Do patients' and referral centers' characteristics influence multiple sclerosis phenotypes? Results from the Italian multiple sclerosis and related disorders register

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RESEARCH PRODUCT

Do patients' and referral centers' characteristics influence multiple sclerosis phenotypes? Results from the Italian multiple sclerosis and related disorders register

Roberto Bergamaschi Ettore Beghi Cristina Bosetti Michela Ponzio Claudia Santucci Vito Lepore Paola Mosconi U Aguglia M P Amato A L Ancona B Ardito C Avolio R Balgera P Banfi V Barcella P Barone P Bellantonio A Berardinelli R Bergamaschi P Bertora M Bianchi P Bramanti V Brescia Morra G Brichetto A M Brioschi M Buccafusca S Bucello V Busillo B Calchetti R Cantello M Capobianco F Capone L Capone D Cargnelutti M Carrozzi E Cartechini G Cavaletti P Cavalla M G Celani R Clerici M Clerico E Cocco P Confalonieri M G Coniglio A Conte F Corea S Cottone P Crociani F D'andrea M C Danni G De Luca D De Pascalis M De Riz F De Robertis G De Rosa N De Stefano M Della Corte A Di Sapio R Docimo M Falcini N Falcone S Fermi E Ferraro M T Ferrò M Fortunato M Foschi A Gajofatto A Gallo P Gallo M Gatto P Gazzola A Giordano F Granella M F Grasso M G Grasso L M E Grimaldi P Iaffaldano D Imperiale M Inglese R Iodice S Leva V Luezzi A Lugaresi G Lus D Maimone L Mancinelli G T Maniscalco G A Marfia B Marini A Marson N Mascoli L Massacesi F Melani M Merello G Meucci M Mirabella S Montepietra D Nasuelli P Nicolao F Passantino F Patti M Peresson I Pesci C Piantadosi M L Piras M Pizzorno K Plewnia C Pozzilli A Protti R Quatrale S Realmuto G Ribizzi S Rinalduzzi A Rini S Romano M Romeo M Ronzoni P Rossi M Rovaris G Salemi G Santangelo M Santangelo G Santuccio P Sarchielli L Sinisi P Sola C Solaro D Spitaleri S Strumia T Tassinari S Tonietti C Tortorella R Totaro A Tozzo G Trivelli M Ulivelli P Valentino S Venturi M Vianello M Zaffaroni R Zarbo Maria Trojano Mario Alberto Battaglia Marco Capobianco Maura Pugliatti Monica Ulivelli Paola Mosconi Claudio Gasperini Francesco Patti Maria Pia Amato Roberto Bergamaschi Giancarlo Comi

subject

Multiple Sclerosis Centers’ characteristics; Italian Multiple Sclerosis Register; Multiple sclerosis phenotypes; Real-world data Settore MED/42 - Igiene Generale e Applicata Italian Multiple Sclerosis Register Dermatology General Medicine Multiple Sclerosis Chronic Progressive Settore MED/26 Settore SECS-S/04 - Demografia Centers’ characteristics Multiple sclerosis phenotype Real-world data Settore MED/01 - Statistica Medica Psychiatry and Mental health Multiple Sclerosis Relapsing-Remitting Phenotype Recurrence Humans Female Settore MED/26 - Neurologia Neurology (clinical)Centers’ characteristic Referral and Consultation Multiple sclerosis phenotypes

description

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.

year	journal	country	edition	language
2022-06-07

10.1007/s10072-022-06169-7 https://hdl.handle.net/10281/404150