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Abstract Details

Clinical And Paraclinical Markers Of Disability Progression After A First Neurological Event: A Long Term Follow-Up Study
Multiple Sclerosis
P5 - Poster Session 5 (8:00 AM-9:00 AM)
9-015
The aim of the current study was to explore prognostic markers of long term disability progression after a first demyelinating event.
As the current paradigm in multiple sclerosis is that axonal damage occurs early in the course of the disease, the identification of early predictors of long term disability progression is of critical importance in everyday clinical practice.
Patients admitted to San Raffaele Hospital between 2000 and 2013 for a first demyelinating event and with a minimum follow up of 2 years have been included. We evaluated baseline clinical, MRI, neurophysiological and CSF data as well as modifiable risk factors and assessed their prognostic value for subsequent development of disability worsening.

A total of 255 patients (median follow-up 138.8 months) were included in the study. After the first demyelinating event, 160 (63%) had relapses in the follow-up while 214 (84%) developed new subclinical lesions. Multivariate logistic regression showed that older age, female sex, presence of spinal cord lesions at disease onset, partial recovery from the first clinical episode, presence of OCBs, elevated abnormal evoked potential scores, lower vitamin D levels in association to hard smoking during follow up are predictive factors of disability progression over medium and long term follow-up.
Our study shows that the early spinal cord involvement, especially when associated with partial recovery from first clinical episode was the single most important prognostic factor for long term disability occurrence. Moreover, low vitamin D levels at onset, in association with smoking during the observational period were related to worse outcomes, supporting the recommendation of vitamin D supplementation and of abstention from smoking for all patients from the early phases of the disease.
Authors/Disclosures
Gloria Dalla Costa
PRESENTER 		No disclosure on file
Vittorio Martinelli (S. Raffaele Hospital) Dr. Martinelli has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis, Biogen, Sanofi Genzyme, TEVA and Merck. Dr. Martinelli has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck .
Francesca Sangalli No disclosure on file
Bruno Colombo Bruno Colombo has nothing to disclose.
Lucia Moiola, MD, PhD (Fondazione Centro San Raffaele) Dr. Moiola has nothing to disclose.
No disclosure on file
Letizia M. Leocani, MD (University Vita-Salute San Raffaele, INSPE) Dr. Leocani has received personal compensation in the range of $0-$499 for serving as a Consultant for Roche . Dr. Leocani has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Merck. Dr. Leocani has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Bristol Myers Squibb. Dr. Leocani has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Med-ex learning.
Massimo Filippi, MD, FÂ鶹´«Ã½Ó³»­ (Ospedale San Raffaele, Neuroimaging Research Unit) Dr. Filippi has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Alexion, Almirall, Biogen, Merck, Novartis, Roche, Sanofi. Dr. Filippi has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion, Biogen, Bristol-Myers Squibb, Merck, Novartis, Roche, Sanofi, Sanofi-Aventis, Sanofi-Genzyme, Takeda. Dr. Filippi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Bayer, Biogen, Celgene, Chiesi Italia SpA, Eli Lilly, Genzyme, Janssen, Merck-Serono, Neopharmed Gentili, Novartis, Novo Nordisk, Roche, Sanofi, Takeda, and TEVA. Dr. Filippi has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Springer Nature. The institution of Dr. Filippi has received research support from Biogen Idec, Merck-Serono, Novartis, Roche, the Italian Ministry of Health, the Italian Ministry of University and Research, and Fondazione Italiana Sclerosi Multipla.
Giancarlo Comi, MD (University Vita-Salute) Dr. Comi has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Janssen. Dr. Comi has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Bristol Myers Squibb. Dr. Comi has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Dr. Comi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Janssen. Dr. Comi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Bristol Myers Squibb. Dr. Comi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Novartis. Dr. Comi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Aspen Healthcare. Dr. Comi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Sanofi. Dr. Comi has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Sanofi. Dr. Comi has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Rewind.