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Abstract Details

Baseline predictors of disability worsening among patients wth a Clinically Isolated Syndrome.
Multiple Sclerosis
P5 - Poster Session 5 (11:45 AM-12:45 PM)
3-015
A large amount of evidence has been accumulated concerning several prognostic factors that could help detect patients with aggressive MS, but the identification of patients with MS at higher risk of progression still needs to be refined.
To determine which variables at disease onset might independently predict disability worsening in patients with clinically isolated syndrome (CIS), and whether disease-modifying treatments (DMTs) might prevent a worse evolution.
Single-center, observational study from June 1996 to August 2022. All consecutive patients with a clinically isolated syndrome (CIS) with CSF and serum obtained within 12 months from disease onset were prospectively collected. Multivariable Cox regression models were used to study the risk of 6-month confirmed disability worsening (6mCDW), Expanded Disability Status Scale (EDSS) score of 3, relapse-associated worsening (RAW), and progression independent of relapse activity (PIRA).

We included 327 patients with a median (interquartile range, IQR) age at first symptom of 33.9 (27.1–42.4) years and a median (IQR) follow-up of 5.43 (3.17–9.08) years. A higher T2 lesion load and higher baseline EDSS were associated with higher risk of 6mCDW and EDSS of 3. However, sNfL >10 pg/ml and LS-OCMB showed the highest risk of both outcomes. In contrast, DMTs, but especially HE-DMTs, were associated with a lower risk of 6mCDW and EDSS 3. A higher risk of RAW was observed only among patients with high sNfL levels and LS-OCMB, counteracted by DMTs. However, no effect was observed with DMTs in the risk of PIRA and the only predictors of a higher risk of this outcome were a higher age of disease onset and LS-OCMB. 

Biomarkers such as LS-OCMB and sNfL levels obtained within first year of disease might predict patients with a higher risk of disability worsening among patients with a CIS. These patients are optimal candidates to receive early DMTs, especially HE-DMTs.
Authors/Disclosures
Enric Monreal Laguillo
PRESENTER
Enric Monreal Laguillo has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Enric Monreal Laguillo has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Enric Monreal Laguillo has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi. Enric Monreal Laguillo has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck. Enric Monreal Laguillo has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Bristol-Myers Squibb. Enric Monreal Laguillo has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Biogen. Enric Monreal Laguillo has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Sanofi. Enric Monreal Laguillo has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Novartis. Enric Monreal Laguillo has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Merck. Enric Monreal Laguillo has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Janssen. Enric Monreal Laguillo has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Bristol-Myers Squibb.
José Ignacio Fernández Velasco (Hospital Universitario Ramón y Cajal) José Ignacio Fernández Velasco has nothing to disclose.
Susana Sainz de la Maza Susana Sainz de la Maza has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Almirall, Biogen, Merck, Novartis, Roche and Sanofi-Genzyme.
Noelia Villarrubia (Ramon y Cajal University Hospital) Noelia Villarrubia has nothing to disclose.
Mercedes Espiño No disclosure on file
Fernando Rodriguez Jorge, PhD Dr. Rodriguez Jorge has received personal compensation in the range of $0-$499 for serving as a Consultant for Bial. Dr. Rodriguez Jorge has received personal compensation in the range of $0-$499 for serving as a Consultant for Sanofi.
Juan Luis Chico-Garcia, MD (Hospital Ramon y Cajal) Dr. Chico-Garcia has received personal compensation in the range of $0-$499 for serving as a Consultant for BIAL. Dr. Chico-Garcia has received personal compensation in the range of $0-$499 for serving on a Speakers Bureau for SANOFI.
Jaime Masjuanvallejo (Viajes Itaca) Jaime Masjuanvallejo has nothing to disclose.
Lucienne Costa Costa-Frossard Franca, Sr., PhD (Hospital Universitario Ramón y Cajal) Dr. Franca has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Almirall. Dr. Franca has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Biogen. Dr. Franca has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Bayer. Dr. Franca has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Biopas. Dr. Franca has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Bristoll-Mayer. Dr. Franca has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Ipsen. Dr. Franca has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Merck. Dr. Franca has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Novartis. Dr. Franca has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Sanofi. Dr. Franca has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Teva. Dr. Franca has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Roche.
Luisa M. Villar (Hospital Ramon Y Cajal) Luisa M. Villar has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Luisa M. Villar has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Bristol-Myers Squibb. Luisa M. Villar has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Sanofi. Luisa M. Villar has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Merck. Luisa M. Villar has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Roche. Luisa M. Villar has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Novartis. Luisa M. Villar has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Bristol-Myers Squibb. The institution of Luisa M. Villar has received research support from European Union. The institution of Luisa M. Villar has received research support from Instituto de Salud Carlos III (Spanish Goverment).