Sociodemographic and clinical factors related to the progression of disability in patients with multiple sclerosis

Authors

Keywords:

disability, multiple sclerosis, disability progression, clinical predictors

Abstract

Multiple sclerosis (MS) is a chronic inflammatory demyelinating disease of the central nervous system (CNS), with variable prognosis, and significant social impact. The prevalence in Colombia was 7.52 per 100,000 inhabitants during 2013 and has increased by 60% from 2009 to 2013. Objective: identify the sociodemographic and clinical factors related to disability progression in MS. Methodology: A descriptive study with a cross-sectional analytical component was carried out using disability progression as the dependent variable. The medical records of 216 patients living within the Metropolitan Area of Valle de Aburrá, Antioquia, Colombia. Results: In the multivariate model, by adjusting the MS phenotype for the other variables, the following factors were associated with a greater likelihood of having disability progression: primary progressive (OR 3.246, 95% CI 1.294 - 8.145, P-value = 0.012); cerebellar complications (OR 2.498, 95% CI 1.186 - 5.265, P-value = 0.016); antidepressant drugs (OR 2.336, 95% CI 1.054 - 5.176, P-value = 0.037); the presence of other neurological diseases (OR 3.392, 95% CI 1.139 - 10.102, P-value = 0.028); and active lesions on magnetic resonance imaging (OR 2.162, 95% CI 1.042 - 4.485, -P = 0.038). Those with pathologies other than cardiovascular, metabolic, mental, autoimmune, or infectious diseases had a lower likelihood of disability progression (OR 0.138, 95% CI 0.024 - 0.799, P-value = 0.028). Conclusions:  The results of the present work can serve as a starting point for monitoring patients, contributing to problem-solving, and improving the quality of life for people with this disease.

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References

Compston A, editor. McAlpine's multiple sclerosis. 4th ed. Philadelphia: Churchill Livingstone Elsevier; 2005: 982.

Camargo Rojas AP, Gómez López AM, Hernández LF, Palacios Sánchez E. Symptoms present in Multiple Sclerosis: case series. Acta Neurológica Colomb. 2018; 34: 108-14.

Debouverie M, Pittion-Vouyovitch S, Louis S, Guillemin F, LORSEP Group. Natural history of multiple sclerosis in a population-based cohort. Eur J Neurol. 2008; 15: 916-21.

Dendrou CA, Fugger L, Friese MA. Immunopathology of multiple sclerosis. Nat Rev Immunol. 2015; 15: 545-58.

Lucchinetti CF, Calabresi PA. Multiple Sclerosis. Dan L., editor. N Engl J Med. 2018; 378: 169-80.

Guarnizo Á, Bermúdez S, Torres Ó, Nassar A, Torres C. Diagnosis and evaluation of multiple sclerosis. 2016; 27: 4543-55.

Brola W, Sobolewski P, Żak M, Flaga S, Fudala M, Siutka D, et al. Profile of Polish patients with primary progressive multiple sclerosis. Mult Scler Relat Disord. 2019; 33: 33-8.

Vergara I, Toro G. Multiple Sclerosis. An experience of 30 years. Acta Neurol Colomb. 1990; 1: 72-86.

Sánchez Munera JL, Aguirre Castañeda C, Arcos Burgos OM, Jiménez Ramírez I, Jiménez Jaramillo ME, León Sarmiento FE, et al. Prevalence of multiple sclerosis in Colombia. Rev Neurol. 2000; 31: 1101-03.

Jiménez CE. Current status of multiple sclerosis in Colombia. Acta Neurol Colomb. 2015; 31: 385-90.

Sánchez JL, Palacio LG, Uribe CS, Londoño AC, Villa A, Jiménez M, et al. Clinical features of multiple sclerosis in a genetically homogeneous tropical population. Mult Scler Houndmills Basingstoke Engl. 2001; 7: 227-9.

Arcos-Burgos M, Palacio G, Sánchez JL, Londoño AC, Uribe CS, Jiménez M, et al. Multiple sclerosis: association to HLA DQalpha in a tropical population. Exp Clin Immunogenet. 1999; 16: 131-8.

Sánchez Munera JL, Palacio Baena LG, Londoño AC, Uribe Uribe CS, Jiménez Jaramillo ME, Villa LA, et al. Multiple sclerosis: epidemiological-genetic approach in inhabitants of Antioquia, Colombia. HLA Dqa linkage disequilibrium. Rev Neurol. 2000; 30: 170.

Kurtzke JF. Rating neurologic impairment in multiple sclerosis: an expanded disability status scale (EDSS). Neurology. 1983; 33: 1444-52.

