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One‐year MRI scan predicts clinical response to interferon beta in multiple sclerosis
Author(s) -
Prosperini L.,
Gallo V.,
Petsas N.,
Borriello G.,
Pozzilli C.
Publication year - 2009
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/j.1468-1331.2009.02708.x
Subject(s) - medicine , multiple sclerosis , expanded disability status scale , magnetic resonance imaging , interferon beta 1b , lesion , interferon beta , surgery , radiology , psychiatry
Background and purpose: To define the predictive value of clinical and magnetic resonance imaging (MRI) characteristics in identifying relapsing‐remitting multiple sclerosis (RR‐MS) patients with sustained disability progression during interferon beta (IFNB) treatment. Methods: All patients receiving treatment with one of the available IFNB formulations for at least 1 year were included in this single‐centre, prospective and post‐marketing study. Demographic, clinical and MRI data were collected at IFNB start and at 1 year of therapy; patients were followed‐up at least yearly. Poor clinical response was defined as the occurrence of a sustained disability progression of ≥1 point in the Expanded Disability Status Scale (EDSS) during the follow‐up period. Results: Out of 454 RR‐MS patients starting IFNB therapy, data coming from 394 patients with a mean follow‐up of 4.8 (2.4) years were analysed. Sixty patients were excluded because of too short follow‐up. Less than 1/3 (30.4%) of the patients satisfied the criterion of ‘poor responders’. Patients presenting new lesions on T2‐weighted MRI scan after 1 year of therapy (compared with baseline) had a higher risk of being poor responder to treatment with IFNB during the follow‐up period (HR 16.8, 95% CI 7.6–37.1, P < 0.001). An augmented risk increasing the number of lesions was observed, with a 10‐fold increase for each new lesion. Conclusions: Developing new T2‐hyperintense lesions during IFNB treatment was the best predictor of long‐term poor response to therapy. MRI scans performed after 1 year of IFNB treatment may be useful in contributing to early identification of poor responders.