ADVERSE PROGNOSTIC FACTORS PREDICTING DISEASE MODIFYING THERAPIES IN MS: A REAL- WORLD COHORT

BackgroundMultiple sclerosis (MS) demonstrates considerable variability in disease course and prognosis. An improved understanding of factors that predict long-term outcome, particularly early in disease allows for informed, personalised decisions to optimise MS treatment.MethodsData was collected on sequential, newly diagnosed patients from a single MS centre from 2016-2018. Demographic, clinical, and radiological features at disease onset were documented and number of adverse prognostic factors (APF) listed for individual patients. Number and type of APF was then correlated with outcome variables including EDSS, time to first relapse and DMT choice to understand influence of these factors on early clinical management decisions.Results176 people were diagnosed in Cardiff in the 2-year study period. 2 were excluded due to missing baseline imaging. At the time of diagnosis 60% had 3 or more APFs. A higher number of APFs was associ- ated with the decision to prescribe high- versus moderate-efficacy therapies (OR= 1.34; 95% CI 1.04, 1.73, p=0.02) and males were also more likely to receive high-efficacy DMTs (OR 2.11; 95% CI 1.32-3.36, p=0.002).ConclusionsThese data provide description of the frequency and patterns of APFs at time of MS diagnosis and illustrate their influence on initial therapeutic interventions and short-term outcomes.