MS Briefs

Key clinical point: Increased high-density lipoprotein cholesterol (HDL-C) is associated with decreased gray matter and cortical atrophy in patients with multiple sclerosis (MS) after adjusting for baseline serum neurofilaments (sNfL).

Major finding: Gray matter volume and cortical volume had significant associations with percent change in HDL-C (P = .0024 and P less than .001, respectively) after adjusting for sNfL as a predictor.

Study details: This prospective longitudinal study assessed patients with relapsing-remitting MS (n = 75) and progressive multiple sclerosis (n = 37) over a 5-year follow-up period.

Disclosures: The study was funded by the National Center for Advancing Translational Sciences of the National Institutes of Health. B Weinstock-Guttman, J Kuhle, R Zivadinov and M Ramanathan reported ties with multiple pharmaceutical companies. The remaining authors declared no conflicts of interest.

Citation: McComb M et al. Mult Scler Relat Disord. 2020 Jul 11. doi: 10.1016/j.msard.2020.102389.

Key clinical point: Increased high-density lipoprotein cholesterol (HDL-C) is associated with decreased gray matter and cortical atrophy in patients with multiple sclerosis (MS) after adjusting for baseline serum neurofilaments (sNfL).

Major finding: Gray matter volume and cortical volume had significant associations with percent change in HDL-C (P = .0024 and P less than .001, respectively) after adjusting for sNfL as a predictor.

Study details: This prospective longitudinal study assessed patients with relapsing-remitting MS (n = 75) and progressive multiple sclerosis (n = 37) over a 5-year follow-up period.

Disclosures: The study was funded by the National Center for Advancing Translational Sciences of the National Institutes of Health. B Weinstock-Guttman, J Kuhle, R Zivadinov and M Ramanathan reported ties with multiple pharmaceutical companies. The remaining authors declared no conflicts of interest.

Citation: McComb M et al. Mult Scler Relat Disord. 2020 Jul 11. doi: 10.1016/j.msard.2020.102389.

Key clinical point: Increased high-density lipoprotein cholesterol (HDL-C) is associated with decreased gray matter and cortical atrophy in patients with multiple sclerosis (MS) after adjusting for baseline serum neurofilaments (sNfL).

Major finding: Gray matter volume and cortical volume had significant associations with percent change in HDL-C (P = .0024 and P less than .001, respectively) after adjusting for sNfL as a predictor.

Study details: This prospective longitudinal study assessed patients with relapsing-remitting MS (n = 75) and progressive multiple sclerosis (n = 37) over a 5-year follow-up period.

Disclosures: The study was funded by the National Center for Advancing Translational Sciences of the National Institutes of Health. B Weinstock-Guttman, J Kuhle, R Zivadinov and M Ramanathan reported ties with multiple pharmaceutical companies. The remaining authors declared no conflicts of interest.

Citation: McComb M et al. Mult Scler Relat Disord. 2020 Jul 11. doi: 10.1016/j.msard.2020.102389.

Key clinical point: Early and continuous ocrelizumab treatment can provide sustained benefit on clinical and magnetic resonance imaging measures for disease progression in patients with relapsing multiple sclerosis (MS).

Major finding: At 5 years, the cumulative proportion of patients with 24-week confirmed disability progression was lower among those who continued ocrelizumab vs those who switched from interferon (IFN) β-1a to ocrelizumab (16.1% vs 21.3%; P = .014). Similarly, brain atrophy was significantly lower among those who continued ocrelizumab than in those who switched to ocrelizumab (P less than .01).

Study details: The OPERA open label extension study evaluated long-term efficacy and safety (5 years follow-up) of ocrelizumab (600 mg) in adults with relapsing MS. Patients previously assigned to INF β-1a  (n = 829) and ocrelizumab (n = 827) entered the open-label extension phase in this study, of which 623 switched to ocrelizumab and 702 continued ocrelizumab, respectively

Disclosures: This study was supported by F. Hoffmann-La Roche Ltd, Basel, Switzerland. The lead author reporting receiving travel reimbursement and writing assistance from F. Hoffmann-La Roche Ltd for CD20-related meetings and presentations. Some of his coinvestigators reported owning stock in, being an employee of, receiving support from, and/or serving on scientific advisory board for F. Hoffmann-La Roche Ltd.

