Prognostic factors for long-term outcomes in relapsing–remitting multiple sclerosis

Objective The objective of this article is to investigate potential clinical and MRI predictors of long-term outcomes in multiple sclerosis (MS). Methods This was a post hoc analysis using data from all 382 patients in the PRISMS long-term follow-up (LTFU) study collected up to eight years after randomisation. An additional analysis was performed including only those patients originally randomised to receive early subcutaneous interferon (IFN) β-1a ( n = 259). Baseline/prestudy variables, indicators of early clinical and MRI activity (baseline to month 24), and indicators of IFN β-1a treatment exposure (including medication possession ratio (MPR)) were investigated as candidate prognostic factors for outcomes measured from baseline and from month 24 to LTFU. Explanatory variables identified from univariate regression models ( p ≤ 0.15) were selected for inclusion in stepwise multiple regression models. Results Candidate prognostic factors selected by the univariate analysis ( p ≤ 0.15) included age, MS duration, baseline brain volume, EDSS score, and log(T2 burden of disease (BOD)). In most of the multivariate regression models applied, higher baseline brain volume and MPR predicted better long-term clinical outcomes, while higher baseline and greater early increase in EDSS score predicted worse outcomes. Conclusion Identification of markers that may be prognostic for long-term disability could help identify MS patients at higher risk of disability progression.

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Long-term prognostic value of longitudinal measurements of blood neurofilament levels

Neurology Neuroimmunology & Neuroinflammation ◽

10.1212/nxi.0000000000000856 ◽

2020 ◽

Vol 7 (5) ◽

pp. e856 ◽

Cited By ~ 2

Author(s):

Dieter A. Häring ◽

Harald Kropshofer ◽

Ludwig Kappos ◽

Jeffrey A. Cohen ◽

Anuja Shah ◽

...

Keyword(s):

Multiple Sclerosis ◽

Light Chain ◽

Prognostic Value ◽

Long Term Outcomes ◽

Neurofilament Light Chain ◽

Neurofilament Light ◽

Longitudinal Measurements ◽

Relapsing Remitting ◽

Edss Score

ObjectiveTo assess the long-term prognostic value of an integral of longitudinal measurements of plasma neurofilament light chain levels (NfLlong) over 12 and 24 months vs single neurofilament light chain (NfL) measurements in patients with relapsing-remitting MS (RRMS) and its additional value when combined with clinical and MRI measures.MethodsThis analysis included continuously fingolimod-treated patients with RRMS from the 24-month FTY720 Research Evaluating Effects of Daily Oral therapy in Multiple Sclerosis (FREEDOMS)/12-month Trial Assessing Injectable Interferon vs FTY720 Oral in Relapsing–Remitting Multiple Sclerosis (TRANSFORMS) phase 3 trials and their long-term extension, LONGTERMS. Patients were classified into high (≥30 pg/mL, n = 110) and low (<30 pg/mL, n = 164) NfL categories based on the baseline (BL) NfL value or the geometric mean NfLlong calculated over 12 and 24 months to predict disability-related outcomes and brain volume loss (BVL). The additional prognostic value of NfL was quantified using the area under the receiver operating characteristic (ROC) curve.ResultsA single high (vs low) NfL measure at BL was prognostic of a higher risk of reaching Expanded Disability Status Scale (EDSS) score ≥4 earlier (hazard ratio [HR] = 2.19; 95% CI = 1.21–3.97) and higher BVL over 120 months (difference: −1.12%; 95% CI = −2.07 to −0.17). When NfLlong was measured over 24 months, high NfL was associated with a higher risk of reaching EDSS score ≥4 (HR = 7.91; 95% CI = 2.99–20.92), accelerated 6-month confirmed disability worsening (HR = 3.14; 95% CI = 1.38–7.11), and 20% worsening in the Timed 25-Foot Walk Test (HR = 3.05; 95% CI = 1.38–6.70). Area under the ROC curve was consistently highest in models combining NfL with clinical and MRI measures.ConclusionsNfLlong had a higher prognostic value than single NfL assessments on long-term outcomes in RRMS. Combining it with clinical and MRI measures increased sensitivity and specificity to predict long-term disease outcomes.Classification of evidenceThis study provides Class I evidence that NfLlong was more strongly associated with long-term outcomes than single NfL assessments in patients with RRMS.

