37th Congress of the European Committee for Treatment and Research in Multiple Sclerosis – October 13-15, 2021

P020 – Difficulties in diagnosis of primary progressive multiple sclerosis: a clinical perspective

K. Blok et al.
Objective: To identify common difficulties in diagnosing PPMS.
Data source: Retrospective analysis of PPMS patient records at two MS centres (n=322).


  • There were reservations about a PPMS diagnosis in 52%
  • Common problems were an incomplete diagnostic work-up, early reports of demyelinating events, failure to exclude alternative diagnoses, lack of laboratory testing, not meeting McDonald 2017 criteria, and concomitant conditions that blurred the MS clinical course.

Conclusion: A thorough medical history and clinical work-up are needed.

P024 – Long-term efficacy of satralizumab in aquaporin-4-IgG-seropositive neuromyelitis optica spectrum disorder (NMOSD): Results from the open-label extension periods of SAkuraSky and SAkuraStar

I. Kleiter et al.
Objective: To evaluate the long-term efficacy of satralizumab in AQP4-IgG+ NMOSD.
Data source: Open-label extension data from the SAkuraSky and SAkuraStar phase III trials (n=111).


  • Mean annualized relapse rate was 0.20; 72-73% were relapse-free
  • 82-90% of patients did not have sustained EDSS worsening by week 192.

Conclusion: Long-term efficacy of satralizumab appears to be sustained.

P032 – COVID-19 in neuromyelitis optica spectrum disorders and myelin oligodendrocyte glycoprotein antibody disease patients in North America; COViMS registry

S.D. Newsome et al.
Objective: To determine COVID-19 outcomes in patients with NMOSD and MOGAD.
Data source: North American COViMS Registry data for patients with NMOSD (n=66) and MOGAD (n=15). Most were receiving treatment with rituximab.


  • 7% of NMOSD patients were not hospitalized, 12.1% were hospitalized only, 9.1% were admitted to ICU/ventilated, 12.1% died.
  • 3% of MOGAD patients were not hospitalized; there were no deaths.

Conclusion: There was a high COVID-19 mortality rate among NMOSD patients, with comorbidities associated with worse outcomes.

P105 – Cortical lesions at diagnosis predict conversion to secondary progressive multiple sclerosis and accumulation of disability: a 20-year follow-up study

G.M. Schiavi et al.
Objective: To examine the value of baseline cortical lesions in predicting progression to SPMS at 20 years.
Data source: Records of patients with MRI at diagnosis and periodic MRIs over a 20-year follow-up period (n=218). Subjects had CIS (21%), RRMS (74%) or PPMS (5%).


  • At 20 years, 21% of CIS/RRMS patients had transitioned to SPMS.
  • Mean number of cortical lesions at baseline was higher in patients who developed SPMS (6.6 vs. 1.3).
  • Mean EDSS score at year 20 was 1.5 in patients with 0 cortical lesions at baseline, 3.0 for patients with 1-3 cortical lesions and 6.0 in those with >3 cortical lesions.
  • Cortical lesion number and EDSS score at baseline were the best predictors of long-term disability.

Conclusion: The presence of cortical lesions may be a useful early predictor of disability.

See also P417 – Spinal cord lesions and brain grey matter atrophy independently predict clinical worsening in multiple sclerosis: a 5-year, multicentre study

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