% 0期刊文章%一个Alvaro Cobo-Calvo %卡门病重%苏珊娜Otero-Romero %一个马里亚诺·鲁伊兹Pere Carbonell-Mirabent % %一个奥古斯汀•Pappolla %哈维尔Villacieros阿尔瓦雷斯Georgina Arrambide % %安吉拉Vidal-Jordana %一个杰昆·卡斯蒂略%英格丽·加兰%玛尔塔·罗德里格斯深峡谷%一个曾孤独Midaglia %卡洛斯Nos % Breogan罗德里格斯Acevedo % Ana de Torres Zabalza %该处Mongay %乔迪力拓%一个Manuel Comabella %克里斯蒂娜钻% Jaume Sastre-Garriga %一个亚历克斯·罗维拉% 3月Tintore % Xavier好吃% T协会的早期治疗起始与长期残疾的风险患者的第一个事件% D 2023% R 10.1212 / WNL脱髓鞘。0000000000207664 % J首页神经病学% P 10.1212 / WNL。0000000000207664 % X介绍早期治疗与患者更好的长期成果第一脱髓鞘事件和早期的多发性硬化症(MS)。然而,磁共振(MR)的发现通常不集成构造倾向分数(PS)在评估结果。我们评估协会接受早期治疗与长期残疾的风险包括一个分数先生(夫人)患者第一次脱髓鞘的事件。方法包括580名患者第一次脱髓鞘事件前瞻性收集1994年至2021年,接受至少一个疾病修改药物(DMD)。患者分为tertiles根据群体的分布的时间从第一脱髓鞘事件第一个DMD:第一tertile(英尺)或早期治疗(6个月;N = 194);第二个(ST)(6.1 -16个月,N = 192)、和第三tertile (TT)(16.1个月,N = 194)。5夫人是根据以下的总和指标:≥9脑损伤(1分);≥1 infratentorial病变(1 pt);≥1脊髓病变(SC)(1分); ≥1 contrast-enhancing (CE) brain lesion (1pt); ≥1 CE SC lesion (1pt). PS based on covariates and the MRS was computed for each of the outcomes. Inverse PS-weighted Cox and linear regression models assessed the risk of different outcomes between tertile groups. Finally, to confirm the role of MR in treatment decision, we studied the time elapsed from the first demyelinating event to treatment initiation according to the MRS in all patients with radiological available information, re-named as raw-MRS.Results Very early treatment decreased the risk of reaching EDSS 3.0 (HR 0.55 [95% CI 0.32; 0.97]), secondary progressive MS (HR 0.40 [95% CI 0.19; 0.85]), sustained disease progression at 12 months after treatment initiation (HR 0.50 [95% CI 0.29; 0.84]), when compared to patients from the TT group. Patients from the FT had a lower disability progression rate (β estimate, -0.009 [95% CI -0.016; -0.002]) and a lower severe disability measured by the PDDS (β estimate, -0.52 [95% CI -0.91; -0.13]) than the TT groups. Finally, there was a 62.4% reduction in the median time between the first demyelinating event and the first-ever treatment initiation from patients displaying a raw-MRS 1 to patients with a raw-MRS 5.Conclusion Using PS models with and without MRS, we showed that treatment initiation at very early stages is associated with a reduction in the risk of long-term disability accrual in patients with a first demyelinating event.Classification of Evidence: This study provides Class III evidence that earlier treatment of MS patients presenting with a first demyelinating event is associated with improved clinical outcomes. %U //www.ez-admanager.com/content/neurology/early/2023/07/19/WNL.0000000000207664.full.pdf