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Clinical and MRI predictors of response to interferon‐beta and glatiramer acetate in relapsing–remitting multiple sclerosis patients
Author(s) -
Romeo M.,
MartinelliBoneschi F.,
Rodegher M.,
Esposito F.,
Martinelli V.,
Comi G.
Publication year - 2013
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1111/ene.12119
Subject(s) - medicine , glatiramer acetate , multiple sclerosis , magnetic resonance imaging , relapsing remitting , cohort , gastroenterology , radiology , immunology
Background and purpose It is still unclear which patients benefit more from available disease‐modifying treatments ( DMT s) in multiple sclerosis ( MS ). Our objective is to identify the baseline clinical and magnetic resonance imaging ( MRI ) predictors of response to first‐line DMT s in a cohort of relapsing–remitting ( RR ) MS patients in a real‐world clinical setting. Methods Consecutive naïve RRMS patients treated with interferon‐beta or glatiramer acetate have been included and followed for 2 years. Patients were grouped into responders (R) in case of absence of clinical and MRI activity, and non‐responders ( NR ) if the on‐treatment annualized relapse rate ( ARR ) reduction was < 50% of the ARR in the 2 years before treatment or in the presence of MRI activity (≥ 2 active lesions at 1‐year MRI or ≥ 4 active lesions at 1 + 2‐year MRI ). Results At 2‐year follow‐up, 272 patients were R (34.6%) and 322 NR (40.9%), and multivariate analysis revealed that a later age at onset of the disease ( P < 0.0001), a lower disability ( P < 0.0001) and a lower number of gadolinium‐enhancing lesions at baseline MRI ( P = 0.002) were predictors of efficacy of DMT s. Moreover, the first year response had a good predictive power on the second year, as 73.7% of 1‐year R had no evidence of clinical and MRI activity within the ensuing year. Conclusion A lower baseline MRI and clinical activity have been identified as predictors of DMT efficacy in patients with RRMS in routine clinical practice. Evaluation of clinical and MRI activity at 1 year is recommended to monitor patients over time.