Citation: Hauser SL et al. Neurology. 2020 Jul 20. doi: 10.1212/WNL.0000000000010376.

Key clinical point: Early and continuous ocrelizumab treatment can provide sustained benefit on clinical and magnetic resonance imaging measures for disease progression in patients with relapsing multiple sclerosis (MS).

Major finding: At 5 years, the cumulative proportion of patients with 24-week confirmed disability progression was lower among those who continued ocrelizumab vs those who switched from interferon (IFN) β-1a to ocrelizumab (16.1% vs 21.3%; P = .014). Similarly, brain atrophy was significantly lower among those who continued ocrelizumab than in those who switched to ocrelizumab (P less than .01).

Study details: The OPERA open label extension study evaluated long-term efficacy and safety (5 years follow-up) of ocrelizumab (600 mg) in adults with relapsing MS. Patients previously assigned to INF β-1a  (n = 829) and ocrelizumab (n = 827) entered the open-label extension phase in this study, of which 623 switched to ocrelizumab and 702 continued ocrelizumab, respectively

Disclosures: This study was supported by F. Hoffmann-La Roche Ltd, Basel, Switzerland. The lead author reporting receiving travel reimbursement and writing assistance from F. Hoffmann-La Roche Ltd for CD20-related meetings and presentations. Some of his coinvestigators reported owning stock in, being an employee of, receiving support from, and/or serving on scientific advisory board for F. Hoffmann-La Roche Ltd.

Citation: Hauser SL et al. Neurology. 2020 Jul 20. doi: 10.1212/WNL.0000000000010376.

Key clinical point: Early and continuous ocrelizumab treatment can provide sustained benefit on clinical and magnetic resonance imaging measures for disease progression in patients with relapsing multiple sclerosis (MS).

Major finding: At 5 years, the cumulative proportion of patients with 24-week confirmed disability progression was lower among those who continued ocrelizumab vs those who switched from interferon (IFN) β-1a to ocrelizumab (16.1% vs 21.3%; P = .014). Similarly, brain atrophy was significantly lower among those who continued ocrelizumab than in those who switched to ocrelizumab (P less than .01).

Study details: The OPERA open label extension study evaluated long-term efficacy and safety (5 years follow-up) of ocrelizumab (600 mg) in adults with relapsing MS. Patients previously assigned to INF β-1a  (n = 829) and ocrelizumab (n = 827) entered the open-label extension phase in this study, of which 623 switched to ocrelizumab and 702 continued ocrelizumab, respectively

Disclosures: This study was supported by F. Hoffmann-La Roche Ltd, Basel, Switzerland. The lead author reporting receiving travel reimbursement and writing assistance from F. Hoffmann-La Roche Ltd for CD20-related meetings and presentations. Some of his coinvestigators reported owning stock in, being an employee of, receiving support from, and/or serving on scientific advisory board for F. Hoffmann-La Roche Ltd.

Citation: Hauser SL et al. Neurology. 2020 Jul 20. doi: 10.1212/WNL.0000000000010376.

Key clinical point: Real-world data demonstrates effectiveness of rituximab in reducing disease activity and maintaining long-term treatment in patients with multiple sclerosis (MS).

Major finding: The odds for experiencing a clinical relapse, contrast-enhancing lesions (CEL), and/or new T2 lesions were greater with fingolimod  (adjusted odds ratio [aOR], 3.17; P less than .001)  and dimethyl fumarate (aOR, 2.68; P less than .001) compared with rituximab. Similarly, natalizimab vs rituximab showed higher odds for disease activity (aOR, 1.36; P = 0.216). The odds for discontinuation were higher for fingolimod (aOR, 2.02; P = .005) and dimethyl fumarate (aOR, 3.27; P less than .001) compared with rituximab.

Study details: A retrospective real-world study included MS patients who were initiated on rituximab (n = 182), natalizumab (n = 451), fingolimod (n = 271) or dimethyl fumarate (n = 342) and followed for 2 years.

