Predictors of Long-term Disability in Multiple Sclerosis: Real World Data from a Cohort of Egyptian Patients

Specification of prognostic factors in multiple sclerosis (MS) is crucial for clinicians to guide therapeutic protocols. This study aimed to identify demographic, clinical, and radiological factors associated with disability on a long-term basis in relapsing-remitting MS (RRMS) and secondary progressive MS (SPMS).

This was a retrospective study conducted on patients with RRMS and SPMS with a disease duration of at least 10 years. Demographic, clinical, and radiological parameters were collected from the medical records.

During the study period, 217 patients were recruited with a mean disease duration of 14.9 ± 4.6 (range: 10-35) years. Regression analysis revealed that age (B = 0.071, CI: 0.00-0.132, P = 0.025), male sex (B = –0.825, CI: –1.444 to –0.206, P = 0.009), duration between first 2 attacks (B = -0.007, CI: -0.015-0.000, P = 0.037), and involvement of pyramidal (B = 0.754, CI: 0.051-1.457, P = 0.036) or cerebellar domains (B = 1.355, CI: 0.542-2.168, P = 0.001) at disease onset were the only parameters that had an independent effect on EDSS.

Predictors of long-term disability in our cohort were closely similar, but not typically identical to predictors reported in the literature. Age, male sex, short duration between first 2 relapses pyramidal and cerebellar affection were the strongest predictors of disability in patients with RRMS and SPMS.