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Correlates and trajectories of relapses in relapsing–remitting multiple sclerosis.

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Title: Correlates and trajectories of relapses in relapsing–remitting multiple sclerosis.
Authors: Young, Carolyn A. (AUTHOR), Rog, David J. (AUTHOR), Sharrack, Basil (AUTHOR), Tanasescu, Radu (AUTHOR), Kalra, Seema (AUTHOR), Harrower, Timothy (AUTHOR), Tennant, Alan (AUTHOR), Mills, Roger J. (AUTHOR), Young, Carolyn (AUTHOR), Rog, David (AUTHOR), Constantinescu, Cris (AUTHOR), Majeed, Tahir (AUTHOR), Santander, Helen (AUTHOR), Harrower, Tim (AUTHOR), Leach, Oliver (AUTHOR), Nicholas, Richard (AUTHOR), Ford, Helen (AUTHOR), Woolmore, John (AUTHOR), Kipps, Chris (AUTHOR), Johnston, Clare (AUTHOR)
Source: Neurological Sciences. May2024, Vol. 45 Issue 5, p2181-2189. 9p.
Subjects: Multiple sclerosis, Disease relapse, Cancer fatigue, Smoking cessation, Neuralgia
Abstract: Background and aims: In people with relapsing–remitting multiple sclerosis (pwRRMS), data from studies on non-pharmacological factors which may influence relapse risk, other than age, are inconsistent. There is a reduced risk of relapses with increasing age, but little is known about other trajectories in real-world MS care. Methods: We studied longitudinal questionnaire data from 3885 pwRRMS, covering smoking, comorbidities, disease-modifying therapy (DMT), and patient-reported outcome measures, as well as relapses during the past year. We undertook Rasch analysis, group-based trajectory modelling, and multilevel negative binomial regression. Results: The regression cohort of 6285 data sets from pwRRMS over time showed that being a current smoker was associated with 43.9% greater relapse risk; having 3 or more comorbidities increased risk and increasing age reduced risk. Those diagnosed within the last 2 years showed two distinct trajectories, both reducing in relapse frequency but 25.8% started with a higher rate and took 4 years to reduce to the rate of the second group. In the cohort with at least three data points completed, there were three groups: 73.7% followed a low stable relapse rate, 21.6% started from a higher rate and decreased, and 4.7% had an increasing then decreasing pattern. These different trajectory groups showed significant differences in fatigue, neuropathic pain, disability, health status, quality of life, self-efficacy, and DMT use. Conclusions: These results provide additional evidence for supporting pwRRMS to stop smoking and underline the importance of timely DMT decisions and treatment initiation soon after diagnosis with RRMS. [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: Correlates and trajectories of relapses in relapsing–remitting multiple sclerosis.
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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="%22Cancer+fatigue%22">Cancer fatigue</searchLink><br /><searchLink fieldCode="DE" term="%22Smoking+cessation%22">Smoking cessation</searchLink><br /><searchLink fieldCode="DE" term="%22Neuralgia%22">Neuralgia</searchLink>
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  Data: Background and aims: In people with relapsing–remitting multiple sclerosis (pwRRMS), data from studies on non-pharmacological factors which may influence relapse risk, other than age, are inconsistent. There is a reduced risk of relapses with increasing age, but little is known about other trajectories in real-world MS care. Methods: We studied longitudinal questionnaire data from 3885 pwRRMS, covering smoking, comorbidities, disease-modifying therapy (DMT), and patient-reported outcome measures, as well as relapses during the past year. We undertook Rasch analysis, group-based trajectory modelling, and multilevel negative binomial regression. Results: The regression cohort of 6285 data sets from pwRRMS over time showed that being a current smoker was associated with 43.9% greater relapse risk; having 3 or more comorbidities increased risk and increasing age reduced risk. Those diagnosed within the last 2 years showed two distinct trajectories, both reducing in relapse frequency but 25.8% started with a higher rate and took 4 years to reduce to the rate of the second group. In the cohort with at least three data points completed, there were three groups: 73.7% followed a low stable relapse rate, 21.6% started from a higher rate and decreased, and 4.7% had an increasing then decreasing pattern. These different trajectory groups showed significant differences in fatigue, neuropathic pain, disability, health status, quality of life, self-efficacy, and DMT use. Conclusions: These results provide additional evidence for supporting pwRRMS to stop smoking and underline the importance of timely DMT decisions and treatment initiation soon after diagnosis with RRMS. [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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        Value: 10.1007/s10072-023-07155-3
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