Disclosures: This study received no funding. KV Nair, JR Corboy, T Vollmer and E Alvarez reported relationships with multiple pharmaceutical companies.

Citation: Vollmer BL et al. Ann Clin Transl Neurol. 2020 Aug 6. doi: 10.1002/acn3.51111.

Key clinical point: Real-world data demonstrates effectiveness of rituximab in reducing disease activity and maintaining long-term treatment in patients with multiple sclerosis (MS).

Major finding: The odds for experiencing a clinical relapse, contrast-enhancing lesions (CEL), and/or new T2 lesions were greater with fingolimod  (adjusted odds ratio [aOR], 3.17; P less than .001)  and dimethyl fumarate (aOR, 2.68; P less than .001) compared with rituximab. Similarly, natalizimab vs rituximab showed higher odds for disease activity (aOR, 1.36; P = 0.216). The odds for discontinuation were higher for fingolimod (aOR, 2.02; P = .005) and dimethyl fumarate (aOR, 3.27; P less than .001) compared with rituximab.

Study details: A retrospective real-world study included MS patients who were initiated on rituximab (n = 182), natalizumab (n = 451), fingolimod (n = 271) or dimethyl fumarate (n = 342) and followed for 2 years.

Disclosures: This study received no funding. KV Nair, JR Corboy, T Vollmer and E Alvarez reported relationships with multiple pharmaceutical companies.

Citation: Vollmer BL et al. Ann Clin Transl Neurol. 2020 Aug 6. doi: 10.1002/acn3.51111.

Key clinical point: Real-world data demonstrates effectiveness of rituximab in reducing disease activity and maintaining long-term treatment in patients with multiple sclerosis (MS).

Major finding: The odds for experiencing a clinical relapse, contrast-enhancing lesions (CEL), and/or new T2 lesions were greater with fingolimod  (adjusted odds ratio [aOR], 3.17; P less than .001)  and dimethyl fumarate (aOR, 2.68; P less than .001) compared with rituximab. Similarly, natalizimab vs rituximab showed higher odds for disease activity (aOR, 1.36; P = 0.216). The odds for discontinuation were higher for fingolimod (aOR, 2.02; P = .005) and dimethyl fumarate (aOR, 3.27; P less than .001) compared with rituximab.

Study details: A retrospective real-world study included MS patients who were initiated on rituximab (n = 182), natalizumab (n = 451), fingolimod (n = 271) or dimethyl fumarate (n = 342) and followed for 2 years.

Disclosures: This study received no funding. KV Nair, JR Corboy, T Vollmer and E Alvarez reported relationships with multiple pharmaceutical companies.

Citation: Vollmer BL et al. Ann Clin Transl Neurol. 2020 Aug 6. doi: 10.1002/acn3.51111.

Key clinical point: Elevated blood lipid parameters in patients with multiple sclerosis (MS) may harm cognitive functions.

Major finding: A negative correlation was observed between cholesterol and general cognitive functioning score after rehabilitation and the Expanded Disability Status Scale scores (Cronbach alpha, 0.60 and 0.65, respectively). Triglyceride scores also has a negative correlation with working memory scores before and after rehabilitation (Cronbach alpha, 0.36 and 0.40, respectively). Furthermore, body mass index scores had a negative correlation with the visuospatial ability (Cronbach alpha, 0.59)

Study details: The study included 90 inpatients with relapsing remitting, primary and secondary progressive MS who underwent intense neurorehabilitation training.

Disclosures: The study received no funding. The authors reported no conflicts of interest.

Citation: Andaloro A et al. Int J Neurosci. 2020 Aug 7. doi: 10.1080/00207454.2020.1807980.

Key clinical point: Elevated blood lipid parameters in patients with multiple sclerosis (MS) may harm cognitive functions.

Major finding: A negative correlation was observed between cholesterol and general cognitive functioning score after rehabilitation and the Expanded Disability Status Scale scores (Cronbach alpha, 0.60 and 0.65, respectively). Triglyceride scores also has a negative correlation with working memory scores before and after rehabilitation (Cronbach alpha, 0.36 and 0.40, respectively). Furthermore, body mass index scores had a negative correlation with the visuospatial ability (Cronbach alpha, 0.59)

Study details: The study included 90 inpatients with relapsing remitting, primary and secondary progressive MS who underwent intense neurorehabilitation training.

