Timed Up and Go test with the different sub-phases after the most complete segmentation. (1) Standing. (2) Go Walking. (3) Three-meter turning. (4) Return Walking. (5) Pre-sitting turning. (6) Sitting. Image reprinted from Ortega-Bastidas P, Gómez B, Aqueveque P, Luarte-Martínez S, Cano-de-la-Cuerda R. Instrumented Timed Up and Go Test (iTUG)—More Than Assessing Time to Predict Falls: A Systematic Review. Sensors. 2023; 23(7):3426. https://doi.org/10.3390/s23073426. Use is per Creative Commons Attribution (CC BY) license.
Today’s disease-modifying immunotherapies (DMTs) have altered the course of multiple sclerosis (MS) and led to the introduction of high-efficacy early treatment (HEET). However, HEET does not prevent a portion of patients from experiencing relapse activity and disease progression. This single-center retrospective analysis looked at patients with relapsing-onset MS who were started on HEET within 5 years of diagnosis and then followed for at least 5 years. Therapies included anti-CD20, natalizumab, fingolimod, cladribine, and stem cell transplant. Progression at 5 years was defined as: (1) MS clinician documentation of progressive MS, (2) 1-point worsening on Expanded Disability Status Scale (EDSS) in patients with EDSS score ≤ 5.5 or 0.5-point worsening on EDSS in patients with EDSS score ≥ 6 in the absence of relapse, and (3) 20% increase in Timed 25-Foot Walk (T25FW) score.
Of the 315 patients analyzed, 35.6% experienced progression by T25FW, 20.5% by EDSS, and 3.7% by clinician disease category alone. In univariable analyses, progression by T25FW showed associations only at the P <.10 threshold with male sex, Hispanic ethnicity, higher baseline EDSS score, and comorbidity. In exploratory analysis, progression by T25FW at 5 years was also associated with retinal nerve fiber layer on optical coherence tomography.
In conclusion, the author wrote that T25FW is a more sensitive measure of MS disease progression and noted that Hispanic ethnicity places individuals at higher risk of disease progression.
Source: Paredes D. (EPI03) Disease Progression Despite Early High-Efficacy Therapy in Patients With Multiple Sclerosis: Demographics and Clinical Predictors. Int J MS Care. 2024;26(S1):50
