Familial MS May Have a More Aggressive Course

October 10, 2018

BERLIN — Familial multiple sclerosis (MS) may take a more aggressive course than sporadic MS, new data suggest.

The findings come from a new analysis of data from the MS Base Registry and were presented here at the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) 2018 Congress.

"We observed an earlier onset, but also a more severe course in the patients with familial MS compared to those with sporadic MS," Sara Eichau, MD, Virgin Macarena Hospital, Seville, Spain, concluded in her presentation.

Parents with familial MS had a higher annualized relapse rate than those with sporadic MS within the first 5 years of onset, a shorter time between the two first relapses, a shorter time to progression from relapsing remitting MS to secondary progressive MS, and a shorter time to reach an Expanded Disability Status Scale (EDSS) score of 4.0.

The study involved data on 17,739 MS patients from 32 centers worldwide participating in the MS Base Registry.

Of these, 1194 (7.25%) were considered to have familial MS, defined as having at least one first-, second-, or third-degree relative diagnosed with MS.

There was no difference in gender between the familial and sporadic patients with 69% of both phenotypes being female. 

Familial patients had an earlier age of onset (28.1 vs 29.5 years; P = .0009), a higher annualized relapse rate (1.69 vs 1.32; P < .0001), and a shorter time to second attack (Hazard Ratio [HR], 1.2; P < .0001).

Familial patients also showed a higher rate of progression to secondary progressive disease (HR, 1.32; P < .0001), with 50% of familial patients having reached secondary progression after 30 years.

Familial patients also showed a shorter time to reach an EDSS score of 4.0 (HR, 1.27; P < .047).

Commenting for Medscape Medical News, session chair Olaf Stuve, MD, UT Southwestern Medical Center, Dallas, said, "It's always interesting to compare familial and sporadic MS populations as we don't know what leads to accumulation of MS in one family." 

"Ultimately, I would have liked to see how treatment factored into the two phenotypes and that data is not available yet but if for some reason familial MS patients were less likely to receive therapy that might explain the result," he said. "Yes, this data does suggest familial MS may take a more aggressive course, but I would like information on the drug therapies being taken by the two groups before concluding this to be the case."

Eichau disclosed consulting and/or speaking fees from Biogen, Merck Serono, Novartis, Roche, Sanofi, and Teva. Disclosures for coauthors are available in the abstract.

European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) 2018 Congress. Abstract #58. Presented October 10, 2018.

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