According to a latest study, people with multiple sclerosis (MS) who have relapses within the first five years of onset may have more severe disability in the short term in contrast to people who do not have an early relapse. This study is known to be the foremost one to examine how MS relapses affect people during different time periods of the disease.
A relapse is believed to have been defined in the study as worsening of neurological symptoms for more than 24 hours, without a fever or infection. Since relapse-related symptoms often improve within a few weeks, it appears to be indistinct how much disability comes from relapses, and how much from progression.
As part of the study, scientists were believed to have evaluated the medical records of approximately 2,477 people with MS who experienced relapses in British Columbia, Canada. Further, they examined whether the participants appeared to have a disability severe enough to require the use of a cane for walking.
Also, scientists analyzed whether this may have been related to relapses going on within five years, five to ten years, or more than ten years after onset of symptoms. The participants were observed to have been followed for an average of 20 years. During that time, the group seems to have experienced nearly 11,722 relapses.
The findings of the study revealed that people who had a relapse within five years of disease onset appear to be at a 48 percent higher risk i.e. a measure of relative risk of requiring a cane to walk within five years of disease onset as compared to those who did not have an early relapse.
Significantly, the impact of the early relapse seems to have reduced over time. Furthermore, those with early relapse who did not need a cane after five years were observed to be at only a 10 percent higher risk of needing one 10 years after disease onset in contrast to those without early relapses.
Study author Helen Tremlett, PhD, with the University of British Columbia in Vancouver said that, “Our findings may represent an important message to people diagnosed with MS today. Those who have a history of relapses could potentially be offered reassurance that as time goes on, these relapses will have a diminishing effect on their everyday lives. In addition, our study calls upon the need for new medications that target axonal degeneration, which is suspected of causing permanent disability, especially for people who have had MS for many years or who are older at diagnosis.”
“There may be a longer window of opportunity for treating younger people with MS right away, changing the course of progression later on,” continues Tremlett.
Study shows that approximately 85 percent of people with MS seem to begin by having the relapsing-remitting form of the disease. Moreover, many of these people could perhaps later develop secondary progressive MS.
The impact of relapses that happened later, either at five to 10 or more than 10 years after the start of the disease, also seems to have decreased over time and became irrelevant after long-term follow up. Additionally, relapses in people under 25 may have had a longer impact on disability as compared to those over 35 years.
The findings of the study have been published in the journal, Neurology.