Factors associated with benign multiple sclerosis in the New York State MS Consortium (NYSMSC)

Zivadinov, Robert; Cookfair, Diane L.; Krupp, Lauren; Miller, Aaron E.; Lava, Neil; Coyle, Patricia K.; Goodman, Andrew D.; Jubelt, Burk; Lenihan, Michael; Herbert, Joseph; Gottesman, Malcolm; Snyder, David H.; Apatoff, Brian R.; Teter, Barbara E.; Perel, Allan B.; Munschauer, Frederick; Weinstock-Guttman, Bianca

doi:10.1186/s12883-016-0623-2

Table 3 DMT use as a predictor of continued benign status at follow-up in those who were benign at enrollment (n = 742)^a,b,c,d

From: Factors associated with benign multiple sclerosis in the New York State MS Consortium (NYSMSC)

(A) DMT use Ever(n = 633)/Never (n = 109)^e,f
	HR (95 % CI)	p value
DMT use at enrollment and/or follow-up Disease duration (years) at enrollment	0.60 (0.42-0.85) 0.97 (0.97–0.99)	0.009 0.007
(B) DMT use 4-category Cox model^e,f
	HR (95 % CI)	p value
DMT use at enrollment only (n = 83) DMT use at follow-up only (n = 258) DMT use at both enrollment and follow-up (n = 292) Disease duration (years) at enrollment	0.97 (0.74–2.38) 0.80 (0.64–0.99) 0.71 (0.57–0.88) 0.98 (0.97–0.99)	NS 0.037 0.006 0.006

CI confidence interval, DMT disease-modifying therapy, HR hazard ratio MS multiple sclerosis
^aCox regression analyses
^bThe following variables were entered into the full Cox models comparing late benign with benign patients: sex, disease course, race, treatment status, age at onset and disease duration
^cContinuous variables: age at onset (years), disease duration (years since symptom onset)
^dCategorical variables: sex: female compared with male; disease course: secondary-progressive, progressive-relapsing, primary-progressive, compared with relapsing-remitting MS; race: African-American, Other, compared with Caucasian; treatment categories: See footnote f, below
^eForty-six of 788 Criteria I baseline benign follow-up patients were excluded from Cox regression analyses, leaving a total of N = 742 patients; N = 42 patients who were not on treatment at enrollment or follow-up but had a history of IFN-β1a use prior to its approval in 1996 as a result of participation in the IFN-β1a phase 3 trial, and N = 4 patients who were missing DMT data
Never Users: n = 109 patients had no history of DMT use at enrollment and did not use DMT at any time during the study. This group served as the reference category for DMT use in the Ever/Never and 4-category Cox models. DMTs used included interferon beta-1a/b (Avonex®, Rebif®, Betaseron®), glatiramer acetate (Copaxone®), azathioprine, cyclophosphamide, intravenous immunoglobulin, methotrexate, linomide, myelin therapy; mitoxantrone, and natalizumab (1 patient on clinical trial)
^fThere was no difference in likelihood of remaining benign vs converting to late non-benign during follow-up according to sex, disease course, race, or age at onset after adjusting for significant predictors included in the final model

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