Long-term survival of patients with multiple sclerosis in West France

Abstract

In France no data have been published about comparing survival in multiple sclerosis (MS) patients with the general French population. We estimated survival probabilities in MS patients from a major centre for MS in West France. We also compared MS survival with the general population and assessed prognostic parameters. All patients with MS onset after January 1976 and classified as dead or alive on 1 January 2004 were included. One thousand eight-hundred and seventy-nine patients (sex ratio W: M 2.3; relapsing/progressive onset 77.4%/22.6%) fulfilled these criteria, disease duration ranged from one to 28 years. By 2004, 68 patients died (51 due to MS) and the 15 and 25-year survival probabilities were 96% and 88%. Male gender, progressive course (either primary or secondary), polysymptomatic onset, and increased annual relapse rate during the first two years of MS were related to a worse prognosis. After a mean follow-up duration of 12.7 years since clinical onset, MS increased the number of deaths compared with the general population. However taking into account disability status, we found that less disabled MS patients had a better survival and highly disabled patients a worse survival (eight-fold increase of mortality) compared with the French population. Multiple Sclerosis 2007; 13: 865—874. http://msj.sagepub.com

Keywords

multiple sclerosis standardized mortality rates survival

Get full access to this article

View all access options for this article.

References

Weinshenker BG , Bass B. , Rice GP , Noseworthy J. , Carriere W. , Baskerville J. et al. The natural history of multiple sclerosis: a geographically based study. I. Clinical course and disability. Brain 1989; 112: 133—46.

Confavreux C. , Vukusic S. , Adeleine P. Early clinical predictors and progression of irreversible disability in multiple sclerosis: an amnesic process. Brain 2003; 126: 770—82.

Percy AK , Nobrega FT , Okazaki H. , Glattre E. , Kurland LT Multiple sclerosis in Rochester, Minn. A 60-year appraisal. Arch Neurol 1971; 25: 105—11.

Weinshenker BG , Ebers GC The natural history of multiple sclerosis . Can J Neurol Sci 1987; 14: 255—61. 5. Phadke JG Clinical aspects of multiple sclerosis in north-east Scotland with particular reference to its course and prognosis . Brain 1990; 113: 1597—628.

Phadke JG Survival pattern and cause of death in patients with multiple sclerosis: results from an epidemiological survey in north east Scotland. J Neurol Neurosurg Psychiatry 1987; 50: 523—31.

Riise T. , Gronning M. , Aarli JA , Nyland H. , Larsen JP , Edland A. Prognostic factors for life expectancy in multiple sclerosis analysed by Cox-models . J Clin Epidemiol 1988; 41: 1031—36.

Poser S. , Kurtzke JF , Poser W. , Schlaf G. Survival in multiple sclerosis. J Clin Epidemiol 1989; 42: 159—68.

Sadovnick AD , Ebers GC , Wilson RW , Paty DW Life expectancy in patients attending multiple sclerosis clinics. Neurology 1992; 42: 991—94.

Bronnum-Hansen H. , Koch-Henriksen N. , Hyllested K. Survival of patients with multiple sclerosis in Denmark: a nationwide, long-term epidemiologic survey. Neurology 1994; 44: 1901—907.

10.

Bronnum-Hansen H. , Koch-Henriksen N. , Stenager E. Trends in survival and cause of death in Danish patients with multiple sclerosis. Brain 2004; 127: 844—50.

11.

Kantarci O. , Siva A. , Eraksoy M. , Karabudak R. , Sutlas N. , Agaoglu J. et al. Survival and predictors of disability in Turkish MS patients. Turkish Multiple Sclerosis Study Group (TUMSSG). Neurology 1998; 51: 765—72.

12.

Cottrell DA , Kremenchutzky M. , Rice GP , Hader W. , Baskerville J. , Ebers GC The natural history of multiple sclerosis: a geographically based study. 5. The clinical features and natural history of primary progressive multiple sclerosis. Brain 1999; 122: 625—39.

13.

Koch-Henriksen N. The Danish Multiple Sclerosis Registry: a 50-year follow-up. Mult Scler 1999; 5: 293—96.

14.

Levic ZM , Dujmovic I. , Pekmezovic T. , Jarebinski M. , Marinkovic J. , Stojsavljevic N. et al. Prognostic factors for survival in multiple sclerosis. Mult Scler 1999; 5: 171—78.

15.

Wallin MT , Page WF , Kurtzke JF Epidemiology of multiple sclerosis in US veterans. VIII. Long-term survival after onset of multiple sclerosis. Brain 2000 ; 123: 1677—87.

16.

Kurtzke JF , Heltberg A. Multiple sclerosis in the Faroe Islands: an epitome. J Clin Epidemiol 2001; 54: 1—22.

17.

Sumelahti ML , Tienari PJ , Wikstrom J. , Salminen TM , Hakama M. Survival of multiple sclerosis in Finland between 1964 and 1993. Mult Scler 2002; 8: 350—55.

18.

Phadke JG , Downie AW Epidemiology of multiple sclerosis in the north-east (Grampian region) of Scotland—an update. J Epidemiol Community Health 1987; 41: 5—13.

19.

