Background: The Multiple Sclerosis Severity Score (MSSS) is a widely used measure of the disability progression rate. However, the global MSSS may not be the best basis for comparison between all patient groups. Objective: We evaluated sex-specific and onset phenotype–specific MSSS matrices to determine if they were more effective than the global MSSS as a basis for comparison within these subsets. Methods: Using a large international dataset of multiple sclerosis (MS) patient records and the original MSSS algorithm, we constructed global, sex-specific and onset phenotype–specific MSSS matrices. We compared matrices using permutation analysis. Results: Our final dataset included 30,203 MS cases, with 28.9% males and 6.5% progressive-onset cases. Our global MSSS matrix did not differ from previously published data (p > 0.05). The progressive-onset-specific matrix differed significantly from the relapsing-onset-specific matrix (p < 0.001), with lower MSSS attributed to cases with the same Expanded Disability Status Score (EDSS) and disease duration. When evaluated with a simulation, using an onset-specific MSSS improved statistical power in mixed cohorts. There were no significant differences by sex. Conclusion: The differences in the disability accrual rate between progressive- and relapsing-onset MS have a significant effect on MSSS. An onset-specific MSSS should be used when comparing the rate of disability progression among progressive-onset cases and for mixed cohorts.
Redefining the Multiple Sclerosis Severity Score (MSSS): The effect of sex and onset phenotype / Zhou Y.; Claflin S.B.; Stankovich J.; van der Mei I.; Simpson S.; Roxburgh R.H.; Kalincik T.; Blizzard L.; Lugaresi A.; Alroughani R.; Sajedi S.A.; Butzkueven H.; Pucci E.; Spitaleri D.L.A.; Granella F.; Cristiano E.; Yamout B.; Hughes S.; Gouider R.; Sanchez Menoyo J.L.; Olascoaga J.; McGuigan C.; Shaw C.; Kermode A.G.; Kasa K.; Al-Harbi T.; Altintas A.; Laureys G.; Fragoso Y.; Hardy T.A.; Csepany T.; Sirbu C.-A.; Decoo D.; Sas A.; Alvarez-Cermeno J.C.; Kotkata K.; Millan-Pascual J.; Taylor B.V.. - In: MULTIPLE SCLEROSIS. - ISSN 1352-4585. - ELETTRONICO. - 26:13(2020), pp. 1765-1774. [10.1177/1352458519881994]
Redefining the Multiple Sclerosis Severity Score (MSSS): The effect of sex and onset phenotype
Lugaresi A.Writing – Review & Editing
;
2020
Abstract
Background: The Multiple Sclerosis Severity Score (MSSS) is a widely used measure of the disability progression rate. However, the global MSSS may not be the best basis for comparison between all patient groups. Objective: We evaluated sex-specific and onset phenotype–specific MSSS matrices to determine if they were more effective than the global MSSS as a basis for comparison within these subsets. Methods: Using a large international dataset of multiple sclerosis (MS) patient records and the original MSSS algorithm, we constructed global, sex-specific and onset phenotype–specific MSSS matrices. We compared matrices using permutation analysis. Results: Our final dataset included 30,203 MS cases, with 28.9% males and 6.5% progressive-onset cases. Our global MSSS matrix did not differ from previously published data (p > 0.05). The progressive-onset-specific matrix differed significantly from the relapsing-onset-specific matrix (p < 0.001), with lower MSSS attributed to cases with the same Expanded Disability Status Score (EDSS) and disease duration. When evaluated with a simulation, using an onset-specific MSSS improved statistical power in mixed cohorts. There were no significant differences by sex. Conclusion: The differences in the disability accrual rate between progressive- and relapsing-onset MS have a significant effect on MSSS. An onset-specific MSSS should be used when comparing the rate of disability progression among progressive-onset cases and for mixed cohorts.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
