Short-term prognosis in early relapsing-remitting multiple sclerosis

Objective: To characterize a group of patients with early MS using prognost ic factors and to determine whether these prognostic factors impact on shor t-term prognosis. Methods: Data were collected prospectively on 98 patients newly diagnosed with MS in our MS clinic between 1990 and 1998 (average fo llow-up, 37 months from the time of onset of clinically definite MS [CDMS]) . Six prognostic factors were recorded: age at onset, symptoms at onset, MR I status at onset and at diagnosis of CDMS, interval between the first and second attack, attack frequency in the first 2 years, and completeness of r ecovery from initial attacks. Completeness of recovery was determined using Expanded Disability Status Scale scores (EDSS). Progression was determined by final EDSS and changes in EDSS between initial presentation and final f ollow-up. Results: Patients predicted to have low risk of progression of MS based on the prognostic factors represented 17% of our patient population (0 to 1 risk factor for progression). The patients with high risk of progre ssion (4 to 6 risk factors) represented 24% of patients. Patients with a hi gh number of risk factors did significantly worse than those with a small o r medium number of risk factors in terms of final ED;SS and progression to higher EDSS. At the time of diagnosis of CDMS, MRI findings suggestive of M S were seen in 84% of patients (suspicious in 13%, negative in 3%). Conclus ion: Short-term prognosis was influenced by the presence or absence of a hi gh number of these six risk factors.