Disclosures: The study received no funding. The authors reported no conflicts of interest.

Citation: Andaloro A et al. Int J Neurosci. 2020 Aug 7. doi: 10.1080/00207454.2020.1807980.

Key clinical point: Elevated blood lipid parameters in patients with multiple sclerosis (MS) may harm cognitive functions.

Major finding: A negative correlation was observed between cholesterol and general cognitive functioning score after rehabilitation and the Expanded Disability Status Scale scores (Cronbach alpha, 0.60 and 0.65, respectively). Triglyceride scores also has a negative correlation with working memory scores before and after rehabilitation (Cronbach alpha, 0.36 and 0.40, respectively). Furthermore, body mass index scores had a negative correlation with the visuospatial ability (Cronbach alpha, 0.59)

Study details: The study included 90 inpatients with relapsing remitting, primary and secondary progressive MS who underwent intense neurorehabilitation training.

Disclosures: The study received no funding. The authors reported no conflicts of interest.

Citation: Andaloro A et al. Int J Neurosci. 2020 Aug 7. doi: 10.1080/00207454.2020.1807980.

Key clinical point: Early and continuous ocrelizumab treatment can provide sustained benefit on clinical and magnetic resonance imaging measures for disease progression in patients with relapsing multiple sclerosis (MS).

Major finding: At 5 years, the cumulative proportion of patients with 24-week confirmed disability progression was lower among those who continued ocrelizumab vs those who switched from interferon (IFN) β-1a to ocrelizumab (16.1% vs 21.3%; P = .014). Similarly, brain atrophy was significantly lower among those who continued ocrelizumab than in those who switched to ocrelizumab (P less than .01).

Study details: The OPERA open label extension study evaluated long-term efficacy and safety (5 years follow-up) of ocrelizumab (600 mg) in adults with relapsing MS. Patients previously assigned to INF β-1a  (n = 829) and ocrelizumab (n = 827) entered the open-label extension phase in this study, of which 623 switched to ocrelizumab and 702 continued ocrelizumab, respectively

Disclosures: This study was supported by F. Hoffmann-La Roche Ltd, Basel, Switzerland. The lead author reporting receiving travel reimbursement and writing assistance from F. Hoffmann-La Roche Ltd for CD20-related meetings and presentations. Some of his coinvestigators reported owning stock in, being an employee of, receiving support from, and/or serving on scientific advisory board for F. Hoffmann-La Roche Ltd.

Citation: Hauser SL et al. Neurology. 2020 Jul 20. doi: 10.1212/WNL.0000000000010376.

Key clinical point: Early and continuous ocrelizumab treatment can provide sustained benefit on clinical and magnetic resonance imaging measures for disease progression in patients with relapsing multiple sclerosis (MS).

Major finding: At 5 years, the cumulative proportion of patients with 24-week confirmed disability progression was lower among those who continued ocrelizumab vs those who switched from interferon (IFN) β-1a to ocrelizumab (16.1% vs 21.3%; P = .014). Similarly, brain atrophy was significantly lower among those who continued ocrelizumab than in those who switched to ocrelizumab (P less than .01).

Study details: The OPERA open label extension study evaluated long-term efficacy and safety (5 years follow-up) of ocrelizumab (600 mg) in adults with relapsing MS. Patients previously assigned to INF β-1a  (n = 829) and ocrelizumab (n = 827) entered the open-label extension phase in this study, of which 623 switched to ocrelizumab and 702 continued ocrelizumab, respectively

Disclosures: This study was supported by F. Hoffmann-La Roche Ltd, Basel, Switzerland. The lead author reporting receiving travel reimbursement and writing assistance from F. Hoffmann-La Roche Ltd for CD20-related meetings and presentations. Some of his coinvestigators reported owning stock in, being an employee of, receiving support from, and/or serving on scientific advisory board for F. Hoffmann-La Roche Ltd.

Citation: Hauser SL et al. Neurology. 2020 Jul 20. doi: 10.1212/WNL.0000000000010376.

