Longitudinal progression of disability defined by the EDSS scale in patients with multiple sclerosis: data from the Azerbaijani cohort

Aim. To assess longitudinal changes in disability defined by the EDSS scale from the time of diagnosis to the end of the follow-up period, as well as to study transitions between disability categories and their association with disease duration in patients with multiple sclerosis in Azerbaijan.

Materials and methods. A longitudinal observational study with retrospective and prospective components was conducted for 2013 2022. The analysis included 238 patients with confirmed multiple sclerosis who had EDSS data at diagnosis and at the end of the study. Disability was classified as mild (EDSS 0 3.5), moderate (4.0 6.5), and severe (7.0 9.5). The Wilcoxon signed-rank test, Pearson’s χ[2] test, Cramer’s V coefficient, Kruskal Wallis test, and Mann Whitney U test were used.

Results and discussion. At diagnosis, mild disability was identified in 189 (79.4%) patients, and moderate disability in 49 (20.6%). By the end of the study, the proportion of mild disability decreased to 41.6%, moderate disability increased to 43.3%, and severe disability developed in 15.1% of patients. The median EDSS increased from 2.0 [1.0 3.0] to 4.3 [3.0 6.0], and the median ΔEDSS was 2.5 [1.0 3.0] (p<0.001). The baseline EDSS category was closely associated with the final level of disability (χ[2] (2)=104.935; p<0.001; Cramer’s V=0.664). Longer disease duration was associated with transition to more severe EDSS categories.

Conclusions . Significant EDSS progression was observed in patients with multiple sclerosis in Azerbaijan. Baseline EDSS and disease duration may be considered practical indicators of the risk of subsequent disability.

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