46-7.46). An exploratory RECPAM analysis highlighted a significantly higher incidence of a first EDSS-worsening event in patients with multifocal or isolated spinal cord or optic neuritis involvement at onset in comparison to those with an isolated supratentorial or brainstem syndrome. A Cox regression model including RECPAM classes confirmed DMD exposure as the most protective factor against EDSS-worsening events and relapses as the most important risk factor for attaining EDSS worsening.INTERPRETATION:This work represents a step forward in identifying predictors of unfavorable course in pCIS and POMS and supports a protective effect of early DMD treatment in preventing MS development and disability accumulation in this population

Lingua originale	English
pagine (da-a)	729-739
Numero di pagine	11
Rivista	Annals of Neurology
Volume	81
Stato di pubblicazione	Published - 2017

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Salemi, G., Shaygannejad, V., Patrucco, L., Van Pesch, V., Petersen, T., Di Ioia, M., Travaglini, D., Terzi, M., Balgera, R., Sajedi, S. A., Ardito, B., Iaffaldano, P., Spelman, T., Bosco, A., De Luca, G., Lucisano, G., Fiol, M., Di Tommaso, V., Grammond, P., ... Slee, M. (2017). Prognostic indicators in pediatric clinically isolated syndrome. Annals of Neurology, 81, 729-739.

Prognostic indicators in pediatric clinically isolated syndrome. / Salemi, Giuseppe; Shaygannejad, Vahid; Patrucco, Liliana; Van Pesch, Vincent; Petersen, Thor; Di Ioia, Maria; Travaglini, Daniela; Terzi, Murat; Balgera, Roberto; Sajedi, Seyed Aidin; Ardito, Bonaventura; Iaffaldano, Pietro; Spelman, Tim; Bosco, Antonio; De Luca, Giovanna; Lucisano, Giuseppe; Fiol, Marcela; Di Tommaso, Valeria; Grammond, Pierre; Pietrolongo, Erika; Bergamaschi, Roberto; Simone, Marta; Ferrò, Maria Teresa; Iuliano, Gerardo; Savino, Aldo; Cabrera-Gomez, Jose Antonio; Hupperts, Raymond; Margari, Lucia; Mancinelli, Luca; Grasso, Roberta; Vianello, Marika; Vianello, Marika; Singhal, Bhim; Butzkueven, Helmut; Gallo, Paolo; Sola, Patrizia; Pozzilli, Carlo; Barnett, Michael; Granieri, Enrico; Mccombefrom, Pamela; Alroughani, Raed; Scarpini, Elio; Scarpini, Elio; Rio, Maria Edite; Corea, Francesco; Alroughani, Raed; Vianello, Marika; Bellantonio, Paolo; Fernández Bolaños, Ricardo; Grand'Maison, Francois; Protti, Alessandra; Zwanikken, Cees; Paolicelli, Damiano; Spitaleri, Daniele; Avolio, Carlo; Lus, Giacomo; De Robertis, Francesca; Lechner-Scott, Jeannette; Rezzonico, Monica; Corea, Francesco; Rottoli, Maria Rosa; Cavalla, Paola; Brescia Morra, Vincenzo; Maimone, Davide; Boz, Cavit; Zimatore, Giovanni Bosco; Granella, Franco; Cocco, Eleonora; Solaro, Claudio; Millefiorini, Enrico; Lugaresi, Alessandra; Farina, Deboah; Duquette, Pierre; Trojano, Maria; Izquierdo, Guillermo; Ghezzi, Angelo; Pucci, Eugenio; Costantino, Gianfranco; Paine, Mark; Pozzilli, Carlo; Di Battista, Giancarlo; Tortorella, Carla; Bertolotto, Antonio; Montanari, Enrico; Patti, Francesco; Durelli, Luca; Tedeschi, Gioacchino; Amato, Maria Pia; Comi, Giancarlo; Barnett, Michael; Coniglio, Gabriella; Slee, Mark.

In: Annals of Neurology, Vol. 81, 2017, pag. 729-739.