Key clinical point: Early and continuous ocrelizumab treatment can provide sustained benefit on clinical and magnetic resonance imaging measures for disease progression in patients with relapsing multiple sclerosis (MS).

Major finding: At 5 years, the cumulative proportion of patients with 24-week confirmed disability progression was lower among those who continued ocrelizumab vs those who switched from interferon (IFN) β-1a to ocrelizumab (16.1% vs 21.3%; P = .014). Similarly, brain atrophy was significantly lower among those who continued ocrelizumab than in those who switched to ocrelizumab (P less than .01).

Study details: The OPERA open label extension study evaluated long-term efficacy and safety (5 years follow-up) of ocrelizumab (600 mg) in adults with relapsing MS. Patients previously assigned to INF β-1a  (n = 829) and ocrelizumab (n = 827) entered the open-label extension phase in this study, of which 623 switched to ocrelizumab and 702 continued ocrelizumab, respectively

Disclosures: This study was supported by F. Hoffmann-La Roche Ltd, Basel, Switzerland. The lead author reporting receiving travel reimbursement and writing assistance from F. Hoffmann-La Roche Ltd for CD20-related meetings and presentations. Some of his coinvestigators reported owning stock in, being an employee of, receiving support from, and/or serving on scientific advisory board for F. Hoffmann-La Roche Ltd.

Citation: Hauser SL et al. Neurology. 2020 Jul 20. doi: 10.1212/WNL.0000000000010376.

Key clinical point: Increased high-density lipoprotein cholesterol (HDL-C) is associated with decreased gray matter and cortical atrophy in patients with multiple sclerosis (MS) after adjusting for baseline serum neurofilaments (sNfL).

Major finding: Gray matter volume and cortical volume had significant associations with percent change in HDL-C (P = .0024 and P less than .001, respectively) after adjusting for sNfL as a predictor.

Study details: This prospective longitudinal study assessed patients with relapsing-remitting MS (n = 75) and progressive multiple sclerosis (n = 37) over a 5-year follow-up period.

Disclosures: The study was funded by the National Center for Advancing Translational Sciences of the National Institutes of Health. B Weinstock-Guttman, J Kuhle, R Zivadinov and M Ramanathan reported ties with multiple pharmaceutical companies. The remaining authors declared no conflicts of interest.

Citation: McComb M et al. Mult Scler Relat Disord. 2020 Jul 11. doi: 10.1016/j.msard.2020.102389.

Key clinical point: Increased high-density lipoprotein cholesterol (HDL-C) is associated with decreased gray matter and cortical atrophy in patients with multiple sclerosis (MS) after adjusting for baseline serum neurofilaments (sNfL).

Major finding: Gray matter volume and cortical volume had significant associations with percent change in HDL-C (P = .0024 and P less than .001, respectively) after adjusting for sNfL as a predictor.

Study details: This prospective longitudinal study assessed patients with relapsing-remitting MS (n = 75) and progressive multiple sclerosis (n = 37) over a 5-year follow-up period.

Disclosures: The study was funded by the National Center for Advancing Translational Sciences of the National Institutes of Health. B Weinstock-Guttman, J Kuhle, R Zivadinov and M Ramanathan reported ties with multiple pharmaceutical companies. The remaining authors declared no conflicts of interest.

Citation: McComb M et al. Mult Scler Relat Disord. 2020 Jul 11. doi: 10.1016/j.msard.2020.102389.

Key clinical point: Increased high-density lipoprotein cholesterol (HDL-C) is associated with decreased gray matter and cortical atrophy in patients with multiple sclerosis (MS) after adjusting for baseline serum neurofilaments (sNfL).

Major finding: Gray matter volume and cortical volume had significant associations with percent change in HDL-C (P = .0024 and P less than .001, respectively) after adjusting for sNfL as a predictor.

Study details: This prospective longitudinal study assessed patients with relapsing-remitting MS (n = 75) and progressive multiple sclerosis (n = 37) over a 5-year follow-up period.

Disclosures: The study was funded by the National Center for Advancing Translational Sciences of the National Institutes of Health. B Weinstock-Guttman, J Kuhle, R Zivadinov and M Ramanathan reported ties with multiple pharmaceutical companies. The remaining authors declared no conflicts of interest.

