DALLAS—Eighty-two percent of patients who present with late-onset multiple sclerosis (MS) have a relapsing-remitting course, and the others have a progressive illness, researchers reported at the 2014 Cooperative Meeting of CMSC and ACTRIMS.
Claudia Chaves, MD, and colleagues retrospectively reviewed the database from the Lahey Hospital and Medical Center’s MS Center in Lexington, Massachusetts, and selected patients with new-onset MS at age 50 and older. The investigators sought to determine the clinical characteristics and imaging features among patients with late-onset MS.
Fifty patients who presented to the clinic had late-onset MS, which was 7% of all patients with MS, according to Dr. Chaves. Forty-one patients (30 women; mean age, 55) had a relapsing-remitting course, and nine patients (seven women; mean age, 53.6) had a progressive illness. Gait problems were present in 80% of patients with relapsing-remitting MS and in all patients with progressive disease. Patients with progressive illness were significantly more likely to have motor deficits and a higher Expanded Disability Status Scale (EDSS) score, compared with those with relapsing-remitting MS.
Patients with progressive illness had higher odds of cognitive impairment and more difficulties with coordination, though the rate was not statistically significant. Patients with relapsing-remitting MS had 2.2 times the odds of having sensory abnormalities. “No statistically significant difference was found for MRI measures between the two groups, including the presence of supra and infratentorial lesions, spinal cord involvement, contrast enhancement, and cerebral atrophy,” noted the investigators.
“However, the odds of infratentorial and spinal cord involvement were higher in [those with relapsing-remitting MS] and [those with progressive illness], respectively.” Ninety percent of patients with relapsing-remitting MS had been treated with a disease-modifying agent, and 78% of those with progressive illness were treated with a disease-modifying agent.
“Gait difficulties were common in both groups, with motor deficits and higher EDSS score significantly more common in patients with progressive disease,” the researchers concluded. “The MRI findings and clinical evolution were not significantly different between the two groups over the time period studied.”
—Colby Stong