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STUDY: Benign MS, how common is it?

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  • STUDY: Benign MS, how common is it?

    So that much-maligned Tecfidera ad might be right 17% of the time... -D

    Benign Multiple Sclerosis - Recognition as a Defined Clinical Subtype

    Sophia Yang, Madison Clague, Saud Sadiq
    Tisch Multiple Sclerosis Research Center of New York

    Objective: Our objective is to determine if there is a subset of patients with multiple sclerosis who have a,favorable long term clinically benign disease course.

    Background: It is believed that untreated or minimally treated MS is inevitably associated with long-term disability. However, most aggressive therapies are associated with potentially serious adverse effects and may not be necessary in all patients. In this study, we followed clinically definite MS patients for at least 15 years following initial diagnosis to define the entity of benign MS (BMS).

    Design/Methods: In this IRB approved study, we examined data from 1,520 consecutiive patients seen at the Tisch MSRCNY by a single neurologist. We selected patients as having benign disease if the following criteria were met: disease duration of at least 15 years or more during which neither clinical relapses or change in EDSS occurred and MRI findings remained stable. In addition, all patients were either untreated or treated with a single therapeutic agent. Furthermore, cognition evaluation was either formally or informally tested in all patients. Patients who had accumulated an EDSS of greater than 2.5 were excluded from the study.

    Results: Of the total number of patients, 265 met the criteria for BMS (17.4%). Of these BMS patients, 211 were female (79.6%) and 54 were male (20.4%). Approximately 62.6% were treated with a single disease-modifying medication and while 37.4% were untreated. The average age at disease onset was 33.7, and the average duration of disease was 22.6 years. Moreover, 25.3% (67 of 265) of BMS patients had been followed for more than 25 years post diagnosis. None of the BMS patients had significant cognitive impairment, cerebellar dysfunction or spasticity.

    Conclusions: BMS is an entity that should be considered as an entity when treatments with potentially serious adverse events are initiated.

    Dave Bexfield