Citation: McComb M et al. Mult Scler Relat Disord. 2020 Jul 11. doi: 10.1016/j.msard.2020.102389.

Key clinical point: Natalizumab is effective on the inflammatory phase of relapsing-remitting multiple sclerosis (RRMS). The frequency of poor outcomes is low and are predicted by disease activity criteria.

Major finding: At 10 years, the cumulative probabilities for secondary progressive multiple sclerosis (SPMS) conversion, Expanded Disability Status Scale (EDSS) worsening, reaching EDSS-4 and EDSS-6 were 23.7%, 30.4%, 25.1%, and 12.4%, respectively with natalizumab. The mean reduction in annualized relapsed rate at 10 years was 97.5% (P less than .0001). Factors predictive of disability at the long-term were not reaching ‘no evidence of disease activity’ (NEDA)-3, MRI worsening, increased EDSS score, and to a lesser extent the occurrence of relapse.

Study details: TYSTEN was a real-life observational study that assessed 770 patients with RRMS starting Natalizumab between 2007 and 2012. The mean follow-up duration was 97.2 months and mean treatment duration for natalizumab was 66 months.

Disclosures: The study received no funding. The presenting author had no disclosures. Some of his coinvestigators reported ties with Biogen Idec.

Citation: Bigaut K et al. Mult Scler. 2020 Jul 9. doi: 10.1177/1352458520936239.

Key clinical point: Natalizumab is effective on the inflammatory phase of relapsing-remitting multiple sclerosis (RRMS). The frequency of poor outcomes is low and are predicted by disease activity criteria.

Major finding: At 10 years, the cumulative probabilities for secondary progressive multiple sclerosis (SPMS) conversion, Expanded Disability Status Scale (EDSS) worsening, reaching EDSS-4 and EDSS-6 were 23.7%, 30.4%, 25.1%, and 12.4%, respectively with natalizumab. The mean reduction in annualized relapsed rate at 10 years was 97.5% (P less than .0001). Factors predictive of disability at the long-term were not reaching ‘no evidence of disease activity’ (NEDA)-3, MRI worsening, increased EDSS score, and to a lesser extent the occurrence of relapse.

Study details: TYSTEN was a real-life observational study that assessed 770 patients with RRMS starting Natalizumab between 2007 and 2012. The mean follow-up duration was 97.2 months and mean treatment duration for natalizumab was 66 months.

Disclosures: The study received no funding. The presenting author had no disclosures. Some of his coinvestigators reported ties with Biogen Idec.

Citation: Bigaut K et al. Mult Scler. 2020 Jul 9. doi: 10.1177/1352458520936239.

Key clinical point: Natalizumab is effective on the inflammatory phase of relapsing-remitting multiple sclerosis (RRMS). The frequency of poor outcomes is low and are predicted by disease activity criteria.

Major finding: At 10 years, the cumulative probabilities for secondary progressive multiple sclerosis (SPMS) conversion, Expanded Disability Status Scale (EDSS) worsening, reaching EDSS-4 and EDSS-6 were 23.7%, 30.4%, 25.1%, and 12.4%, respectively with natalizumab. The mean reduction in annualized relapsed rate at 10 years was 97.5% (P less than .0001). Factors predictive of disability at the long-term were not reaching ‘no evidence of disease activity’ (NEDA)-3, MRI worsening, increased EDSS score, and to a lesser extent the occurrence of relapse.

Study details: TYSTEN was a real-life observational study that assessed 770 patients with RRMS starting Natalizumab between 2007 and 2012. The mean follow-up duration was 97.2 months and mean treatment duration for natalizumab was 66 months.

Disclosures: The study received no funding. The presenting author had no disclosures. Some of his coinvestigators reported ties with Biogen Idec.

Citation: Bigaut K et al. Mult Scler. 2020 Jul 9. doi: 10.1177/1352458520936239.

Key clinical point: Stressful life events are associated with an increased risk of developing multiple sclerosis (MS).