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Relevance of hypointense brain MRI lesions for long-term worsening of clinical disability in relapsing multiple sclerosis

Multiple Sclerosis Journal ◽

10.1177/1352458513494490 ◽

2013 ◽

Vol 20 (2) ◽

pp. 214-219 ◽

Cited By ~ 25

Author(s):

Antonio Giorgio ◽

Maria Laura Stromillo ◽

Maria Letizia Bartolozzi ◽

Francesca Rossi ◽

Marco Battaglini ◽

...

Keyword(s):

Multiple Sclerosis ◽

Brain Mri ◽

Univariate Analysis ◽

Brain Lesion ◽

Brain Magnetic Resonance Imaging ◽

Stepwise Multiple Regression ◽

Lesion Volume ◽

Magnetic Resonance Imaging Mri ◽

Relapsing Remitting Multiple Sclerosis

Background: The accrual of brain focal pathology is considered a good substrate of disability in relapsing–remitting multiple sclerosis (RRMS). However, knowledge on long-term lesion evolution and its relationship with disability progression is poor. Objective: The objective of this paper is to evaluate in RRMS the long-term clinical relevance of brain lesion evolution. Methods: In 58 RRMS patients we acquired, using the same scanner and protocol, brain magnetic resonance imaging (MRI) at baseline and 10±0.5 years later. MRI data were correlated with disability changes as measured by the Expanded Disability Status Scale (EDSS). Results: The annualized 10-year lesion volume (LV) growth was +0.25±0.5 cm3 (+6.7±8.7%) for T2-weighted (T2-W) lesions and +0.20±0.31 cm3 (+11.5±12.3%) for T1-weighted (T1-W) lesions. The univariate analysis showed moderate correlations between baseline MRI measures and EDSS at 10 years ( p < 0.001). Also, 10-year EDSS worsening correlated with LV growth and the number of new/enlarging lesions measured over the same period ( p < 0.005). In the stepwise multiple regression analysis, EDSS worsening over 10 years was best correlated with the combination of baseline T1-W lesion count and increasing T1-W LV ( R = 0.61, p < 0.001). Conclusion: In RRMS patients, long-term brain lesion accrual is associated with worsening in clinical disability. This is particularly true for hypointense, destructive lesions.

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Long-term Disease Outcomes in Multiple Sclerosis Patients Categorised by Baseline Brain Volume and with No Disease Activity over 2 Years

10.26226/morressier.59a3eda9d462b8028d895770 ◽

2017 ◽

Author(s):

Michael H. Barnett

Keyword(s):

Multiple Sclerosis ◽

Disease Activity ◽

Brain Volume ◽

Disease Outcomes ◽

Multiple Sclerosis Patients

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Comparison of 24 month changes in brain volume among long term users of fingolimod versus glatiramer acetate in patients with multiple sclerosis

10.26226/morressier.5b719e455aff74008ae4c9fc ◽

2018 ◽

Author(s):

Justin Honce

Keyword(s):

Multiple Sclerosis ◽

Glatiramer Acetate ◽

Brain Volume

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Early High-dose Caffeine Improves Respiratory Outcomes in Preterm Infants

Children ◽

10.3390/children8060501 ◽

2021 ◽

Vol 8 (6) ◽

pp. 501

Author(s):

Vineet Lamba ◽

Oscar Winners ◽

Prem Fort

Keyword(s):

Mechanical Ventilation ◽

Preterm Infants ◽

Regression Models ◽

High Dose ◽

Long Term Outcomes ◽

Logistic Regression Models ◽

Caffeine Citrate ◽

Timing Of Initiation ◽

Respiratory Outcomes

The objective of the study is to determine if early high-dose caffeine (HD) therapy is associated with shorter duration of mechanical ventilation, bronchopulmonary dysplasia (BPD), or decreased need for mechanical ventilation. We conducted a single center, retrospective cohort study of 273 infants less than 32 weeks gestational age (GA). Infants receiving early HD (10 mg/kg/day maintenance) caffeine citrate started within 24 h of life were compared with those receiving LD (6 mg/kg/day) with variable timing of initiation using linear and logistic regression models. The infants in the early HD group had 91.4 (95% confidence interval (CI): −166.6, −16.1; p = 0.018) less hours of mechanical ventilation up to 36 weeks PMA or discharge as compared with the LD group. Moreover, infants in the HD group had 0.37 (95% CI: 0.14, 0.97; p = 0.042) times lower odds of developing moderate/severe BPD compared with the LD group. Infants receiving early HD caffeine had improved respiratory outcomes with no increase in measured comorbidities. Large prospective studies are needed to determine the long-term outcomes of using high-dose caffeine prophylaxis for preterm infants.