Sánchez-López CR, Perestelo-Pérez L, Ramos-Pérez C, López-Bastida J, Serrano-Aguilar P. Health-related quality of life in patients with amyotrophic lateral sclerosis. Neurology. 2014; 1; 29: 27-35.

Yadav SK, Mindur JE, Ito K, Dhib-Jalbut S. Advances in the immunopathogenesis of multiple sclerosis. Curr Opin Neurol. 2015; 28: 206-19.

Fernández Fernández Ó. Recurrent-remitting multiple sclerosis clinic. Prognostic factors. Rev Neurol. 2002; 35: 1067.

Goldenberg MM. Multiple Sclerosis Review. Pharm Ther. 2012; 37: 175-84.

From Andrés de Frutos C. Interest of outbreaks in multiple sclerosis. Pathophysiology and treatment. Rev Neurol. 2003; 36: 409-16.

Montalban X, Hauser SL, Kappos L, Arnold DL, Bar-Or A, Comi G, et al. Ocrelizumab versus Placebo in Primary Progressive Multiple Sclerosis. N Engl J Med. 2017 19; 376: 209-20.

Basak T, Unver V, Demirkaya S. Activities of daily living and self-care agency in patients with multiple sclerosis for the first 10 years. Rehabil Nurs Off J Assoc Rehabil Nurses. 2015; 40: 60-5.

Kanekar N, Aruin AS. The role of clinical and instrumented outcome measures in balance control of individuals with multiple sclerosis. Mult Scler Int. 2013; 2013: 1-10.

Hernández Posada A. People with disabilities: Their quality of life. Aquichan. 2004; 4.

Magaña-Zamora L, Chiquete E, Campos-González ID, Cantú-Leal R, Ibarra-Bravo O, Punzo-Bravo G, et al. Risk factors and prognosis of patients with multiple sclerosis from the state of Michoacán, Mexico: A case-control study. Rev Mex Neurocienc. 2012; 13: 78-85.

International Multiple Sclerosis Federation. Atlas of Multiple Sclerosis third edition. 2020.

Tintore M, Rovira À, Río J, Otero-Romero S, Arrambide G, Tur C, et al. Defining high, medium and low impact prognostic factors for developing multiple sclerosis. Brain J Neurol. 2015; 138: 1863-74.

Arteaga-Noriega A, Zapata-Beríritu J, Castro-Álvarez JF, Benjumea-Bedoya D, Segura-Cardona A, González Gomez D. Clinical and Radiological Factors Related to the Progression of Disability in Multiple Sclerosis. Rev Ecuat Neurol. 2020; 29: 62-71.

Bowen JD. Highly Aggressive Multiple Sclerosis: Contin Lifelong Learn Neurol. 2019; 25: 689-714.

Cottrell DA, Kremenchutzky M, Rice GP, Koopman WJ, Hader W, Baskerville J, et al. The natural history of multiple sclerosis: a geographically based study. 5. The clinical features and natural history of primary progressive multiple sclerosis. Brain J Neurol. 1999; 122: 625-39.

Boiko A, Vorobeychik G, Paty D, Devonshire V, Sadovnick D, University of British Columbia MS Clinic Neurologists. Early onset multiple sclerosis: a longitudinal study. Neurology. 2002; 59: 1006-10.

Cierny D, Lehotsky J, Hanysova S, Michalik J, Kantorova E, Sivak S, et al. The age at onset in Multiple Sclerosis is associated with patient's prognosis. Bratisl Med J. 2017; 118: 374-7.

Oliveira SR, Simão ANC, Alfieri DF, Flauzino T, Kallaur AP, Mezzaroba L, et al. Vitamin D deficiency is associated with disability and disease progression in multiple sclerosis patients independently of oxidative and nitrosative stress. J Neurol Sci. 2017; 381: 213-9.

Calabrese M, Poretto V, Favaretto A, Alessio S, Bernardi V, Romualdi C, et al. Cortical lesion load associates with progression of disability in multiple sclerosis. Brain J Neurol. 2012; 135: 2952-61.

Dalton CM. Progressive ventricular enlargement in patients with clinically isolated syndromes is associated with the early development of multiple sclerosis. J Neurol Neurosurg Psychiatry. 2002; 73: 141-7.

Fisniku LK, Brex PA, Altmann DR, Miszkiel KA, Benton CE, Lanyon R, et al. Disability and T2 MRI lesions: a 20-year follow-up of patients with relapse onset of multiple sclerosis. Brain. 2008; 131: 808-17.