Major finding: Stressful major life events that happened prior to disease onset significantly increased the risk by 17%-30%. Women were more vulnerable than men under certain stressful scenarios such as conflict at work or within families, marriage, sickness, or accident of family members.

Study details: A large Swedish case-control study of 2,930 patients with MS and 6,170 control participants.

Disclosures: Dr. Jiang was supported by a starting package from the Swedish Research Council.

Citation: Jiang X et al. Eur J Neurol. 2020 Aug 2. doi: 10.1111/ene.14458.

Key clinical point: Stressful life events are associated with an increased risk of developing multiple sclerosis (MS).

Major finding: Stressful major life events that happened prior to disease onset significantly increased the risk by 17%-30%. Women were more vulnerable than men under certain stressful scenarios such as conflict at work or within families, marriage, sickness, or accident of family members.

Study details: A large Swedish case-control study of 2,930 patients with MS and 6,170 control participants.

Disclosures: Dr. Jiang was supported by a starting package from the Swedish Research Council.

Citation: Jiang X et al. Eur J Neurol. 2020 Aug 2. doi: 10.1111/ene.14458.

Key clinical point: Stressful life events are associated with an increased risk of developing multiple sclerosis (MS).

Major finding: Stressful major life events that happened prior to disease onset significantly increased the risk by 17%-30%. Women were more vulnerable than men under certain stressful scenarios such as conflict at work or within families, marriage, sickness, or accident of family members.

Study details: A large Swedish case-control study of 2,930 patients with MS and 6,170 control participants.

Disclosures: Dr. Jiang was supported by a starting package from the Swedish Research Council.

Citation: Jiang X et al. Eur J Neurol. 2020 Aug 2. doi: 10.1111/ene.14458.

Key clinical point: Higher Expanded Disability Status Scale (EDSS) score is associated with an unfavorable urologic course in patients with multiple sclerosis (MS), and increased postvoid residual volume (PVR) correlates with male gender, EDSS, and disease course.

Major finding: The presence of lower urinary tract symptoms (LUTS) was more frequently associated with a primary progressive disease course (P = .040), a higher level of disability (mean EDSS of 6.4, P = .011), and urinary tract infection (P = .002). PVR values were higher in patients with LUTS vs. those without (P = .011). Increased PVR correlated with male gender (P less than .001), EDSS score (P = .005), and disease course (P = .041). Higher PVR correlated with incontinence (P = .007), chronic urinary retention (P less than .001), incomplete emptying (P = .015), and diminished stream intensity (P = .040).

Study details: The findings are based on a study of 501 patients with clinically definite MS (68.9% females; mean age: 56.0 ± 12.3 years).

Disclosures: No study sponsor was identified. The authors declared no conflicts of interest.

Citation: Monti Bragadin M et al. Mult Scler Relat Disord. 2020 Jul 5. doi: 10.1016/j.msard.2020.102378.

Key clinical point: Higher Expanded Disability Status Scale (EDSS) score is associated with an unfavorable urologic course in patients with multiple sclerosis (MS), and increased postvoid residual volume (PVR) correlates with male gender, EDSS, and disease course.

Major finding: The presence of lower urinary tract symptoms (LUTS) was more frequently associated with a primary progressive disease course (P = .040), a higher level of disability (mean EDSS of 6.4, P = .011), and urinary tract infection (P = .002). PVR values were higher in patients with LUTS vs. those without (P = .011). Increased PVR correlated with male gender (P less than .001), EDSS score (P = .005), and disease course (P = .041). Higher PVR correlated with incontinence (P = .007), chronic urinary retention (P less than .001), incomplete emptying (P = .015), and diminished stream intensity (P = .040).

Study details: The findings are based on a study of 501 patients with clinically definite MS (68.9% females; mean age: 56.0 ± 12.3 years).

Disclosures: No study sponsor was identified. The authors declared no conflicts of interest.

Citation: Monti Bragadin M et al. Mult Scler Relat Disord. 2020 Jul 5. doi: 10.1016/j.msard.2020.102378.

Key clinical point: Higher Expanded Disability Status Scale (EDSS) score is associated with an unfavorable urologic course in patients with multiple sclerosis (MS), and increased postvoid residual volume (PVR) correlates with male gender, EDSS, and disease course.

