Long-term evolution of MS disability in the treatment era

Studies that look at the evolution of MS over many years are called natural history studies. Previous natural history studies were performed before the availability of disease modifying drugs (such as interferon, fingolimod, etc.).

In this study, from the San Francisco MS Centre in California, researchers studied 507 people who they had originally recruited in 2004 and followed for more than a decade.

Researchers reported that, in this group, only 11% of people with relapsing-onset MS had developed progressive disability later in the course of the disease when assessed 12 years later. Using predictions based on previous studies, before disease modifying drugs were available, they were expecting to see 36-50% conversion to progressive MS.

The researchers found that MRI markers of active disease, such as enhancing lesions, did not predict a more severe disease later. They also found that they could not use short-term disease progression (such as increase in neurological examination scored by EDSS) to predict longer-term progression.

This study suggests that short-term progression of MS does not necessarily mean more severe disease after a decade, when compared to people who have a less severe progression at the beginning of their disease.

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