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