Table 2 Risks of untreated relapsing MS
Treatment targets | Evidence of association | Long-term outcome |
|---|---|---|
T2 lesion volume | Increase of 0.8–l ml/year | Correlates with increased relapse frequency and long term disability outcomes. |
T1 black hole conversion | 40–50 % of lesions go on to form black holes | Correlation with clinical measures and disability progression. |
Brain atrophy | 0.5–1 %/year in MS vs. <0.1 % in healthy controls | Correlation with cognitive outcomes and EDSS in the long term. |
Clinical relapses | Annualized relapse rate in placebo arms: 0.5–1.38 | Relapses associated with decreased quality of life. |
Relapses associated with accrual of disability. | ||
Earlier onset of SPMS. | ||
Disability accrual | Average change of 0.27 EDSS points/per relapse | Increased likelihood of long term disability. |
MRI and lesional activity associated with disability progression |