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4 results on '"Relapse phenotype"'

1. SMILE: a predictive model for Scoring the severity of relapses in MultIple scLErosis.

Author

Lejeune, F., Chatton, A., Laplaud, D.-A., Le Page, E., Wiertlewski, S., Edan, G., Kerbrat, A., Veillard, D., Hamonic, S., Jousset, N., Le Frère, F., Ouallet, J.-C., Brochet, B., Ruet, A., Foucher, Y., and Michel, Laure

Subjects
*MULTIPLE sclerosis, *PREDICTION models, *SENSORY disorders, *DISEASE duration
Abstract

Background: In relapsing–remitting multiple sclerosis (RRMS), relapse severity and residual disability are difficult to predict. Nevertheless, this information is crucial both for guiding relapse treatment strategies and for informing patients. Objective: We, therefore, developed and validated a clinical-based model for predicting the risk of residual disability at 6 months post-relapse in MS. Methods: We used the data of 186 patients with RRMS collected during the COPOUSEP multicentre trial. The outcome was an increase of ≥ 1 EDSS point 6 months post-relapse treatment. We used logistic regression with LASSO penalization to construct the model, and bootstrap cross-validation to internally validate it. The model was externally validated with an independent retrospective French single-centre cohort of 175 patients. Results: The predictive factors contained in the model were age > 40 years, shorter disease duration, EDSS increase ≥ 1.5 points at time of relapse, EDSS = 0 before relapse, proprioceptive ataxia, and absence of subjective sensory disorders. Discriminative accuracy was acceptable in both the internal (AUC 0.82, 95% CI [0.73, 0.91]) and external (AUC 0.71, 95% CI [0.62, 0.80]) validations. Conclusion: The predictive model we developed should prove useful for adapting therapeutic strategy of relapse and follow-up to individual patients. [ABSTRACT FROM AUTHOR]

Published
2021
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2. Contribution of different relapse phenotypes to disability in multiple sclerosis.

Author

Stewart, Tamasine, Spelman, Tim, Havrdova, Eva, Horakova, Dana, Trojano, Maria, Izquierdo, Guillermo, Duquette, Pierre, Girard, Marc, Prat, Alexandre, Lugaresi, Alessandra, Grand’Maison, Francois, Grammond, Pierre, Sola, Patrizia, Shaygannejad, Vahid, Hupperts, Raymond, Alroughani, Raed, Oreja-Guevara, Celia, Pucci, Eugenio, Boz, Cavit, and Lechner-Scott, Jeannette

Subjects
*MULTIPLE sclerosis, *MYELIN sheath diseases, *DEMYELINATION, *PHENOTYPES, *PROGNOSIS
Abstract

Objective: This study evaluated the effect of relapse phenotype on disability accumulation in multiple sclerosis. Methods: Analysis of prospectively collected data was conducted in 19,504 patients with relapse-onset multiple sclerosis and minimum 1-year prospective follow-up from the MSBase cohort study. Multivariable linear regression models assessed associations between relapse incidence, phenotype and changes in disability (quantified with Expanded Disability Status Scale and its Functional System scores). Sensitivity analyses were conducted. Results: In 34,858 relapses recorded during 136,462 patient-years (median follow-up 5.9 years), higher relapse incidence was associated with greater disability accumulation (β = 0.16, p < 0.001). Relapses of all phenotypes promoted disability accumulation, with the most pronounced increase associated with pyramidal (β = 0.27 (0.25–0.29)), cerebellar (β = 0.35 (0.30–0.39)) and bowel/bladder (β = 0.42 (0.35–0.49)) phenotypes (mean (95% confidence interval)). Higher incidence of each relapse phenotype was associated with an increase in disability in the corresponding neurological domain, as well as anatomically related domains. Conclusion: Relapses are associated with accumulation of neurological disability. Relapses in pyramidal, cerebellar and bowel/bladder systems have the greatest association with disability change. Therefore, prevention of these relapses is an important objective of disease-modifying therapy. The differential impact of relapse phenotypes on disability outcomes could influence management of treatment failure in multiple sclerosis. [ABSTRACT FROM AUTHOR]

Published
2017
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3. SMILE: a predictive model for scoring the severity of relapses in multIple sclerosis

