Inflammation may be a modifiable aspect of long-term disability for patients with primary progressive MS (PPMS), according to results published in JAMA Neurology. Massimo Filippi, MD, and colleagues examined the impact of disease-modifying treatments (DMTs) on the risk for becoming wheelchair-dependent among 409 patients with PPMS (288 treated and 121 untreated). During follow-up, 37% of patients reached an Expanded Disability Status Scale (EDSS) score of 7.0. Higher EDSS score at baseline (adjusted HR [aHR],1.32), superimposed relapses (aHR, 2.37), and DMT exposure (aHR, 1.75) were linked with a greater risk for an EDSS score of 7.0, while the interaction term between DMT and superimposed relapses was tied to a lower risk for an EDSS score of 7.0 (aHR, 0.33). Similar findings were seen when treatment based on DMT class was considered and when DMT was included as a time dependent covariate. The findings indicate that inflammation “may be associated with a reduced risk of becoming wheelchair-dependent by current licensed DMTs,” Dr. Filippi and colleagues wrote.
