PT -期刊文章盟Alvaro Cobo-Calvo AU -卡门病重盟苏珊娜Otero-Romero盟Pere Carbonell-Mirabent AU -马里亚诺·鲁伊斯盟-奥古斯汀•Pappolla盟-哈维尔Villacieros阿尔瓦雷斯Georgina Arrambide AU -安吉拉Vidal-Jordana盟盟-杰昆·卡斯蒂略盟英格丽•AU -玛尔塔Rodriguez深峡谷盟曾孤独Midaglia AU -卡洛斯Nos盟Breogan罗德里格斯Acevedo AU - Ana de Torres Zabalza盟该处Mongay AU -乔迪力拓盟Manuel Comabella盟——克里斯蒂娜•奥杰盟Jaume Sastre-Garriga AU -亚历克斯·罗维拉盟- Mar Tintore盟Xavier好吃的TI -协会的早期治疗起始与长期残疾的风险患者的第一个援助- 10.1212 / WNL脱髓鞘事件。0000000000207664 DP - 2023年7月19日TA -神经病首页学PG - 10.1212 / WNL。0000000000207664 4099 - http://n.首页neurology.org/content/early/2023/07/19/WNL.0000000000207664.short 4100 - //www.ez-admanager.com/content/early/2023/07/19/WNL.0000000000207664.full AB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.

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