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Do patients' and referral centers' characteristics influence multiple sclerosis phenotypes? Results from the Italian multiple sclerosis and related disorders register.

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Title: Do patients' and referral centers' characteristics influence multiple sclerosis phenotypes? Results from the Italian multiple sclerosis and related disorders register.
Authors: Bergamaschi, Roberto (AUTHOR), Beghi, Ettore (AUTHOR), Bosetti, Cristina (AUTHOR), Ponzio, Michela (AUTHOR), Santucci, Claudia (AUTHOR), Lepore, Vito (AUTHOR), Mosconi, Paola (AUTHOR), Aguglia, U. (AUTHOR), Amato, M. P. (AUTHOR), Ancona, A. L. (AUTHOR), Ardito, B. (AUTHOR), Avolio, C. (AUTHOR), Balgera, R. (AUTHOR), Banfi, P. (AUTHOR), Barcella, V. (AUTHOR), Barone, P. (AUTHOR), Bellantonio, P. (AUTHOR), Berardinelli, A. (AUTHOR), Bergamaschi, R. (AUTHOR), Bertora, P. (AUTHOR)
Source: Neurological Sciences. Sep2022, Vol. 43 Issue 9, p5459-5469. 11p. 3 Charts, 1 Graph.
Subjects: Multiple sclerosis, Disease relapse, Medical referrals, Phenotypes, Disease complications
Abstract: Background: Multiple sclerosis (MS) is characterized by phenotypical heterogeneity, partly resulting from demographic and environmental risk factors. Socio-economic factors and the characteristics of local MS facilities might also play a part.Methods: This study included patients with a confirmed MS diagnosis enrolled in the Italian MS and Related Disorders Register in 2000-2021. Patients at first visit were classified as having a clinically isolated syndrome (CIS), relapsing-remitting (RR), primary progressive (PP), progressive-relapsing (PR), or secondary progressive MS (SP). Demographic and clinical characteristics were analyzed, with centers' characteristics, geographic macro-areas, and Deprivation Index. We computed the odds ratios (OR) for CIS, PP/PR, and SP phenotypes, compared to the RR, using multivariate, multinomial, mixed effects logistic regression models.Results: In all 35,243 patients from 106 centers were included. The OR of presenting more advanced MS phenotypes than the RR phenotype at first visit significantly diminished in relation to calendar period. Females were at a significantly lower risk of a PP/PR or SP phenotype. Older age was associated with CIS, PP/PR, and SP. The risk of a longer interval between disease onset and first visit was lower for the CIS phenotype, but higher for PP/PR and SP. The probability of SP at first visit was greater in the South of Italy.Discussion: Differences in the phenotype of MS patients first seen in Italian centers can be only partly explained by differences in the centers' characteristics. The demographic and socio-economic characteristics of MS patients seem to be the main determinants of the phenotypes at first referral. [ABSTRACT FROM AUTHOR]
Copyright of Neurological Sciences is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Do patients' and referral centers' characteristics influence multiple sclerosis phenotypes? Results from the Italian multiple sclerosis and related disorders register.
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  Data: <searchLink fieldCode="AR" term="%22Bergamaschi%2C+Roberto%22">Bergamaschi, Roberto</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Beghi%2C+Ettore%22">Beghi, Ettore</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Bosetti%2C+Cristina%22">Bosetti, Cristina</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Ponzio%2C+Michela%22">Ponzio, Michela</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Santucci%2C+Claudia%22">Santucci, Claudia</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Lepore%2C+Vito%22">Lepore, Vito</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Mosconi%2C+Paola%22">Mosconi, Paola</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Aguglia%2C+U%2E%22">Aguglia, U.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Amato%2C+M%2E+P%2E%22">Amato, M. P.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Ancona%2C+A%2E+L%2E%22">Ancona, A. L.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Ardito%2C+B%2E%22">Ardito, B.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Avolio%2C+C%2E%22">Avolio, C.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Balgera%2C+R%2E%22">Balgera, R.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Banfi%2C+P%2E%22">Banfi, P.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Barcella%2C+V%2E%22">Barcella, V.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Barone%2C+P%2E%22">Barone, P.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Bellantonio%2C+P%2E%22">Bellantonio, P.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Berardinelli%2C+A%2E%22">Berardinelli, A.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Bergamaschi%2C+R%2E%22">Bergamaschi, R.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Bertora%2C+P%2E%22">Bertora, P.</searchLink> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22Neurological+Sciences%22">Neurological Sciences</searchLink>. Sep2022, Vol. 43 Issue 9, p5459-5469. 11p. 3 Charts, 1 Graph.
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  Data: <searchLink fieldCode="DE" term="%22Multiple+sclerosis%22">Multiple sclerosis</searchLink><br /><searchLink fieldCode="DE" term="%22Disease+relapse%22">Disease relapse</searchLink><br /><searchLink fieldCode="DE" term="%22Medical+referrals%22">Medical referrals</searchLink><br /><searchLink fieldCode="DE" term="%22Phenotypes%22">Phenotypes</searchLink><br /><searchLink fieldCode="DE" term="%22Disease+complications%22">Disease complications</searchLink>
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  Label: Abstract
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  Data: <bold>Background: </bold>Multiple sclerosis (MS) is characterized by phenotypical heterogeneity, partly resulting from demographic and environmental risk factors. Socio-economic factors and the characteristics of local MS facilities might also play a part.<bold>Methods: </bold>This study included patients with a confirmed MS diagnosis enrolled in the Italian MS and Related Disorders Register in 2000-2021. Patients at first visit were classified as having a clinically isolated syndrome (CIS), relapsing-remitting (RR), primary progressive (PP), progressive-relapsing (PR), or secondary progressive MS (SP). Demographic and clinical characteristics were analyzed, with centers' characteristics, geographic macro-areas, and Deprivation Index. We computed the odds ratios (OR) for CIS, PP/PR, and SP phenotypes, compared to the RR, using multivariate, multinomial, mixed effects logistic regression models.<bold>Results: </bold>In all 35,243 patients from 106 centers were included. The OR of presenting more advanced MS phenotypes than the RR phenotype at first visit significantly diminished in relation to calendar period. Females were at a significantly lower risk of a PP/PR or SP phenotype. Older age was associated with CIS, PP/PR, and SP. The risk of a longer interval between disease onset and first visit was lower for the CIS phenotype, but higher for PP/PR and SP. The probability of SP at first visit was greater in the South of Italy.<bold>Discussion: </bold>Differences in the phenotype of MS patients first seen in Italian centers can be only partly explained by differences in the centers' characteristics. The demographic and socio-economic characteristics of MS patients seem to be the main determinants of the phenotypes at first referral. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Neurological Sciences is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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