Risultato della ricerca: Article › peer review

Salemi, G, Shaygannejad, V, Patrucco, L, Van Pesch, V, Petersen, T, Di Ioia, M, Travaglini, D, Terzi, M, Balgera, R, Sajedi, SA, Ardito, B, Iaffaldano, P, Spelman, T, Bosco, A, De Luca, G, Lucisano, G, Fiol, M, Di Tommaso, V, Grammond, P, Pietrolongo, E, Bergamaschi, R, Simone, M, Ferrò, MT, Iuliano, G, Savino, A, Cabrera-Gomez, JA, Hupperts, R, Margari, L, Mancinelli, L, Grasso, R, Vianello, M, Vianello, M, Singhal, B, Butzkueven, H, Gallo, P, Sola, P, Pozzilli, C, Barnett, M, Granieri, E, Mccombefrom, P, Alroughani, R, Scarpini, E, Scarpini, E, Rio, ME, Corea, F, Alroughani, R, Vianello, M, Bellantonio, P, Fernández Bolaños, R, Grand'Maison, F, Protti, A, Zwanikken, C, Paolicelli, D, Spitaleri, D, Avolio, C, Lus, G, De Robertis, F, Lechner-Scott, J, Rezzonico, M, Corea, F, Rottoli, MR, Cavalla, P, Brescia Morra, V, Maimone, D, Boz, C, Zimatore, GB, Granella, F, Cocco, E, Solaro, C, Millefiorini, E, Lugaresi, A, Farina, D, Duquette, P, Trojano, M, Izquierdo, G, Ghezzi, A, Pucci, E, Costantino, G, Paine, M, Pozzilli, C, Di Battista, G, Tortorella, C, Bertolotto, A, Montanari, E, Patti, F, Durelli, L, Tedeschi, G, Amato, MP, Comi, G, Barnett, M, Coniglio, G & Slee, M 2017, 'Prognostic indicators in pediatric clinically isolated syndrome', Annals of Neurology, vol. 81, pagg. 729-739.

Salemi, Giuseppe ; Shaygannejad, Vahid ; Patrucco, Liliana ; Van Pesch, Vincent ; Petersen, Thor ; Di Ioia, Maria ; Travaglini, Daniela ; Terzi, Murat ; Balgera, Roberto ; Sajedi, Seyed Aidin ; Ardito, Bonaventura ; Iaffaldano, Pietro ; Spelman, Tim ; Bosco, Antonio ; De Luca, Giovanna ; Lucisano, Giuseppe ; Fiol, Marcela ; Di Tommaso, Valeria ; Grammond, Pierre ; Pietrolongo, Erika ; Bergamaschi, Roberto ; Simone, Marta ; Ferrò, Maria Teresa ; Iuliano, Gerardo ; Savino, Aldo ; Cabrera-Gomez, Jose Antonio ; Hupperts, Raymond ; Margari, Lucia ; Mancinelli, Luca ; Grasso, Roberta ; Vianello, Marika ; Vianello, Marika ; Singhal, Bhim ; Butzkueven, Helmut ; Gallo, Paolo ; Sola, Patrizia ; Pozzilli, Carlo ; Barnett, Michael ; Granieri, Enrico ; Mccombefrom, Pamela ; Alroughani, Raed ; Scarpini, Elio ; Scarpini, Elio ; Rio, Maria Edite ; Corea, Francesco ; Alroughani, Raed ; Vianello, Marika ; Bellantonio, Paolo ; Fernández Bolaños, Ricardo ; Grand'Maison, Francois ; Protti, Alessandra ; Zwanikken, Cees ; Paolicelli, Damiano ; Spitaleri, Daniele ; Avolio, Carlo ; Lus, Giacomo ; De Robertis, Francesca ; Lechner-Scott, Jeannette ; Rezzonico, Monica ; Corea, Francesco ; Rottoli, Maria Rosa ; Cavalla, Paola ; Brescia Morra, Vincenzo ; Maimone, Davide ; Boz, Cavit ; Zimatore, Giovanni Bosco ; Granella, Franco ; Cocco, Eleonora ; Solaro, Claudio ; Millefiorini, Enrico ; Lugaresi, Alessandra ; Farina, Deboah ; Duquette, Pierre ; Trojano, Maria ; Izquierdo, Guillermo ; Ghezzi, Angelo ; Pucci, Eugenio ; Costantino, Gianfranco ; Paine, Mark ; Pozzilli, Carlo ; Di Battista, Giancarlo ; Tortorella, Carla ; Bertolotto, Antonio ; Montanari, Enrico ; Patti, Francesco ; Durelli, Luca ; Tedeschi, Gioacchino ; Amato, Maria Pia ; Comi, Giancarlo ; Barnett, Michael ; Coniglio, Gabriella ; Slee, Mark. / Prognostic indicators in pediatric clinically isolated syndrome. In: Annals of Neurology. 2017 ; Vol. 81. pagg. 729-739.

