WESTPORT, CT (Reuters Health) Feb 21 - The apolipoprotein E epsilon-4 (ApoE e4) allele is associated with significantly faster progression of disability in patients with multiple sclerosis, according to the results of an Israeli study.
Dr. Amos D. Korczyn, of Tel Aviv University, and colleagues followed 205 patients, of whom 41 were heterozygous for the ApoE e4 allele. The researchers report their findings in the February 13th issue of Neurology.
The age at onset was significantly earlier in the e4 carriers than among the noncarriers, 31.8 versus 35.1 years, respectively. A trend to higher expanded disability status scale (EDSS) scores, observed at 5 years after disease onset, became significant by 10 years. Furthermore, the progressive form of MS was significantly more frequent among patients with the e4 allele.
An EDSS score of 4 was reached by 50% of noncarriers at 19 years of disease duration, compared with 7 years among the e4 carriers. Twenty-five years was required for 50% of noncarriers to reach an EDSS score of 6, compared with 14 years for the carriers.
The authors note that previous studies have been divided as to whether there is an association between ApoE genotype and progression of MS. Their own analysis showed that a measure used in several other studies, the progression index (a function of current EDSS score divided by duration of disease) was not significantly associated with ApoE e4.
Dr. Korczyn's group suggests that ApoE genotyping may be useful in counseling MS patients and in deciding which patients should be encouraged to begin early treatment.
2000 Reuters Ltd.