Riise T, Grønning M, Fernández O, Lauer K, Midgard R, Minderhoud JM, et al. Early prognostic factors for disability in multiple sclerosis, a European multicenter study. Acta Neurol Scand. 1992; 85: 212-8.

Calabrese M, Rinaldi F, Mattisi I, Bernardi V, Favaretto A, Perini P, et al. The predictive value of gray matter atrophy in clinically isolated syndromes. Neurology. 2011 19; 77: 257-63.

García de Gurtubay Galligo I, Gila Useros L, Morales Blanquez G, Gállego Culleré J, Ayuso Blanco MT, Manubens Bertrán JM. Multiple sclerosis and epileptic seizures. Rev Neurol. 2000; 30: 827.

De la fe A, Suárez AAP, Agramonte M de los AR, Ercilla EC, Moreno DU. Multiple Sclerosis associated with Parkinson's Disease. I investigated Medico-Surgical. 2021; 13.

Marrie RA, Cohen J, Stuve O, Trojano M, Sørensen PS, Reingold S, et al. A systematic review of the incidence and prevalence of comorbidity in multiple sclerosis: Overview. Mult Scler J. 2015; 21: 263-81.

Cárdenas Robledo S, Otero Romero S, Montalban Gairin X, Tintoré Subirana M del M. Prevalence and impact of comorbidities in patients with multiple sclerosis. Rev Neurol. 2020; 71: 151.

Ríos Martínez MJ, Arteaga Noriega A. Modifying drugs in multiple sclerosis: current therapeutic schemes. Rev Chil Neuropsico. 2020; 15: 32-7.

Martinez-Altarriba MC, Ramos-Campoy O, Luna-Calcaño IM, Arrieta-Antón E. Review of multiple sclerosis. Diagnosis and treatment. Med Fam. 2015; 41: 324-8.

Zabay Neiro tape. How to reduce cardiovascular risk factors in people with multiple sclerosis. Elsevier Connect. 2018.

Watson GS, Craft S. Insulin resistance, inflammation, and cognition in Alzheimer's Disease: Lessons for multiple sclerosis. J Neurol Sci. 2006; 245: 21-33.

Marrie RA, Horwitz RI. Emerging effects of comorbidities on multiple sclerosis. Lancet Neurol. 2010; 9: 820-8.

Marrie RA, Rudick R, Horwitz R, Cutter G, Tyry T, Campagnolo D, et al. Vascular comorbidity is associated with more rapid disability progression in multiple sclerosis. Neurology. 2010; 74: 1041-7.

Koch MW, Glazenborg A, Uyttenboogaart M, Mostert J, De Keyser J. Pharmacologic treatment of depression in multiple sclerosis. Cochrane Multiple Sclerosis and Rare Diseases of the CNS Group, editor. Cochrane Database Syst Rev. 2011.

Rovira A, Tintoré M, Álvarez-Cermeño JC, Izquierdo G, Prieto JM. Recommendations for the use and interpretation of magnetic resonance imaging studies in multiple sclerosis. Neurology. 2010; 25:248-65.

Kappos L, De Stefano N, Freedman MS, Cree BA, Radue EW, Sprenger T, et al. Inclusion of brain volume loss in a revised measure of 'no evidence of disease activity' (NEDA-4) in relapsing – remitting multiple sclerosis. Mult Scler J. 2016; 22: 1297-305.

Huamaní C, Rojas E, Inca J. Highly active multiple sclerosis: is it possible to start early therapy with highly efficacious drugs. 2017;8.

Wattjes MP. Evidence-based guidelines: MAGNIMS consensus guidelines on the use of MRI in multiple sclerosis - establishing disease prognosis and monitoring patients. Nat Rev Neurol. 2015; 11: 597-606.

Arrambide G, Rovira A, Sastre-Garriga J, Tur C, Castilló J, Río J, et al. Spinal cord lesions: A modest contributor to diagnosis in clinically isolated syndromes but a relevant prognostic factor. Mult Scler J. 2018; 24: 301-12.

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Published

2023-04-14

How to Cite

Aníbal Arteaga Noriega, José William Martínez, John Fredy Castro Álvarez, Dione Benjumea Bedoya, Johanna Gutiérrez Vargas, Angela Segura Cardona, Difariney González Gómez, María Isabel Zuluaga, & José Zapata Berruecos. (2023). Sociodemographic and clinical factors related to the progression of disability in patients with multiple sclerosis. AVFT – Archivos Venezolanos De Farmacología Y Terapéutica, 40(9). Retrieved from http://saber.ucv.ve/ojs/index.php/rev_aavft/article/view/26177