@article{d8712d1060214b2db7a1400e569012f1,

title = "Prognostic indicators in pediatric clinically isolated syndrome",

abstract = "OBJECTIVE:To assess prognostic factors for a second clinical attack and a first disability-worsening event in pediatric clinically isolated syndrome (pCIS) suggestive of multiple sclerosis (MS) patients.METHODS:A cohort of 770 pCIS patients was followed up for at least 10 years. Cox proportional hazard models and Recursive Partitioning and Amalgamation (RECPAM) tree-regression were used to analyze data.RESULTS:In pCIS, female sex and a multifocal onset were risk factors for a second clinical attack (hazard ratio [HR], 95% confidence interval [CI] = 1.28, 1.06-1.55; 1.42, 1.10-1.84, respectively), whereas disease-modifying drug (DMD) exposure reduced this risk (HR, 95% CI = 0.75, 0.60-0.95). After pediatric onset MS (POMS) diagnosis, age at onset younger than 15 years and DMD exposure decreased the risk of a first Expanded Disability Status Scale (EDSS)-worsening event (HR, 95% CI = 0.59, 0.42-0.83; 0.75, 0.71-0.80, respectively), whereas the occurrence of relapse increased this risk (HR, 95% CI = 5.08, 3.46-7.46). An exploratory RECPAM analysis highlighted a significantly higher incidence of a first EDSS-worsening event in patients with multifocal or isolated spinal cord or optic neuritis involvement at onset in comparison to those with an isolated supratentorial or brainstem syndrome. A Cox regression model including RECPAM classes confirmed DMD exposure as the most protective factor against EDSS-worsening events and relapses as the most important risk factor for attaining EDSS worsening.INTERPRETATION:This work represents a step forward in identifying predictors of unfavorable course in pCIS and POMS and supports a protective effect of early DMD treatment in preventing MS development and disability accumulation in this population",

author = "Giuseppe Salemi and Vahid Shaygannejad and Liliana Patrucco and {Van Pesch}, Vincent and Thor Petersen and {Di Ioia}, Maria and Daniela Travaglini and Murat Terzi and Roberto Balgera and Sajedi, {Seyed Aidin} and Bonaventura Ardito and Pietro Iaffaldano and Tim Spelman and Antonio Bosco and {De Luca}, Giovanna and Giuseppe Lucisano and Marcela Fiol and {Di Tommaso}, Valeria and Pierre Grammond and Erika Pietrolongo and Roberto Bergamaschi and Marta Simone and Ferr{\`o}, {Maria Teresa} and Gerardo Iuliano and Aldo Savino and Cabrera-Gomez, {Jose Antonio} and Raymond Hupperts and Lucia Margari and Luca Mancinelli and Roberta Grasso and Marika Vianello and Marika Vianello and Bhim Singhal and Helmut Butzkueven and Paolo Gallo and Patrizia Sola and Carlo Pozzilli and Michael Barnett and Enrico Granieri and Pamela Mccombefrom and Raed Alroughani and Elio Scarpini and Elio Scarpini and Rio, {Maria Edite} and Francesco Corea and Raed Alroughani and Marika Vianello and Paolo Bellantonio and {Fern{\'a}ndez Bola{\~n}os}, Ricardo and Francois Grand'Maison and Alessandra Protti and Cees Zwanikken and Damiano Paolicelli and Daniele Spitaleri and Carlo Avolio and Giacomo Lus and {De Robertis}, Francesca and Jeannette Lechner-Scott and Monica Rezzonico and Francesco Corea and Rottoli, {Maria Rosa} and Paola Cavalla and {Brescia Morra}, Vincenzo and Davide Maimone and Cavit Boz and Zimatore, {Giovanni Bosco} and Franco Granella and Eleonora Cocco and Claudio Solaro and Enrico Millefiorini and Alessandra Lugaresi and Deboah Farina and Pierre Duquette and Maria Trojano and Guillermo Izquierdo and Angelo Ghezzi and Eugenio Pucci and Gianfranco Costantino and Mark Paine and Carlo Pozzilli and {Di Battista}, Giancarlo and Carla Tortorella and Antonio Bertolotto and Enrico Montanari and Francesco Patti and Luca Durelli and Gioacchino Tedeschi and Amato, {Maria Pia} and Giancarlo Comi and Michael Barnett and Gabriella Coniglio and Mark Slee",

