Defining High Risk for Aggressive MS at Onset

Studies have shown that the number of lesions on MRI at clinical onset of multiple sclerosis (MS) is an independent predictor of long-term outcomes (e.g., N Engl J Med 2002; 346:158). To see what findings at MS diagnosis predict more aggressive long-term disease progression, investigators from the Barcelona clinically isolated syndrome cohort (started in 1995) retrospectively evaluated 401 MS patients with at least 10 years of follow-up, defining cane dependence as aggressive disease.

Average follow-up was 14 years. Of all participants, 7% required a cane within 10 years and 9% within 15 years. Those who had aggressive MS during follow-up did not differ from the other participants in sex or age. A nonsignificantly higher proportion of those …