Long-Term Clinical Stability in a Subset of MS Patients with Minimal Therapeutic Intervention (P3.055)

Objective: Our objective is to document a subset of MS patients with long-term disease stability and minimal therapeutic intervention. Background: There are an increasing number of therapeutic options in MS. It is important to determine if a subset of patients can be managed with minimal therapeutic intervention. Methods: In this IRB-approved study, we examined data from 1,659 patients seen at the Tisch MSRCNY by a single neurologist in 1 year. Patients of interest met the following criteria: disease duration greater than 10 years, absence of any clinical relapses or change in EDSS, and stable MRI findings. In addition, these patients were either untreated or treated with a single therapeutic agent. Results: We examined data from 225 MS patients who were clinically stable for greater than 10 years of observation following diagnosis. Fifty-two percent (116 of 225) of these patients were followed for greater than 15 years and 36[percnt] (81 of 225) had a stable disease course for more than 20 years following diagnosis. Of these patients, 176 were female (78[percnt]) and 49 were male (22[percnt]). Sixty-five percent were treated with a single disease-modifying medication and had remained stable on that drug while 35[percnt] were untreated. The average age at onset was 34.1, and the average duration of disease was 19.2 years. Of the 114 patients who had comprehensive cognition testing, only 4 (3.5[percnt]) patients had mild cognitive impairment. At the time of initial diagnosis, the most consistent clinical findings seen in these stable patients were the absence of cognitive/cerebellar dysfunction as well as the absence of spasticity. Conclusions: Our data supports the existence of a group of MS patients who have a good prognosis and show no discernible evidence of disease activity or progression 10 to 20 years following diagnosis, despite having received minimal or no long-term treatment. Disclosure: Dr. Blackshear has nothing to disclose. Dr. Josephs has nothing to disclose. Dr. Sadiq has nothing to disclose.