Multiple Sclerosis Journal - October 2017 - 1492

Multiple Sclerosis Journal 23(11)
Table 2. Kaplan-Meier estimates of time from birth, disease onset and MS diagnosis to EDSS score milestones 3.0, 4.0 and 6.0.

EDSS score 3.0
All
Sex
Female
Male
Onset phenotype
Bout onset
Progressive onset
EDSS score 4.0
All
Sex
Female
Male
Onset phenotype
Bout onset
Progressive onset
EDSS score 6.0
All
Sex
Female
Male
Onset phenotype
Bout onset
Progressive onset
Scenariosa
Worst
Middle case
Best
Any number of clinic
visitsb

Median time from birth
(years)

Median time from disease onset
(years)

Median time from diagnosis
(years)

Total number
(% reached)

Median age
(95% CI)

Total number (%
reached)

Time (95% CI)

Total number
(% reached)

Time (95% CI)

7864 (40.1%)

55.4 (54.8−55.8)

7579 (40.3%)

19.8 (19.1−20.6)

6854 (37.5%)

14.9 (14.4−15.6)

5712 (39%)
2152 (43.1%)

55.9 (55.4−56.5)
53.9 (52.9−54.8)

5496 (39.2%)
2083 (43.2%)

20.8 (20.1−21.5)
17.9 (16.8−18.4)

5001 (35%)
1853 (39.3%)

15.5 (14.9−16.2)
13 (12.1−14.0)

7270 (38.3%)
308 (85%)

55.3 (54.8−55.8)
54.8 (53.4−55.8)

7032 (38.4%)
295 (85.7%)

20.8 (20.1−21.4)
7.8 (6.6−8.6)

6463 (36.2%)
210 (79%)

15.5 (14.9−16.1)
3.9 (3.1−5.0)

8453 (28%)

60.7 (60.1−61.2)

8156 (28.1%)

26.2 (25.3−26.7)

7548 (26.7%)

19.9 (19.9−21.0)

6108 (26.5%)
2345 (31.7%)

61.7 (60.7−62.4)
58.3 (57.5−59.2)

5883 (26.7%)
2273 (32%)

27.9 (26.4−28.7)
22.6 (21.5−24.3)

5449 (25.5%)
2099 (31.1%)

21.2 (20.0−22.6)
17.1 (15.7−18.3)

7760 (26.0%)
387 (67.7%)

60.9 (60.3−61.7)
57.9 (56.4−59.7)

7513 (26.1%)
373 (67.8%)

27.4 (26.3−28.3)
11.7 (10.4−12.5)

7023 (24.8%)
322 (64.6%)

20.9 (19.8−22)
5.5 (4.6−6.3)

9800 (25.1%)

64.3 (63.6−64.7)

9457 (25.2%)

30.4 (29.4−31.1)

8672 (23.4%)

23.1 (22.2−24.1)

7038 (23.6%)
2762 (28.8%)

64.8 (64.2−65.5)
62.8 (61.3−63.6)

6781 (23.8%)
2676 (28.9%)

31.7 (30.5−32.6)
26.7 (25.3−28.3)

6212 (21.9%)
2460 (27.1%)

24.7 (23.2−25.8)
20.3 (19.0−21.8)

8828 (22.7%)
632 (64.4%)

65.0 (64.3−65.7)
60.3 (59.2−61.3)

8547 (22.4%)
612 (65%)

31.8 (30.7−32.6)
13.9 (12.6−14.8)

7925 (20.9%)
518 (60.8%)

24.6 (23.4−25.8)
8.6 (7.7−9.3)

10,393 (29.3%)
10,393 (29.4%)
10,415 (29.5%)
13,368 (23.1%)

62.9 (62.3−63.5)
62.6 (62.1−63.1)
62.5 (62.1−63.0)
65.6 (65.1−66.1)

10,050 (29.7%)
10,050 (29.7%)
10,050 (29.7%)
12,703 (23.3%)

28.7 (27.8−29.6)
27.7 (26.6−28.4)
27.9 (27.3−28.7)
31.3 (30.5−32.2)

8706 (23.7%)
9052 (26.6%)
9127 (27.2%)
11,257 (21.8%)

23.1 (22.1−24.0)
21.4 (20.7−22.3)
21.2 (20.5−21.9)
23.3 (22.4−24.1)

MS: multiple sclerosis; EDSS: Expanded Disability Scale Status; CI: confidence interval.
aScenarios simulated the situation where those with first recorded EDSS more than 6.0 were assumed to have reached the EDSS score 6.0 at the time of disease
onset (worst), middle point between onset and first clinic visit (middle case) and at the time of EDSS record (best).
bNo restriction in the number of clinic visits.

unfavourable clinical course in men which was
reported previously by Confavreux and Vukusic.14
and was regardless of follow-up scale (age or disease
duration). However, male MS patients died at lower
rates than females when compared to the general population. We also observed a significant regional difference in the risk of disability worsening. Patients
residing in the south of Sweden did generally better
(i.e. 2 years longer time to EDSS score 3.0) compared
to those living in the centre or north. However, the
difference weakened by increase in the follow-up

1492

time. Such differences in the risk of short-term outcomes (EDSS 3.0 and conversion to SPMS) can possibly be the result of regional differences in patients'
management and access to care (e.g. distance to MS
specialist clinics, etc.) in different regions of Sweden
in the early stages of MS, but can theoretically depend
on environmental factors or even in differences in the
use of the EDSS Scale.
While our overall estimation of time from MS onset
to EDSS score 6.0 (30.4 (95% CI: 29.4-31.1) years)

journals.sagepub.com/home/msj
https://journals.sagepub.com/home/msj
Table of Contents for the Digital Edition of Multiple Sclerosis Journal - October 2017