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Long-term Outcomes and Prognostic Factors for Trabeculectomy With Mitomycin C in Eyes With Uveitic Glaucoma

Journal of Glaucoma ◽

10.1097/ijg.0b013e3182685167 ◽

2014 ◽

Vol 23 (2) ◽

pp. 88-94 ◽

Cited By ~ 56

Author(s):

Keiichiro Iwao ◽

Masaru Inatani ◽

Takahiko Seto ◽

Yuji Takihara ◽

Minako Ogata-Iwao ◽

...

Keyword(s):

Prognostic Factors ◽

Mitomycin C ◽

Long Term Outcomes ◽

Uveitic Glaucoma

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Which prognostic factors are important for long-term outcomes in symptomatic obstructive colon cancer? A multi-institutional retrospective cohort study

Journal of Minimally Invasive Surgery ◽

10.7602/jmis.2021.24.3.128 ◽

2021 ◽

Vol 24 (3) ◽

pp. 128-138 ◽

Cited By ~ 1

Author(s):

Chang Hwan Kim ◽

Jung Hoon Bae ◽

Chul Seung Lee ◽

Seung-Rim Han ◽

In Kyu Lee ◽

...

Keyword(s):

Colon Cancer ◽

Cohort Study ◽

Prognostic Factors ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Long Term Outcomes

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Analysis of Prognostic Factors Affecting Short-term and Long-term Outcomes of Gastric Cancer Resection

Anticancer Research ◽

10.21873/anticanres.15140 ◽

2021 ◽

Vol 41 (7) ◽

pp. 3523-3534

Author(s):

PIOTR KULIG ◽

PRZEMYSŁAW NOWAKOWSKI ◽

MAREK SIERZĘGA ◽

RADOSŁAW PACH ◽

OLIWIA MAJEWSKA ◽

...

Keyword(s):

Gastric Cancer ◽

Prognostic Factors ◽

Long Term Outcomes ◽

Short Term ◽

Factors Affecting ◽

Cancer Resection ◽

Gastric Cancer Resection

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P065 LONG TERM OUTCOMES AFTER LAPAROSCOPIC REPAIR OF VENTRAL HERNIAS LOCATED ON THE ABDOMINAL BORDERS

British Journal of Surgery ◽

10.1093/bjs/znab395.061 ◽

2021 ◽

Vol 108 (Supplement_8) ◽

Author(s):

Camillo Leonardo Bertoglio ◽

Marianna Maspero ◽

Lorenzo Morini ◽

Bruno Alampi ◽

Simona Grimaldi ◽

...

Keyword(s):

Chronic Pain ◽

Laparoscopic Repair ◽

Univariate Analysis ◽

Open Approach ◽

Long Term Outcomes ◽

Defect Area ◽

Ptfe Mesh ◽

Ventral Hernias

Abstract Aim To assess the long-term outcomes after laparoscopic repair (LR) of ventral hernias located on the abdominal borders. Material and methods Out of our prospectively collected LR database, all cases of ventral hernias were reviewed. Defects located near the abdominal borders were identified (M1, M5, L1 and L4 according to the EHS classification). All patients received intraperitoneal implantation of an e-PTFE mesh. The primary aim of this study was to assess long-term outcomes. Results Out of 175 LR, 105 (60%) had a M1 component, 61 (35%) an M5, 24 (14%) an L1 and 5 (3%) an L4. The median defect width was 9 cm (range 2.5 - 30), the median length 13 (range 2 - 30), with a median defect area of 92 cm2 (range 5 - 471). Two (1%) cases required conversion to open approach. After a median follow up of 55 months, there were 7 recurrences: 4/105 in M1 patients, 1/61 M5 patients, 1/24 L1 patients and 1/4 L4 patients. 41 patients (23%) experienced chronic seroma, while 24 (14%) had chronic pain. 6 patients (3%) required a reoperation with mesh removal. At univariate analysis, only previous hernia repair was associated with recurrence; COPD, hypertension and M5 defect were associated with seroma development; seroma development and chronic pain were mutually associated. Conclusions Laparoscopic repair for ventral hernias is safe and feasible, with good long term outcomes.

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