Background: The Multiple Sclerosis Severity Score (MSSS) is a widely used measure of the disability progression rate. However, the global MSSS may not be the best basis for comparison between all patient groups. Objective: We evaluated sex-specific and onset phenotype–specific MSSS matrices to determine if they were more effective than the global MSSS as a basis for comparison within these subsets. Methods: Using a large international dataset of multiple sclerosis (MS) patient records and the original MSSS algorithm, we constructed global, sex-specific and onset phenotype–specific MSSS matrices. We compared matrices using permutation analysis. Results: Our final dataset included 30,203 MS cases, with 28.9% males and 6.5% progressive-onset cases. Our global MSSS matrix did not differ from previously published data (p > 0.05). The progressive-onset-specific matrix differed significantly from the relapsing-onset-specific matrix (p < 0.001), with lower MSSS attributed to cases with the same Expanded Disability Status Score (EDSS) and disease duration. When evaluated with a simulation, using an onset-specific MSSS improved statistical power in mixed cohorts. There were no significant differences by sex. Conclusion: The differences in the disability accrual rate between progressive- and relapsing-onset MS have a significant effect on MSSS. An onset-specific MSSS should be used when comparing the rate of disability progression among progressive-onset cases and for mixed cohorts.
Redefining the Multiple Sclerosis Severity Score (MSSS): The effect of sex and onset phenotype / Zhou, Y.; Claflin, S. B.; Stankovich, J.; van der Mei, I.; Simpson, S.; Roxburgh, R. H.; Kalincik, T.; Blizzard, L.; Lugaresi, A.; Alroughani, R.; Sajedi, S. A.; Butzkueven, H.; Pucci, E.; Spitaleri, D. L. A.; Granella, F.; Cristiano, E.; Yamout, B.; Hughes, S.; Gouider, R.; Sanchez Menoyo, J. L.; Olascoaga, J.; Mcguigan, C.; Shaw, C.; Kermode, A. G.; Kasa, K.; Al-Harbi, T.; Altintas, A.; Laureys, G.; Fragoso, Y.; Hardy, T. A.; Csepany, T.; Sirbu, C. -A.; Decoo, D.; Sas, A.; Alvarez-Cermeno, J. C.; Kotkata, K.; Millan-Pascual, J.; Taylor, B. V.. - In: MULTIPLE SCLEROSIS. - ISSN 1352-4585. - (2019), p. 1352458519881994. [10.1177/1352458519881994]
Redefining the Multiple Sclerosis Severity Score (MSSS): The effect of sex and onset phenotype
Granella F.;
2019-01-01
Abstract
Background: The Multiple Sclerosis Severity Score (MSSS) is a widely used measure of the disability progression rate. However, the global MSSS may not be the best basis for comparison between all patient groups. Objective: We evaluated sex-specific and onset phenotype–specific MSSS matrices to determine if they were more effective than the global MSSS as a basis for comparison within these subsets. Methods: Using a large international dataset of multiple sclerosis (MS) patient records and the original MSSS algorithm, we constructed global, sex-specific and onset phenotype–specific MSSS matrices. We compared matrices using permutation analysis. Results: Our final dataset included 30,203 MS cases, with 28.9% males and 6.5% progressive-onset cases. Our global MSSS matrix did not differ from previously published data (p > 0.05). The progressive-onset-specific matrix differed significantly from the relapsing-onset-specific matrix (p < 0.001), with lower MSSS attributed to cases with the same Expanded Disability Status Score (EDSS) and disease duration. When evaluated with a simulation, using an onset-specific MSSS improved statistical power in mixed cohorts. There were no significant differences by sex. Conclusion: The differences in the disability accrual rate between progressive- and relapsing-onset MS have a significant effect on MSSS. An onset-specific MSSS should be used when comparing the rate of disability progression among progressive-onset cases and for mixed cohorts.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
