title: The influence of immunomodulatory treatment on the clinical course of multiple sclerosis.
abstract: BACKGROUND
  Multiple sclerosis (MS) is a chronic disease of the central nervous system. One of the major questions concerning the clinical progression of MS, still insufficiently elaborated or confirmed, is if it can be slowed down or augmented by external factors. Immunomodulatory treatment is a disease modifiable factor shown to influence disease progression of various medical conditions.
  
  
  OBJECTIVE
  To investigate if treatment affects the long-term clinical progression of MS, measured as time from diagnosis to score of 4 or higher of Expanded Disability Status Scale (EDSS).
  
  
  METHODS
  Longitudinal, prospective data concerning treatment status and EDSS were collected by health professionals in the Swedish MS Registry. Study cohort comprised new diagnosed MS patients at Karolinska Hospital between 2001 and 2005. Survival analysis adjusted for suspected confounders was used with the outcome variable time from diagnosis to EDSS ≥ 4.
  
  
  RESULTS
  Early treatment was correlated with longer time from diagnosis to EDSS ≥ 4 (HR: 1.77; 95 % CI: 1.15-2.73; p = 0.01). Additionally, the influence of the covariates-age at onset and the baseline EDSS, which were statistically significant with hazard ratios of 1.03 and 2.1, respectively, was found.
  
  
  CONCLUSIONS
  Early treatment was associated with a better clinical outcome.
authors.affiliation: Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden, andrius.kavaliunas@ki.se.
authors.forename: Andrius
authors.initials: A
authors.lastname: Kavaliunas
authors.forename: Leszek
authors.initials: L
authors.lastname: Stawiarz
authors.forename: Jonas
authors.initials: J
authors.lastname: Hedbom
authors.forename: Anna
authors.initials: A
authors.lastname: Glaser
authors.forename: Jan
authors.initials: J
authors.lastname: Hillert
mesh_terms: D017668:Age of Onset; D005260:Female; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use*; D053208:Kaplan-Meier Estimate; D008137:Longitudinal Studies; D008297:Male; D009103:Multiple Sclerosis / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D011379:Prognosis; D011446:Prospective Studies; D012042:Registries / Q000706:statistics & numerical data*; D013548:Sweden / Q000453:epidemiology; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D007155:Immunologic Factors