Approximately 80 to 85% of people with multiple sclerosis (MS) are initially
diagnosed with relapsing-remitting MS, which is marked by symptom
flare-ups followed by periods of remission. Most people eventually
transition to secondary progressive MS, which does not have wide swings
in symptoms but instead a slow, steady, worsening of the disease.
While some medications have been shown to slow or even halt
progression of relapsing-remitting MS, there are currently none shown to
slow progression of secondary progressive MS.
‘Older people who progressed to secondary progressive multiple sclerosis were four times as likely to report having fatigue than people whose disease did not progress.’
In older people with MS, having fatigue and limited leg function is
more often seen in people with MS progression than in those without,
according to a preliminary study that will be presented
at the American Academy of Neurology's 69th Annual Meeting in Boston.
"Study participants with those symptoms were more likely to progress
from relapsing-remitting MS to secondary progressive MS within five
years," said study author Bianca Weinstock-Guttman of the Jacobs
School of Medicine and Biomedical Sciences at the University of Buffalo
in Buffalo, N.Y., and a member of the American Academy of Neurology.
"Better understanding who is at high risk of getting worse may
eventually allow us to tailor more specific treatments to these people."
For the study, 155 people age 50 or older who had
relapsing-remitting MS for at least 15 years were evaluated for symptoms
and level of disability at the beginning of the study and then again
five years later, at which point they had been living with MS an average
of 22 years.
In all, 30% of people in the study had progressed to secondary progressive MS by the five-year mark.
Those who progressed to secondary progressive MS were four times as
likely to report having fatigue, 92% compared to 68% of
people whose disease did not progress. The results were the same after
researchers adjusted for other factors that could affect disease
progression, such as age, how long people had the disease and how severe
their disability was.
Those whose disease progressed were also three times as likely to
have reported limitations in leg function, such as weakness and/or
spasms, at the beginning of the study, 53% compared to 22%
for those who didn't progress.
Those who progressed were older at the start of the study than
those who did not progress, with an average age of 55 compared to 52.
They also had a higher rate of disability at the beginning of the study
as well as five years later.
"While more research needs to be done, this study brings us closer
to understanding which older adults with MS may be at higher risk of
getting worse," said Weinstock-Guttman. "With the aging population, this
information will be vital as people with MS, their families and policy
makers make decisions about their care."