Choosing an MS Course Type
Placeholder: MS course type shapes the whole disability trajectory.
- ~85%: RRMS share of onset (most common start)
- ~10-15%: PPMS share of onset (progressive from onset)
- 0-10: EDSS scale range (in 0.5 increments)
- ~30: Median RRMS age (typical onset age)
What EDSS measures
Placeholder: EDSS scores mobility and neurological function.
Baseline Disability Accumulation
Placeholder: RRMS steps up at relapses; PPMS declines smoothly.
- ~0.5-1.0: RRMS relapse jump (EDSS points per relapse)
- ~0.2-0.3: PPMS annual rate (EDSS points per year)
- partial: Remission recovery (incomplete over time)
- ~1.0-1.5: Early EDSS baseline (at diagnosis)
Stepwise vs continuous
Placeholder: relapses cause jumps; PPMS has no plateaus.
RRMS to SPMS Conversion
Placeholder: relapses fade, gradual decline phase begins instead.
- ~10-15 yrs: Median conversion time (after RRMS onset)
- steady: Post-conversion slope (less relapse-driven)
- ~0.15-0.2: SPMS annual rate (EDSS points per year)
- year 12: Conversion marker (used in this model)
Why the curve bends
Placeholder: inflammation shifts toward neurodegeneration.
Disease-Modifying Therapy Effect
Placeholder: effective DMT flattens the slope of decline.
- -40 to -60%: High-efficacy DMT (relapse rate reduction)
- ~70%: Slope reduction max (modeled here)
- better: Earlier start (outcome benefit)
- limited: PPMS DMT options (fewer proven agents)
Flattening the curve
Placeholder: therapy reduces slope, rarely reverses damage.
Comparing Trajectories Across Course Types
Placeholder: overlay all three courses with and without therapy.
- RRMS+DMT: Best outcome (flattest trajectory)
- PPMS: Steepest untreated (no plateau phase)
- early Tx: Key decision point (window matters most)
- walking aid: EDSS 6.0 milestone (needed at this level)
Takeaway
Placeholder: course type and therapy timing both matter.