{"id":178200,"date":"2023-12-13T02:38:35","date_gmt":"2023-12-13T08:38:35","guid":{"rendered":"https:\/\/lifeboat.com\/blog\/2023\/12\/disease-progression-independent-of-relapse-activity-vs-relapse-associated-worsening-in-patients-with-pediatric-onset-multiple-sclerosis"},"modified":"2023-12-13T02:38:35","modified_gmt":"2023-12-13T08:38:35","slug":"disease-progression-independent-of-relapse-activity-vs-relapse-associated-worsening-in-patients-with-pediatric-onset-multiple-sclerosis","status":"publish","type":"post","link":"https:\/\/lifeboat.com\/blog\/2023\/12\/disease-progression-independent-of-relapse-activity-vs-relapse-associated-worsening-in-patients-with-pediatric-onset-multiple-sclerosis","title":{"rendered":"Disease Progression Independent of Relapse Activity vs. Relapse-Associated Worsening in Patients with Pediatric-Onset Multiple Sclerosis"},"content":{"rendered":"<p style=\"padding-right: 20px\"><a class=\"aligncenter blog-photo\" href=\"https:\/\/lifeboat.com\/blog.images\/disease-progression-independent-of-relapse-activity-vs-relapse-associated-worsening-in-patients-with-pediatric-onset-multiple-sclerosis2.jpg\"><\/a><\/p>\n<p>Progression independent of relapse activity (PIRA) has been increasingly recognized in people with multiple sclerosis (MS; <a routerlink=\"\/na54962\" href=\"https:\/\/www.jwatch.org\/na54962\">NEJM JW Neurol May 24 2022<\/a> and <i>JAMA Neurol<\/i> 2022; 79:682). To learn more about PIRA, investigators used data from the Italian MS Register on 16,130 patients with relapsing-remitting MS, including 1,383 with pediatric-onset MS (POMS; median age at onset, 16), 14,113 with adult-onset MS (AOMS; median age at onset, 29), and 634 with late-onset MS (LOMS; median age at onset, 52).<\/p>\n<p>Compared with patients with POMS, patients with LOMS had the highest incidence of PIRA (hazard ratio <HR>, 2.98), followed by those with AOMS (HR, 1.42). Compared with the POMS patient group, the LOMS patient group had the lowest risk for relapse-associated worsening (HR, 0.69), followed by the AOMS group (HR, 0.88). Cumulative PIRA incidence was 1.3% of patients at age 20 years, increased rapidly between ages 21 and 30 (9%), and rose progressively from 40 to 70 (from 22% to 79%). Cumulative incidence of relapse-associated worsening showed a different pattern of increases over time (e.g., 0.5% at age 20; 7.8% at age 40; 14.4% at age 50; 24.1% at age 60; 27.7% at age 70).<\/p>\n<p>These authors provide data supporting the notion that MS pathophysiology is different between patients with PIRA and those with relapse-associated worsening. While relapse-associated worsening seems to increase gradually and reach a plateau, PIRA begins in the 20s and continues to increase. PIRA encompasses accumulating neurodegenerative processes, supporting the concept that a subset of patients experience progression even within the relapsing-remitting phase of the disease.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Progression independent of relapse activity (PIRA) has been increasingly recognized in people with multiple sclerosis (MS; NEJM JW Neurol May 24 2022 and JAMA Neurol 2022; 79:682). To learn more about PIRA, investigators used data from the Italian MS Register on 16,130 patients with relapsing-remitting MS, including 1,383 with pediatric-onset MS (POMS; median age at [\u2026]<\/p>\n","protected":false},"author":662,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[11,47],"tags":[],"class_list":["post-178200","post","type-post","status-publish","format-standard","hentry","category-biotech-medical","category-neuroscience"],"_links":{"self":[{"href":"https:\/\/lifeboat.com\/blog\/wp-json\/wp\/v2\/posts\/178200","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/lifeboat.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/lifeboat.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/lifeboat.com\/blog\/wp-json\/wp\/v2\/users\/662"}],"replies":[{"embeddable":true,"href":"https:\/\/lifeboat.com\/blog\/wp-json\/wp\/v2\/comments?post=178200"}],"version-history":[{"count":0,"href":"https:\/\/lifeboat.com\/blog\/wp-json\/wp\/v2\/posts\/178200\/revisions"}],"wp:attachment":[{"href":"https:\/\/lifeboat.com\/blog\/wp-json\/wp\/v2\/media?parent=178200"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/lifeboat.com\/blog\/wp-json\/wp\/v2\/categories?post=178200"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/lifeboat.com\/blog\/wp-json\/wp\/v2\/tags?post=178200"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}