Table 4.13.

Progression in multiple sclerosis: data from the main series describing the long-term course and prognosis

Study	Time from onset of multiple sclerosis to progression (years)	Factors predictive of time from onset of multiple sclerosis to progression (years)
Long-term natural history series with cross-sectional and/or some longitudinal assessment
R. Müller 1949; 1951	Observed data All cases: 10 (median)	Observed data Gender: male, shorter Age at onset of multiple sclerosis: older, shorter Initial symptoms: optic nerve/brainstems/sensory, longer; motor, shorter Number of relapses during the first 5 years: greater, shorter
McAlpine and Compston 1952	Observed data Cases with a relapsing–remitting initial course of multiple sclerosis: 30 (median)	Observed data Gender: none
Riise et al 1992	Not available	Cox's proportional hazards regression model Cases with a relapsing–remitting initial course of multiple sclerosis: Gender: none Age at onset of multiple sclerosis: older, shorter Initial symptoms: pyramidal/cerebellar, shorter; visual, longer
Trojano et al 1995	Not available	Life table analysis Multivariate analysis Cases with a relapsing–remitting initial course of multiple sclerosis: Gender/initial symptoms: none Age at onset of multiple sclerosis: younger, longer Recovery from first episode: complete, longer Time from initial relapse to second episode: none Number of relapses during the first 2 years: none
Myhr et al 2001	Life table analysis Cases with a relapsing–remitting initial course of multiple sclerosis: 76th percentile: 10 57th percentile: 19	Not available
Long-term natural history cohorts with longitudinal follow-up
Lyon, France, multiple sclerosis cohort
Confavreux 1977 Confavreux et al 1980	Life table analysis All cases: 11 (median)	Life table analysis All cases: Gender: none Age at onset of multiple sclerosis: younger, longer Cases with a relapsing–remitting initial course of multiple sclerosis: Time from initial episode to second episode: shorter, shorter
Confavreux et al 2000; 2003 Vukusic and Confavreux 2003b	Life table analysis Cases with a relapsing–remitting initial course of multiple sclerosis: 19.1 [95% CI 17.1–21.1] (median)	Cox proportional hazards regression model Cases with a relapsing–remitting initial course of multiple sclerosis: Gender: female, longer Age at onset of multiple sclerosis: younger, longer Initial symptoms: brainstem/long tracts, none; optic neuritis, slightly longer Time from initial episode to second episode: shorter, shorter
Gothenburg, Sweden, multiple sclerosis cohort
Broman et al 1981 Runmarker and Andersen 1993 Eriksson et al 2003	Life table analysis All cases: 9 (median) Cases with a ‘clinically isolated syndrome’ at onset: 19.0 ± 1.6 (median ± SEM)	Life table analysis Cox regression analysis Cases with a relapsing–remitting initial course of multiple sclerosis and cases with a ‘clinically isolated syndrome’ at onset: Gender: male, shorter Age at onset of multiple sclerosis: younger, longer Season of onset/year of onset/seen from onset: none Initial symptoms: optic neuritis/sensory/monoregional, longer; long tracts, shorter Recovery from first episode: complete, longer Time from initial episode to second neurological episode:a none Number of relapses during the first 5 years of multiple sclerosis:b none Disability score at 5 years of multiple sclerosis:b higher, shorter Number of affected functional systems at 5 years of multiple sclerosis:b greater, shorter
London, Ontario, multiple sclerosis cohort
Weinshenker et al 1989a; 1989b	Life table analysis All cases: 5.8 ± 0.3 (median ± SEM)	Not available
Long-term history series from the therapeutic era
Amato et al 1999 Amato and Ponziani 2000	Life table analysis Cases with a relapsing–remitting initial course of multiple sclerosis: 70th percentile: 11	Life table analysis Cox regression analysis Cases with a relapsing–remitting initial course of multiple sclerosis: Gender/age at onset of multiple sclerosis: none Initial symptoms: pyramidal/cerebellar/sphincter/visual, shorter Number of affected functional systems at onset of multiple sclerosis: greater, shorter Recovery from first episode: incomplete, shorter Time from initial episode to second neurological episode: longer, shorter Number of relapses during the first 2 years of multiple sclerosis: none Oligoclonal bands in cerebrospinal fluid at onset of multiple sclerosis: present, shorter Brain MRI at onset of multiple sclerosis: suggestive, slightly shorter

SD = standard deviation.

SEM = standard error of the mean.

^aTime to end point (onset of progression) estimated by the survival analysis using the second episode as starting point.

^bTime to end point (onset of progression) estimated by the survival analysis using 5 years after onset as starting point.