Association between age and inflammatory disease activity on magnetic resonance imaging in relapse onset multiple sclerosis during long‐term follow‐up

Abstract

AbstractBackground and purposeInflammatory disease activity in multiple sclerosis (MS) decreases with advancing age. Previous work found a decrease in contrast‐enhancing lesions (CELs) with age. Here, we describe the relation of age and magnetic resonance imaging (MRI) measures of inflammatory disease activity during long‐term follow‐up in a large real‐world cohort of people with relapse onset MS.MethodsWe investigated MRI data from the long‐term observational Amsterdam MS cohort. We used logistic regression models and negative binomial generalized estimating equations to investigate the associations between age and radiological disease activity after a first clinical event.ResultsWe included 1063 participants and 10,651 cranial MRIs. Median follow‐up time was 6.1 years (interquartile range = 2.4–10.9 years). Older participants had a significantly lower risk of CELs on baseline MRI (40–50 years vs. <40 years: odds ratio [OR] = 0.640, 95% confidence interval [CI] = 0.45–0.90; >50 years vs. <40 years: OR = 0.601, 95% CI = 0.33–1.08) and a lower risk of new T2 lesions or CELs during follow‐up (40–50 years vs. <40 years: OR = 0.563, 95% CI = 0.47–0.67; >50 years vs. <40 years: OR = 0.486, 95% CI = 0.35–0.68).ConclusionsGreater age is associated with a lower risk of inflammatory MRI activity at baseline and during long‐term follow‐up. In patients aged >50 years, a less aggressive treatment strategy might be appropriate compared to younger patients.