Author

F. Le Frere, Anne Kerbrat, Yohann Foucher, Arthur Chatton, L. Michel, David-Axel Laplaud, E. Le Page, David Veillard, F. Lejeune, Sandrine Wiertlewski, Gilles Edan, Natacha Jousset, Stéphanie Hamonic, Jean-Christophe Ouallet, Bruno Brochet, Aurélie Ruet, Centre hospitalier universitaire de Nantes (CHU Nantes), Centre de Recherche en Transplantation et Immunologie (U1064 Inserm - CRTI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN), MethodS in Patients-centered outcomes and HEalth ResEarch (SPHERE), Université de Tours-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes - UFR des Sciences Pharmaceutiques et Biologiques, CHU Pontchaillou [Rennes], Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Bordeaux [Bordeaux], Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Tours, Microenvironment, Cell Differentiation, Immunology and Cancer (MICMAC), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes - UFR des Sciences Pharmaceutiques et Biologiques, Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre d’Investigation Clinique de Nantes (CIC Nantes), Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre hospitalier universitaire de Nantes (CHU Nantes), Neurocentre Magendie : Physiopathologie de la Plasticité Neuronale (U1215 Inserm - UB), Université de Bordeaux (UB)-Institut François Magendie-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), INSERM, Neurocentre Magendie, U1215, Physiopathologie de la Plasticité Neuronale, F-33000 Bordeaux, France, Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1), and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)

Subjects
Adult, medicine.medical_specialty, Multiple Sclerosis, Ataxia, Neurology, [SDV]Life Sciences [q-bio], [SDV.CAN]Life Sciences [q-bio]/Cancer, Logistic regression, Disability Evaluation, 03 medical and health sciences, Multiple Sclerosis, Relapsing-Remitting, 0302 clinical medicine, Lasso (statistics), Recurrence, Internal medicine, Relapse phenotype, Humans, Medicine, 030212 general & internal medicine, ComputingMilieux_MISCELLANEOUS, Retrospective Studies, Therapeutic strategy, Neuroradiology, business.industry, Multiple sclerosis, medicine.disease, 3. Good health, Predictive model, Relapse recovery, Cohort, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, EDSS, Neurology (clinical), medicine.symptom, business, 030217 neurology & neurosurgery
Abstract

International audience; BACKGROUND: In relapsing-remitting multiple sclerosis (RRMS), relapse severity and residual disability are difficult to predict. Nevertheless, this information is crucial both for guiding relapse treatment strategies and for informing patients. OBJECTIVE: We, therefore, developed and validated a clinical-based model for predicting the risk of residual disability at 6 months post-relapse in MS. METHODS: We used the data of 186 patients with RRMS collected during the COPOUSEP multicentre trial. The outcome was an increase of ≥ 1 EDSS point 6 months post-relapse treatment. We used logistic regression with LASSO penalization to construct the model, and bootstrap cross-validation to internally validate it. The model was externally validated with an independent retrospective French single-centre cohort of 175 patients. RESULTS: The predictive factors contained in the model were age > 40 years, shorter disease duration, EDSS increase ≥ 1.5 points at time of relapse, EDSS = 0 before relapse, proprioceptive ataxia, and absence of subjective sensory disorders. Discriminative accuracy was acceptable in both the internal (AUC 0.82, 95% CI [0.73, 0.91]) and external (AUC 0.71, 95% CI [0.62, 0.80]) validations. CONCLUSION: The predictive model we developed should prove useful for adapting therapeutic strategy of relapse and follow-up to individual patients.

