Multiple sclerosis in older adults: the clinical profile and impact of interferon Beta treatment.
BACKGROUND
We examined (1) patient characteristics and disease-modifying drug (DMD) exposure in late-onset (LOMS, ≥50 years at symptom onset) versus adult-onset (AOMS, 18-<50 years) MS and (2) the association between interferon-beta (IFNβ) and disability progression in older relapsing-onset MS adults (≥50 years).


METHODS
This retrospective study (1980-2004, British Columbia, Canada) included 358 LOMS and 5627 AOMS patients. IFNβ-treated relapsing-onset MS patients aged ≥50 (regardless of onset age, 90) were compared with 171 contemporary and 106 historical controls. Times to EDSS 6 from onset and from IFNβ eligibility were examined using survival analyses.


RESULTS
LOMS patients (6%) were more likely to be male, with motor onset and a primary-progressive course, and exhibit faster progression and were less likely to take DMDs. Nonetheless, 57% were relapsing-onset, of which 31% were prescribed DMDs, most commonly IFNβ. Among older relapsing-onset MS adults, no significant association between IFNβ exposure and disability progression was found when either the contemporary (hazard ratio [HR]: 0.46; 95% CI: 0.18-1.22) or historical controls (HR: 0.54; 95% CI: 0.20-1.42) were considered.


CONCLUSIONS
LOMS differed clinically from AOMS. One-third of older relapsing-onset MS patients were prescribed a DMD. IFNβ exposure was not significantly associated with reduced disability in older MS patients.
Department of Medicine, Division of Neurology and Brain Research Centre, UBC Hospital, University of British Columbia, 2211 Wesbrook Mall, Vancouver, BC, Canada V6T 2B5.
Afsaneh
A
Shirani
Department of Medicine, Division of Neurology and Brain Research Centre, UBC Hospital, University of British Columbia, 2211 Wesbrook Mall, Vancouver, BC, Canada V6T 2B5.
Yinshan
Y
Zhao
Department of Statistics, University of British Columbia, 3182 Earth Sciences Building, 2207 Main Mall, Vancouver, BC, Canada V6T 1Z4.
John
J
Petkau
Department of Statistics, University of British Columbia, 3182 Earth Sciences Building, 2207 Main Mall, Vancouver, BC, Canada V6T 1Z4.
Paul
P
Gustafson
Department of Statistics, University of British Columbia, 3182 Earth Sciences Building, 2207 Main Mall, Vancouver, BC, Canada V6T 1Z4.
Mohammad Ehsanul
0000-0002-0346-2871
ME
Karim
College of Pharmacy and Nutrition, University of Saskatchewan, 110 Science Place, Saskatoon, SK, Canada S7N 5C9.
Charity
0000-0003-1409-0214
C
Evans
Department of Medicine, Division of Neurology and Brain Research Centre, UBC Hospital, University of British Columbia, 2211 Wesbrook Mall, Vancouver, BC, Canada V6T 2B5.
Elaine
0000-0002-1956-1700
E
Kingwell
Department of Medicine, Division of Neurology and Brain Research Centre, UBC Hospital, University of British Columbia, 2211 Wesbrook Mall, Vancouver, BC, Canada V6T 2B5 ; Department of Public Health Sciences, Karolinska Institutet, 171 77 Stockholm, Sweden.
Mia L
ML
van der Kop
Department of Medicine, Division of Neurology and Brain Research Centre, UBC Hospital, University of British Columbia, 2211 Wesbrook Mall, Vancouver, BC, Canada V6T 2B5.
Joel
J
Oger
Department of Medicine, Division of Neurology and Brain Research Centre, UBC Hospital, University of British Columbia, 2211 Wesbrook Mall, Vancouver, BC, Canada V6T 2B5.
Helen
H
Tremlett
D017668:Age of Onset; D000368:Aged; D002170:Canada; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D016899:Interferon-beta / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000188:drug therapy* / Q000453:epidemiology* / Q000503:physiopathology
D016899:Interferon-beta