학술논문
Do patients' and referral centers' characteristics influence multiple sclerosis phenotypes? Results from the Italian multiple sclerosis and related disorders register.
Document Type
Academic Journal
Author
Bergamaschi R; IRCCS Fondazione Mondino, Pavia, Italy.; Beghi E; Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy.; Bosetti C; Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy.; Ponzio M; Scientific Research Area, Italian Multiple Sclerosis Foundation, Genoa, Italy.; Santucci C; Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy.; Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.; Lepore V; Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy.; Mosconi P; Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy. paola.mosconi@marionegri.it.; Laboratorio di Ricerca per il Coinvolgimento dei Cittadini in Sanità, Dipartimento di Salute Pubblica, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Via Mario Negri 2, 20156, Milan, Italy. paola.mosconi@marionegri.it.; Aguglia U; Amato MP; Ancona AL; Ardito B; Avolio C; Balgera R; Banfi P; Barcella V; Barone P; Bellantonio P; Berardinelli A; Bergamaschi R; Bertora P; Bianchi M; Bramanti P; Morra VB; Brichetto G; Brioschi AM; Buccafusca M; Bucello S; Busillo V; Calchetti B; Cantello R; Capobianco M; Capone F; Capone L; Cargnelutti D; Carrozzi M; Cartechini E; Cavaletti G; Cavalla P; Celani MG; Clerici R; Clerico M; Cocco E; Confalonieri P; Coniglio MG; Conte A; Corea F; Cottone S; Crociani P; D'Andrea F; Danni MC; De Luca G; de Pascalis D; De Riz M; De Robertis F; De Rosa G; De Stefano N; Corte MD; Di Sapio A; Docimo R; Falcini M; Falcone N; Fermi S; Ferraro E; Ferrò MT; Fortunato M; Foschi M; Gajofatto A; Gallo A; Gallo P; Gatto M; Gazzola P; Giordano A; Granella F; Grasso MF; Grasso MG; Grimaldi LME; Iaffaldano P; Imperiale D; Inglese M; Iodice R; Leva S; Luezzi V; Lugaresi A; Lus G; Maimone D; Mancinelli L; Maniscalco GT; Marfia GA; Marini B; Marson A; Mascoli N; Massacesi L; Melani F; Merello M; Meucci G; Mirabella M; Montepietra S; Nasuelli D; Nicolao P; Passantino F; Patti F; Peresson M; Pesci I; Piantadosi C; Piras ML; Pizzorno M; Plewnia K; Pozzilli C; Protti A; Quatrale R; Realmuto S; Ribizzi G; Rinalduzzi S; Rini A; Romano S; Romeo M; Ronzoni M; Rossi P; Rovaris M; Salemi G; Santangelo G; Santangelo M; Santuccio G; Sarchielli P; Sinisi L; Sola P; Solaro C; Spitaleri D; Strumia S; Tassinari T; Tonietti S; Tortorella C; Totaro R; Tozzo A; Trivelli G; Ulivelli M; Valentino P; Venturi S; Vianello M; Zaffaroni M; Zarbo R; Trojano M; Battaglia MA; Capobianco M; Pugliatti M; Ulivelli M; Mosconi P; Gasperini C; Patti F; Amato MP; Bergamaschi R; Comi G
Source
Publisher: Springer-Verlag Italia Country of Publication: Italy NLM ID: 100959175 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1590-3478 (Electronic) Linking ISSN: 15901874 NLM ISO Abbreviation: Neurol Sci Subsets: MEDLINE
Subject
Language
English
Abstract
Background: Multiple sclerosis (MS) is characterized by phenotypical heterogeneity, partly resulting from demographic and environmental risk factors. Socio-economic factors and the characteristics of local MS facilities might also play a part.
Methods: This study included patients with a confirmed MS diagnosis enrolled in the Italian MS and Related Disorders Register in 2000-2021. Patients at first visit were classified as having a clinically isolated syndrome (CIS), relapsing-remitting (RR), primary progressive (PP), progressive-relapsing (PR), or secondary progressive MS (SP). Demographic and clinical characteristics were analyzed, with centers' characteristics, geographic macro-areas, and Deprivation Index. We computed the odds ratios (OR) for CIS, PP/PR, and SP phenotypes, compared to the RR, using multivariate, multinomial, mixed effects logistic regression models.
Results: In all 35,243 patients from 106 centers were included. The OR of presenting more advanced MS phenotypes than the RR phenotype at first visit significantly diminished in relation to calendar period. Females were at a significantly lower risk of a PP/PR or SP phenotype. Older age was associated with CIS, PP/PR, and SP. The risk of a longer interval between disease onset and first visit was lower for the CIS phenotype, but higher for PP/PR and SP. The probability of SP at first visit was greater in the South of Italy.
Discussion: Differences in the phenotype of MS patients first seen in Italian centers can be only partly explained by differences in the centers' characteristics. The demographic and socio-economic characteristics of MS patients seem to be the main determinants of the phenotypes at first referral.
(© 2022. The Author(s).)
Methods: This study included patients with a confirmed MS diagnosis enrolled in the Italian MS and Related Disorders Register in 2000-2021. Patients at first visit were classified as having a clinically isolated syndrome (CIS), relapsing-remitting (RR), primary progressive (PP), progressive-relapsing (PR), or secondary progressive MS (SP). Demographic and clinical characteristics were analyzed, with centers' characteristics, geographic macro-areas, and Deprivation Index. We computed the odds ratios (OR) for CIS, PP/PR, and SP phenotypes, compared to the RR, using multivariate, multinomial, mixed effects logistic regression models.
Results: In all 35,243 patients from 106 centers were included. The OR of presenting more advanced MS phenotypes than the RR phenotype at first visit significantly diminished in relation to calendar period. Females were at a significantly lower risk of a PP/PR or SP phenotype. Older age was associated with CIS, PP/PR, and SP. The risk of a longer interval between disease onset and first visit was lower for the CIS phenotype, but higher for PP/PR and SP. The probability of SP at first visit was greater in the South of Italy.
Discussion: Differences in the phenotype of MS patients first seen in Italian centers can be only partly explained by differences in the centers' characteristics. The demographic and socio-economic characteristics of MS patients seem to be the main determinants of the phenotypes at first referral.
(© 2022. The Author(s).)