Major finding: The presence of lower urinary tract symptoms (LUTS) was more frequently associated with a primary progressive disease course (P = .040), a higher level of disability (mean EDSS of 6.4, P = .011), and urinary tract infection (P = .002). PVR values were higher in patients with LUTS vs. those without (P = .011). Increased PVR correlated with male gender (P less than .001), EDSS score (P = .005), and disease course (P = .041). Higher PVR correlated with incontinence (P = .007), chronic urinary retention (P less than .001), incomplete emptying (P = .015), and diminished stream intensity (P = .040).

Study details: The findings are based on a study of 501 patients with clinically definite MS (68.9% females; mean age: 56.0 ± 12.3 years).

Disclosures: No study sponsor was identified. The authors declared no conflicts of interest.

Citation: Monti Bragadin M et al. Mult Scler Relat Disord. 2020 Jul 5. doi: 10.1016/j.msard.2020.102378.

Key clinical point: In patients with relapsing-remitting multiple sclerosis (RRMS), initiating high-efficacy disease-modifying therapies (heDMT) lowers the risk of Expanded Disability Status Scale (EDSS) score worsening and relapses compared to initiating medium-efficacy DMT (meDMT).

Major finding: The absolute probabilities of a 6-month confirmed EDSS score worsening at 2- and 4-year follow-ups were 11.5% and 16.7% for heDMT initiators and 18.3% and 30.1% for meDMT initiators, respectively (hazard ratio [HR], 0.53; P = .006). The heDMT initiators had a lower probability of a first relapse than meDMT initiators (HR, 0.50; 95% confidence interval, 0.37-0.67).

Study details: In this Danish population-based study, 194 patients with RRMS starting initial therapy with heDMT were matched to 194 patients starting meDMT.

Disclosures: There was no targeted funding. The presenting author reported receiving support for congress participation from Roche.

Citation: Buron MD et al. Neurology. 2020 Jul 7. doi: 10.1212/WNL.0000000000010135.

Key clinical point: In patients with relapsing-remitting multiple sclerosis (RRMS), initiating high-efficacy disease-modifying therapies (heDMT) lowers the risk of Expanded Disability Status Scale (EDSS) score worsening and relapses compared to initiating medium-efficacy DMT (meDMT).

Major finding: The absolute probabilities of a 6-month confirmed EDSS score worsening at 2- and 4-year follow-ups were 11.5% and 16.7% for heDMT initiators and 18.3% and 30.1% for meDMT initiators, respectively (hazard ratio [HR], 0.53; P = .006). The heDMT initiators had a lower probability of a first relapse than meDMT initiators (HR, 0.50; 95% confidence interval, 0.37-0.67).

Study details: In this Danish population-based study, 194 patients with RRMS starting initial therapy with heDMT were matched to 194 patients starting meDMT.

Disclosures: There was no targeted funding. The presenting author reported receiving support for congress participation from Roche.

Citation: Buron MD et al. Neurology. 2020 Jul 7. doi: 10.1212/WNL.0000000000010135.

Key clinical point: In patients with relapsing-remitting multiple sclerosis (RRMS), initiating high-efficacy disease-modifying therapies (heDMT) lowers the risk of Expanded Disability Status Scale (EDSS) score worsening and relapses compared to initiating medium-efficacy DMT (meDMT).

Major finding: The absolute probabilities of a 6-month confirmed EDSS score worsening at 2- and 4-year follow-ups were 11.5% and 16.7% for heDMT initiators and 18.3% and 30.1% for meDMT initiators, respectively (hazard ratio [HR], 0.53; P = .006). The heDMT initiators had a lower probability of a first relapse than meDMT initiators (HR, 0.50; 95% confidence interval, 0.37-0.67).

Study details: In this Danish population-based study, 194 patients with RRMS starting initial therapy with heDMT were matched to 194 patients starting meDMT.

Disclosures: There was no targeted funding. The presenting author reported receiving support for congress participation from Roche.

Citation: Buron MD et al. Neurology. 2020 Jul 7. doi: 10.1212/WNL.0000000000010135.