title: A predictive model for corticosteroid response in individual patients with MS relapses.
abstract: OBJECTIVE
  To derive a simple predictive model to guide the use of corticosteroids in patients with relapsing remitting MS suffering an acute relapse.
  
  
  METHODS
  We analysed individual patient randomised controlled trial data (n=98) using a binary logistic regression model based on age, gender, baseline disability scores [physician-observed: expanded disability status scale (EDSS) and patient reported: multiple sclerosis impact scale 29 (MSIS-29)], and the time intervals between symptom onset or referral and treatment.
  
  
  RESULTS
  Based on two a priori selected cut-off points (improvement in EDSS ≥ 0.5 and ≥ 1.0), we found that variables which predicted better response to corticosteroids after 6 weeks were younger age and lower MSIS-29 physical score at the time of relapse (model fit 71.2% - 73.1%).
  
  
  CONCLUSIONS
  This pilot study suggests two clinical variables which may predict the majority of the response to corticosteroid treatment in patients undergoing an MS relapse. The study is limited in being able to clearly distinguish factors associated with treatment response or spontaneous recovery and needs to be replicated in a larger prospective study.
authors.affiliation: Queen Square Multiple Sclerosis Centre, Department of Neuroinflammation, UCL Institute of Neurology, University College London and National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, United Kingdom.
authors.forename: Martin
authors.initials: M
authors.lastname: Rakusa
authors.affiliation: Clinical Neurology Research Group, Room N16 ITTC Building, Plymouth University Peninsula Schools of Medicine and Dentistry, Tamar Science Park, Davy Road, Plymouth, United Kingdom.
authors.forename: Stefan J
authors.initials: SJ
authors.lastname: Cano
authors.affiliation: Queen Square Multiple Sclerosis Centre, Department of Neuroinflammation, UCL Institute of Neurology, University College London and National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, United Kingdom.
authors.forename: Bernadette
authors.initials: B
authors.lastname: Porter
authors.affiliation: University College London, Institute of Neurology, Dept of Brain Repair and Rehabilitation, London, United Kingdom; Department of Psychology, Royal Holloway, University of London, Surrey, United Kingdom.
authors.forename: Afsane
authors.initials: A
authors.lastname: Riazi
authors.affiliation: Queen Square Multiple Sclerosis Centre, Department of Neuroinflammation, UCL Institute of Neurology, University College London and National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, United Kingdom; University College London, Institute of Neurology, Dept of Brain Repair and Rehabilitation, London, United Kingdom.
authors.forename: Alan J
authors.initials: AJ
authors.lastname: Thompson
authors.affiliation: Queen Square Multiple Sclerosis Centre, Department of Neuroinflammation, UCL Institute of Neurology, University College London and National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, United Kingdom.
authors.forename: Jeremy
authors.initials: J
authors.lastname: Chataway
authors.affiliation: Queen Square Multiple Sclerosis Centre, Department of Neuroinflammation, UCL Institute of Neurology, University College London and National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, United Kingdom; MS Clinic, Brain & Mind Research Institute, University of Sydney, Sydney, Australia; Neuroimmunology Clinic, Concord Repatriation General Hospital, Sydney, Australia.
authors.forename: Todd A
authors.initials: TA
authors.lastname: Hardy
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D015233:Models, Statistical; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000175:diagnosis / Q000188:drug therapy*; D011379:Prognosis; D016896:Treatment Outcome
chemical_list: D000305:Adrenal Cortex Hormones