year = "2017",

language = "English",

volume = "81",

pages = "729--739",

journal = "Annals of Neurology",

issn = "0364-5134",

publisher = "John Wiley and Sons Inc.",

}

TY - JOUR

T1 - Prognostic indicators in pediatric clinically isolated syndrome

AU - Salemi, Giuseppe

AU - Shaygannejad, Vahid

AU - Patrucco, Liliana

AU - Van Pesch, Vincent

AU - Petersen, Thor

AU - Di Ioia, Maria

AU - Travaglini, Daniela

AU - Terzi, Murat

AU - Balgera, Roberto

AU - Sajedi, Seyed Aidin

AU - Ardito, Bonaventura

AU - Iaffaldano, Pietro

AU - Spelman, Tim

AU - Bosco, Antonio

AU - De Luca, Giovanna

AU - Lucisano, Giuseppe

AU - Fiol, Marcela

AU - Di Tommaso, Valeria

AU - Grammond, Pierre

AU - Pietrolongo, Erika

AU - Bergamaschi, Roberto

AU - Simone, Marta

AU - Ferrò, Maria Teresa

AU - Iuliano, Gerardo

AU - Savino, Aldo

AU - Cabrera-Gomez, Jose Antonio

AU - Hupperts, Raymond

AU - Margari, Lucia

AU - Mancinelli, Luca

AU - Grasso, Roberta

AU - Vianello, Marika

AU - Singhal, Bhim

AU - Butzkueven, Helmut

AU - Gallo, Paolo

AU - Sola, Patrizia

AU - Pozzilli, Carlo

AU - Barnett, Michael

AU - Granieri, Enrico

AU - Mccombefrom, Pamela

AU - Alroughani, Raed

AU - Scarpini, Elio

AU - Rio, Maria Edite

AU - Corea, Francesco

AU - Alroughani, Raed

AU - Vianello, Marika

AU - Bellantonio, Paolo

AU - Fernández Bolaños, Ricardo

AU - Grand'Maison, Francois

AU - Protti, Alessandra

AU - Zwanikken, Cees

AU - Paolicelli, Damiano

AU - Spitaleri, Daniele

AU - Avolio, Carlo

AU - Lus, Giacomo

AU - De Robertis, Francesca

AU - Lechner-Scott, Jeannette

AU - Rezzonico, Monica

AU - Corea, Francesco

AU - Rottoli, Maria Rosa

AU - Cavalla, Paola

AU - Brescia Morra, Vincenzo

AU - Maimone, Davide

AU - Boz, Cavit

AU - Zimatore, Giovanni Bosco

AU - Granella, Franco

AU - Cocco, Eleonora

AU - Solaro, Claudio

AU - Millefiorini, Enrico

AU - Lugaresi, Alessandra

AU - Farina, Deboah

AU - Duquette, Pierre

AU - Trojano, Maria

AU - Izquierdo, Guillermo

AU - Ghezzi, Angelo

AU - Pucci, Eugenio

AU - Costantino, Gianfranco

AU - Paine, Mark

AU - Pozzilli, Carlo

AU - Di Battista, Giancarlo

AU - Tortorella, Carla

AU - Bertolotto, Antonio

AU - Montanari, Enrico

AU - Patti, Francesco

AU - Durelli, Luca

AU - Tedeschi, Gioacchino

AU - Amato, Maria Pia

AU - Comi, Giancarlo

AU - Barnett, Michael

AU - Coniglio, Gabriella

AU - Slee, Mark

PY - 2017

Y1 - 2017

N2 - OBJECTIVE:To assess prognostic factors for a second clinical attack and a first disability-worsening event in pediatric clinically isolated syndrome (pCIS) suggestive of multiple sclerosis (MS) patients.METHODS:A cohort of 770 pCIS patients was followed up for at least 10 years. Cox proportional hazard models and Recursive Partitioning and Amalgamation (RECPAM) tree-regression were used to analyze data.RESULTS:In pCIS, female sex and a multifocal onset were risk factors for a second clinical attack (hazard ratio [HR], 95% confidence interval [CI] = 1.28, 1.06-1.55; 1.42, 1.10-1.84, respectively), whereas disease-modifying drug (DMD) exposure reduced this risk (HR, 95% CI = 0.75, 0.60-0.95). After