title: Factors associated with benign multiple sclerosis in the New York State MS Consortium (NYSMSC).
abstract: BACKGROUND
  This retrospective analysis explored prognostic factors associated with a benign multiple sclerosis (BMS) disease course at baseline and over the 4-year follow-up.
  
  
  METHODS
  Patients from the centralized New York State Multiple Sclerosis Consortium registry were classified as having BMS according to 3 different criteria centered on disease duration and disability. Additional analyses explored prognostic factors associated with BMS using the most conservative disability criteria (Expanded Disability Status Scale ≤2 and disease duration ≥10 years).
  
  
  RESULTS
  Among 6258 patients who fulfilled eligibility criteria, 19.8 % to 33.3 % were characterized as having BMS, at baseline depending on classification criteria used. Positive prognostic factors for BMS at baseline included female sex (p < 0.0001) and younger age at onset (p < 0.0001); negative prognostic factors included progressive-onset type of MS and African-American race. Of the 1237 BMS patients (per most conservative criteria), 742 were followed for a median of 4 years to explore effect of disease-modifying treatment (DMT) on benign status. DMT (p = 0.009) and longer disease duration (p = 0.007) were the only significant positive predictors of maintaining BMS at follow-up. The protective effect was stronger for patients taking DMT at both enrollment and follow-up (OR = 0.71; p = 0.006).
  
  
  CONCLUSIONS
  There is a need for development of more reliable prognostic indicators of BMS. Use of DMT was significantly associated with maintaining a benign disease state.
authors.affiliation: Buffalo Neuroimaging Analysis Center, Department of Neurology, School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA. rzivadinov@bnac.net.|Department of Neurology, School of Medicine and Biomedical Sciences, University at Buffalo, 100 High Street, Buffalo, NY, 14203, USA. rzivadinov@bnac.net.
authors.forename: Robert
authors.initials: R
authors.lastname: Zivadinov
authors.affiliation: Department of Neurology, School of Medicine and Biomedical Sciences, University at Buffalo, 100 High Street, Buffalo, NY, 14203, USA.
authors.forename: Diane L
authors.initials: DL
authors.lastname: Cookfair
authors.affiliation: Department of Neurology, Stony Brook University Medical Center, Stony Brook, NY, USA.
authors.forename: Lauren
authors.initials: L
authors.lastname: Krupp
authors.affiliation: The Corinne Goldsmith Dickinson Center of Multiple Sclerosis, Mount Sinai School of Medicine, New York, NY, USA.
authors.forename: Aaron E
authors.initials: AE
authors.lastname: Miller
authors.affiliation: Department of Neurology, Albany Medical School, Multiple Sclerosis Center, Albany, NY, USA.
authors.forename: Neil
authors.initials: N
authors.lastname: Lava
authors.affiliation: Department of Neurology, Stony Brook University Medical Center, Stony Brook, NY, USA.
authors.forename: Patricia K
authors.initials: PK
authors.lastname: Coyle
authors.affiliation: Department of Neurology, University of Rochester Medical Center, Rochester, NY, USA.
authors.forename: Andrew D
authors.initials: AD
authors.lastname: Goodman
authors.affiliation: Department of Neurology, SUNY Upstate Medical University, Syracuse, NY, USA.
authors.forename: Burk
authors.initials: B
authors.lastname: Jubelt
authors.affiliation: Adirondack Neurology Associates, Glens Falls, NY, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Lenihan
authors.affiliation: Department of Neurology, NYU School of Medicine, New York, NY, USA.
authors.forename: Joseph
authors.initials: J
authors.lastname: Herbert
authors.affiliation: Department of Neuroscience, Winthrop University Hospital, Mineola, NY, USA.
authors.forename: Malcolm
authors.initials: M
authors.lastname: Gottesman
authors.affiliation: Department of Neurology, Weill Medical College of Cornell University, New York, NY, USA.|Department of Neurology, Albert Einstein College of Medicine, New York, NY, USA.
authors.forename: David H
authors.initials: DH
authors.lastname: Snyder
authors.affiliation: Multiple Sclerosis Center, New York, NY, USA.
authors.forename: Brian R
authors.initials: BR
authors.lastname: Apatoff
authors.affiliation: Department of Neurology, School of Medicine and Biomedical Sciences, University at Buffalo, 100 High Street, Buffalo, NY, 14203, USA.
authors.forename: Barbara E
authors.initials: BE
authors.lastname: Teter
authors.affiliation: Alpha Neurology, Staten Island, NY, USA.
authors.forename: Allan B
authors.initials: AB
authors.lastname: Perel
authors.affiliation: Department of Neurology, School of Medicine and Biomedical Sciences, University at Buffalo, 100 High Street, Buffalo, NY, 14203, USA.
authors.forename: Frederick
authors.initials: F
authors.lastname: Munschauer
authors.affiliation: Department of Neurology, School of Medicine and Biomedical Sciences, University at Buffalo, 100 High Street, Buffalo, NY, 14203, USA.
authors.forename: Bianca
authors.initials: B
authors.lastname: Weinstock-Guttman
mesh_terms: D000328:Adult; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000175:diagnosis* / Q000188:drug therapy; D009518:New York; D011379:Prognosis; D012042:Registries; D012189:Retrospective Studies; D013997:Time Factors
keywords: Benign multiple sclerosis; DMT; Disease course; Disease-modifying treatment; Multiple sclerosis