Sadovnick AD , Eisen K. , Ebers GC , Paty DW Cause of death in patients attending multiple sclerosis clinics. Neurology 1991; 41: 1193—96.

20.

Miller DH , Hornabrook RW , Purdie G. The natural history of multiple sclerosis: a regional study with some longitudinal data. J Neurol Neurosurg Psychiatry 1992; 55: 341—46.

21.

Midgard R. , Albrektsen G. , Riise T. , Kvale G. , Nyland H. Prognostic factors for survival in multiple sclerosis: a longitudinal, population based study in More and Romsdal, Norway. J Neurol Neurosurg Psychiatry 1995; 58: 417—21.

22.

Koch-Henriksen N. , Bronnum-Hansen H. , Stenager E. Underlying cause of death in Danish patients with multiple sclerosis: results from the Danish Multiple Sclerosis Registry. J Neurol Neurosurg Psychiatry 1998; 65: 56—59.

23.

Pekmezovic T. , Jarebinski M. , Drulovic J. , Stojsavljevic N. , Levic Z. Survival of multiple sclerosis patients in the Belgrade population. Neuroepidemiology 2002; 21: 235—40.

24.

Pittock SJ , Mayr WT , McClelland RL , Jorgensen NW , Weigand SD , Noseworthy JH et al. Change in MSrelated disability in a population-based cohort: a 10-year follow-up study. Neurology 2004; 62: 51—59.

25.

Kurtzke JF , Beebe GW , Nagler B. , Nefzger MD , Auth TL , Kurland LT Studies on the natural history of multiple sclerosis. V. Long-term survival in young men. Arch Neurol 1970; 22: 215—25.

26.

Malmgren RM , Dudley JP , Visscher BR , Valdiviezo NL , Clark VA , Detels R. Mortality in persons with multiple sclerosis in the Seattle and Los Angeles areas. JAMA 1981; 246: 2042—45.

27.

Wynn DR , Rodriguez M. , O'Fallon WM , Kurland LT A reappraisal of the epidemiology of multiple sclerosis in Olmsted County, Minnesota. Neurology 1990; 40: 780—86.

28.

Ebers GC Natural history of multiple sclerosis. J Neurol Neurosurg Psychiatry 2001; 71(Suppl 2): ii16—19.

29.

Weinshenker BG The natural history of multiple sclerosis . Neurol Clin 1995; 13: 119—46.

30.

Confavreux C. , Compston DA , Hommes OR , McDonald WI , Thompson AJ EDMUS, a European database for multiple sclerosis . J Neurol Neurosurg Psychiatry 1992; 55: 671—76.

31.

Poser CM , Paty DW , Scheinberg L. , McDonald WI , Davis FA , Ebers GC et al. New diagnostic criteria for multiple sclerosis: guidelines for research protocols. Ann Neurol 1983; 13: 227—31.

32.

Kurtzke JF Rating neurologic impairment in multiple sclerosis: an expanded disability status scale (EDSS). Neurology 1983; 33: 1444—52.

33.

Schumacker GA , Beebe G. , Kibler RF , Kurland LT , Kurtzke JF , McDowell F. et al. Problems of experimental trials of therapy in multiple sclerosis: Report by the Panel on the Evaluation of Experimental Trials of Therapy in Multiple Sclerosis. Ann N Y Acad Sci 1965; 122: 552—68.

34.

Kaplan EL , Meier P. Nonparametric estimation from incomplete observations. J Am Stat Assoc 1958; 53: 457—81.

35.

Cox DR Regression models and life tables. J R Stat Soc Ser B 1972; 34: 187—220.

36.

Statistical Package for Social Science [program]. SPSS, 2002.

37.

Burr ML Explaining the French paradox. J R Soc Health 1995; 115: 217—19.

38.

Poser S. , Poser W. , Schlaf G. , Firnhaber W. , Lauer K. , Wolter M. et al. Prognostic indicators in multiple sclerosis. Acta Neurol Scand 1986; 74: 387—92.

39.

Riise T. , Gronning M. , Fernandez O. , Lauer K. , Midgard R. , Minderhoud JM et al. Early prognostic factors for disability in multiple sclerosis, a European multicenter study. Acta Neurol Scand 1992; 85: 212—18.

40.

Runmarker B. , Andersen O. Prognostic factors in a multiple sclerosis incidence cohort with twenty-five years of follow-up. Brain 1993; 116: 117—34.

41.

Placebo-controlled multicentre randomised trial of interferon beta-1b in treatment of secondary progressive multiple sclerosis. European Study Group on interferon beta-1b in secondary progressive

MS. Lancet 1998; 352: 1491—97.

42.

Randomized controlled trial of interferon- beta-1a in secondary progressive MS: Clinical results. Neurology 2001; 56: 1496—504.

43.

Cohen JA , Cutter GR , Fischer JS , Goodman AD , Heidenreich FR , Kooijmans MF et al. Benefit of interferon beta-1a on MSFC progression in secondary progressive MS. Neurology 2002; 59: 679—87.

44.

Panitch H. , Miller A. , Paty D. , Weinshenker B. Interferon beta-1b in secondary progressive MS: results from a 3-year controlled study. Neurology 2004; 63: 1788—95.