pediatric onset MS (POMS) diagnosis, age at onset younger than 15 years and DMD exposure decreased the risk of a first Expanded Disability Status Scale (EDSS)-worsening event (HR, 95% CI = 0.59, 0.42-0.83; 0.75, 0.71-0.80, respectively), whereas the occurrence of relapse increased this risk (HR, 95% CI = 5.08, 3.46-7.46). An exploratory RECPAM analysis highlighted a significantly higher incidence of a first EDSS-worsening event in patients with multifocal or isolated spinal cord or optic neuritis involvement at onset in comparison to those with an isolated supratentorial or brainstem syndrome. A Cox regression model including RECPAM classes confirmed DMD exposure as the most protective factor against EDSS-worsening events and relapses as the most important risk factor for attaining EDSS worsening.INTERPRETATION:This work represents a step forward in identifying predictors of unfavorable course in pCIS and POMS and supports a protective effect of early DMD treatment in preventing MS development and disability accumulation in this population

AB - OBJECTIVE:To assess prognostic factors for a second clinical attack and a first disability-worsening event in pediatric clinically isolated syndrome (pCIS) suggestive of multiple sclerosis (MS) patients.METHODS:A cohort of 770 pCIS patients was followed up for at least 10 years. Cox proportional hazard models and Recursive Partitioning and Amalgamation (RECPAM) tree-regression were used to analyze data.RESULTS:In pCIS, female sex and a multifocal onset were risk factors for a second clinical attack (hazard ratio [HR], 95% confidence interval [CI] = 1.28, 1.06-1.55; 1.42, 1.10-1.84, respectively), whereas disease-modifying drug (DMD) exposure reduced this risk (HR, 95% CI = 0.75, 0.60-0.95). After pediatric onset MS (POMS) diagnosis, age at onset younger than 15 years and DMD exposure decreased the risk of a first Expanded Disability Status Scale (EDSS)-worsening event (HR, 95% CI = 0.59, 0.42-0.83; 0.75, 0.71-0.80, respectively), whereas the occurrence of relapse increased this risk (HR, 95% CI = 5.08, 3.46-7.46). An exploratory RECPAM analysis highlighted a significantly higher incidence of a first EDSS-worsening event in patients with multifocal or isolated spinal cord or optic neuritis involvement at onset in comparison to those with an isolated supratentorial or brainstem syndrome. A Cox regression model including RECPAM classes confirmed DMD exposure as the most protective factor against EDSS-worsening events and relapses as the most important risk factor for attaining EDSS worsening.INTERPRETATION:This work represents a step forward in identifying predictors of unfavorable course in pCIS and POMS and supports a protective effect of early DMD treatment in preventing MS development and disability accumulation in this population

UR - http://hdl.handle.net/10447/358415

M3 - Article

VL - 81

SP - 729

EP - 739

JO - Annals of Neurology

JF - Annals of Neurology

SN - 0364-5134

ER -

Prognostic indicators in pediatric clinically isolated syndrome

Abstract

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