Measuring disability progression in MS.

Multiple Sclerosis Center,

Sheba Medical Center,

Tel-Hashomer 52621,

Israel.

The management of patients with relapsing-remitting multiple sclerosis is difficult for the treating physician due to the extremely variable clinical course of the disease, with widely differing rates of progression of disability observed between patients.  The determinants of this variability are unknown. 

Life table analysis provides a method to classify patients on the basis of initial disability scores into percentiles that define their probability of disease progression over a 10-year period.  Using this method, a series of standardised disease progression curves have been generated by analysis of disability data in over one thousand subjects with multiple sclerosis, obtained from Sheba Medical Center, Tel-Hashomer, Israel, database. 

These curves show acceptable validity for predicting disease progression in individual patients.  The comparison of individual patient data against these standardised disability progression curves provides a useful method to assess the risk of progression in individual patients and enables practising neurologists to use a valuable tool for making treatment decisions.