Published
2019

4. Contribution of different relapse phenotypes to disability in multiple sclerosis

Author

Tamasine Stewart, Erik van Munster, Mark Slee, Patrizia Sola, Eva Havrdova, Dana Horakova, Orla Gray, Helmut Butzkueven, Cameron Shaw, Eugenio Pucci, Michael Barnett, Csilla Rozsa, Pamelo McCombe, Vincent Van Pesch, Maria Trojano, Franco Granella, Bhim Singhal, Fraser Moore, Javier Olascoaga, Neil Shuey, Pierre Duquette, Christina Ramo, Tomas Kalincik, Marc Girard, Freek Verheul, José Luis Sánchez Menoyo, Edgardo Cristiano, Pierre Grammond, Julie Prevost, Guillermo Izquierdo, Tim Spelman, Tatjana Petkovska-Boskova, Francois Grand'Maison, Celia Oreja-Guevara, Vahid Shaygannejad, Maria Laura Saladino, Suzanne Hodgkinson, Allan G. Kermode, Norma Deri, Alexandre Prat, Raymond Hupperts, Bruce V. Taylor, Gerardo Iuliano, Daniele Spitaleri, Cavit Boz, Roberto Bergamaschi, Raed Alroughani, Radek Ampapa, Vilija Jokubaitis, Jeannette Lechner-Scott, Maria Pia Amato, Olga Skibina, Alessandra Lugaresi, Steve Vucic, Ilya Kister, Stewart, Tamasine, Spelman, Tim, Havrdova, Eva, Horakova, Dana, Trojano, Maria, Izquierdo, Guillermo, Duquette, Pierre, Girard, Marc, Prat, Alexandre, Lugaresi, Alessandra, Grand'Maison, Francoi, Grammond, Pierre, Sola, Patrizia, Shaygannejad, Vahid, Hupperts, Raymond, Alroughani, Raed, Oreja-Guevara, Celia, Pucci, Eugenio, Boz, Cavit, Lechner-Scott, Jeannette, Bergamaschi, Roberto, Van Pesch, Vincent, Iuliano, Gerardo, Ramo, Cristina, Taylor, Bruce, Slee, Mark, Spitaleri, Daniele, Granella, Franco, Verheul, Freek, Mccombe, Pamela, Hodgkinson, Suzanne, Amato, Maria Pia, Vucic, Steve, Gray, Orla, Cristiano, Edgardo, Barnett, Michael, Sanchez Menoyo, Jose Lui, van Munster, Erik, Saladino, Maria Laura, Olascoaga, Javier, Prevost, Julie, Deri, Norma, Shaw, Cameron, Singhal, Bhim, Moore, Fraser, Rozsa, Csilla, Shuey, Neil, Skibina, Olga, Kister, Ilya, Petkovska-Boskova, Tatjana, Ampapa, Radek, Kermode, Allan, Butzkueven, Helmut, Jokubaitis, Vilija, Kalincik, Toma, and MSBase Study Group

Subjects
Adult, Male, 0301 basic medicine, medicine.medical_specialty, Multiple Sclerosis, Prognosi, multiple sclerosis, Disability Evaluation, 03 medical and health sciences, 0302 clinical medicine, cohort studies, Recurrence, Internal medicine, medicine, Humans, Disabled Persons, Prospective Studies, Prospective cohort study, Expanded Disability Status Scale, business.industry, Incidence (epidemiology), Multiple sclerosis, Interferon-beta, Middle Aged, Prognosis, medicine.disease, Functional system, Phenotype, Confidence interval, relapse phenotype, 030104 developmental biology, Neurology, multiple sclerosi, Chronic Disease, Disease Progression, Physical therapy, Female, observational study, outcome research, Neurology (clinical), business, 030217 neurology & neurosurgery, cohort studie, Cohort study
Abstract

Objective: This study evaluated the effect of relapse phenotype on disability accumulation in multiple sclerosis. Methods: Analysis of prospectively collected data was conducted in 19,504 patients with relapse-onset multiple sclerosis and minimum 1-year prospective follow-up from the MSBase cohort study. Multivariable linear regression models assessed associations between relapse incidence, phenotype and changes in disability (quantified with Expanded Disability Status Scale and its Functional System scores). Sensitivity analyses were conducted. Results: In 34,858 relapses recorded during 136,462 patient-years (median follow-up 5.9 years), higher relapse incidence was associated with greater disability accumulation (β = 0.16, p Conclusion: Relapses are associated with accumulation of neurological disability. Relapses in pyramidal, cerebellar and bowel/bladder systems have the greatest association with disability change. Therefore, prevention of these relapses is an important objective of disease-modifying therapy. The differential impact of relapse phenotypes on disability outcomes could influence management of treatment failure in multiple sclerosis.

Published
2016

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